Allergenicity of Carbohydrates and Their Role in Anaphylactic Events

Abstract

The IgE response to pollen allergens often includes IgE antibodies specific for glycosylation motifs on the pollen proteins. These oligosaccharides are present on many different species and are known as cross-reactive carbohydrate determinants. However, IgE antibodies to plant-derived cross-reactive carbohydrate determinants seem to have only minor clinical significance and have not been related to anaphylaxis. Recently, two novel forms of anaphylaxis have become apparent in the southeastern United States: 1) reactions during the first infusion of the monoclonal antibody cetuximab and 2) adult-onset delayed anaphylaxis to red meat. Detailed investigation of serum antibodies established that in both cases, the patients had IgE antibodies specific for the mammalian oligosaccharide galactose alpha-1, 3-galactose. Identification of these cases is helpful in avoiding infusion reactions to cetuximab or recommending specific avoidance of meat derived from mammals. However, the current evidence does not fully resolve why these IgE antibodies are so common in the Southeast or why the anaphylactic or urticarial reactions to red meat are delayed.

Characterization of Cannabis Sativa Allergens

“…It is not known if these IgE reactive oligosaccharides are similar to other crossreactive carbohydrate determinants that are monovalent and while they exhibit extensive cross-reactivity during analysis of plant extracts in vitro they have limited activity in SPT. 47 Due to limitations in the amount of samples, the cross-reactivity to carbohydrates could not be further addressed in the current study.…”

A Peculiar Cause of Anaphylaxis: No More steak?

“…The delayed anaphylaxis is hypothesized to be related to the biochemistry, digestion and absorption of alpha-gal-containing glycolipids and glycoproteins. 8 Carbohydrates released from digested meat are placed onto lipid particles such as chylomicrons or very low density lipoproteins. 4 Some of these lipid particles, which take several hours to form, could be more potent in activating basophils or mast cells if alpha-gal moieties are presented on their surfaces.…”

“…4 Some of these lipid particles, which take several hours to form, could be more potent in activating basophils or mast cells if alpha-gal moieties are presented on their surfaces. 8 However, this hypothesis remains unproven. Since the article in 2009 linking IgE alpha-gal to anaphylaxis from mammalian meat, 4 cases of meat-induced, delayed anaphylaxis have been reported in Texas, Georgia, South Carolina, Mississippi, Kentucky, Oklahoma, West Virginia and Spain, in addition to the original five southeast states.…”

Alergia alimentaria en pediatría: recomendaciones para su diagnóstico y tratamiento. Texto completo

“…[110][111][112] El consumo regular de PH horneadas es tolerado en el 70% de los pacientes y podría ser beneficioso 111,113,114 al mejorar la calidad de la dieta y acelerar la tolerancia, debido a que genera modificación conformacional de la proteína.…”