ALPHA-GAL SYNDROME - AGS
DOI:
https://doi.org/10.52340/jecm.2024.06.04Keywords:
Alpha-gal, immunoglobulin E, tick biteAbstract
Alpha-gal is a carbohydrate molecule found in most mammals. Alpha-gal syndrome is a delayed-type immunoglobulin E-mediated allergic reaction to red meat in which antibodies to galactose-alpha-1,3-galactose (alpha-gal) are produced. Initially, this syndrome was associated with the "lone star" tick (Lone Star Tick), which is found mainly in the southeastern part of the United States of America. However, alpha-gal syndrome has now been reported on every continent except Antarctica, and at least eight tick species have been confirmed to cause the syndrome. In recent years, information about AGS is growing and interest in this topic is also growing, because it is manifested by a diverse symptom complex and is important for specialists in different fields in terms of differential diagnosis. In individuals with this syndrome, symptoms are usually delayed by 2 to 6 hours. Symptoms can range from mild to severe and include an anaphylactic reaction. which is a life-threatening immediate allergic reaction involving multiple organ systems and requiring immediate medical attention. Importantly, people who are bitten periodically by ticks may develop more severe symptoms. There is no cure for alpha-gal syndrome. In terms of prevention, the most important thing is to avoid tick bites.
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Chung CH, Mirakhur B, Chan E, Le QT, Berlin J, et al. Cetuximab-induced anaphylaxis and IgE specific for galactose-α-1, 3-galactose. New England journal of medicine. 2008 Mar 13;358(11):1109-17.
https://www.nejm.org/doi/full/10.1056/NEJMoa074943
Commins SP. Diagnosis & management of alpha-gal syndrome: lessons from 2,500 patients. Expert Review of Clinical Immunology. 2020 Jul 9:1-1.
https://www.tandfonline.com/doi/abs/10.1080/1744666X.2020.1782745
Commins SP, James HR, Kelly LA, Pochan SL, Workman LJ, et al. The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-α-1, 3-galactose. Journal of Allergy and Clinical Immunology. 2011 May 1;127(5):1286-93.
https://www.sciencedirect.com/science/article/abs/pii/S0091674911003447
Commins SP, James HR, Stevens W, et al. Delayed clinical and ex vivo response to mammalian meat in patients with IgE to galactose-alpha-1,3-galactose. J Allergy Clin Immunol. (2014) 134:108–15. doi: 10.1016/j.jaci.2014.01.024. https://www.jacionline.org/article/S0091-6749(14)00180-8/fulltext
Commins SP, Platts-Mills TA. Tick bites and red meat allergy. Current opinion in allergy and clinical immunology. 2013 Aug;13(4):354. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235259/
Commins SP, Satinover SM, Hosen J, Mozena J, Borish L, Lewis BD, Woodfolk JA, Platts-Mills TA. Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-α-1, 3-galactose. Journal of Allergy and Clinical Immunology. 2009 Feb 1;123(2):426-33. https://www.jacionline.org/article/S0091-6749(08)01931-3/fulltext.
Commins SP, Woodfolk JA, Platts-Mills TA. Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-α-1, 3-galactose. Journal of Allergy and Clinical Immunology. 2009 Feb 1;123(2):426-33. https://alphagalinformation.org/what-is-ags/
Galili U, Clark MR, et al. Evolutionary relationship between the natural anti-Gal antibody and the Gal alpha 1-3Gal epitope in primates. Proceedings of the National Academy of Sciences. 1987 Mar 1;84(5):1369-73. https://www.sciencedirect.com/science/article/pii/S2213219820301768
Galili U. The α-gal epitope (Galα1-3Galβ1-4GlcNAc-R) in xenotransplantation. Biochimie. 2001; 83:557–63. 10.1016/S0300-9084(01)01294-9
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8974695/#B1
Gowda DC, Glushka J, van Halbeek H, Thotakura RN, Bredehorst R, Vogel C-W. N-linked oligosaccharides of cobra venom factor contain novel α (1-3) galactosylated Lex structures. Glycobiology. 2001;11(3):195-208. https://europepmc.org/article/med/30673913
Iweala OI, Choudhary SK, et al. Glycolipid-mediated basophil activation in alpha-gal allergy. Journal of Allergy and Clinical Immunology. 2020 Feb 20 https://www.eurannallergyimm.com/galactose-alpha-1-3-galactose-allergy-a-rare-syndrome-and-an-atypical-presentation/
Mabelane T, Basera W, Botha M, Thomas HF, Ramjith J, Levin ME. Predictive values of alpha‐gal IgE levels and alpha‐gal IgE: Total IgE ratio and oral food challenge‐proven meat allergy in a population with a high prevalence of reported red meat allergy. Pediatric Allergy and Immunology. 2018 Dec;29(8):841-9. https://www.jacionline.org/article/S0091-6749(17)32533-2/pdf
Meat Allergy Tirggered by a Tick Bite with Eri McGintee retrieved from: https://youtu.be/hj96Vvr1WhQ
Morisset M, Richard C, Astier C, et al. Anaphylaxis to pork kidney is related to IgE antibodies specific for galactose-alpha-1,3-galactose. Allergy. (2012) 67:699–704. doi: 10.1111/j.1398-9995.2012.02799.x
https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2021.783279/full#B37
Perusko M, Apostolovic D, Kiewiet MB, et al. Bovine γ‐globulin, lactoferrin, and lactoperoxidase are relevant bovine milk allergens in patients with α‐Gal syndrome. Allergy. 2021 May 3. https://onlinelibrary.wiley.com/doi/full/10.1111/all.14889
Steinke JW, Platts-Mills TA, Commins SP. The alpha-gal story: lessons learned from connecting the dots. J Allergy Clin Immunol. 2015;135(3):58996
Stoltz LP, Cristiano LM, Dowling AP, Wilson JM, Platts-Mills TA, Traister RS. Could chiggers be contributing to the prevalence of galactose-alpha-1, 3-galactose sensitization and mammalian meat allergy?. The journal of allergy and clinical immunology. In practice. 2019 Feb;7(2):664. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549691/
Tobacman JK. The common food additive carrageenan and the alpha-gal epitope. Journal of Allergy and Clinical Immunology. 2015 Dec 1;136(6):1708-9. https://www.jacionline.org/article/S0091-6749(15)01345-7/fulltext
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