Allergy in frequent travelers: the alpha-gal story and the first UK case series

Harper, Verah; Wagner, Annette; Sowa, Paweł; Rutkowski, Krzysztof

doi:10.1016/j.anai.2019.09.018

Cited by 5 publications

(2 citation statements)

References 9 publications

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“…AGS is reported in many areas around the globe (Figure 2), 4,13,25,53–81 but firm estimates of prevalence and incidence are difficult. Challenges in describing the epidemiology stem from the fact that AGS (i) is not a reportable disease, (ii) does not have a dedicated diagnostic medical billing code (at least in the USA), (iii) has marked regional variability and (iv) the alpha‐gal sIgE test may also be costly for some patients, leading to underdiagnosis.…”

Section: Epidemiology Relationship To Ticks and Other Risk Factorsmentioning

confidence: 99%

Tick bites, IgE to galactose‐alpha‐1,3‐galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha‐gal syndrome

Wilson,

Erickson,

Levin

et al. 2024

Allergy

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The recent recognition of a syndrome of tick‐acquired mammalian meat allergy has transformed the previously held view that mammalian meat is an uncommon allergen. The syndrome, mediated by IgE antibodies against the oligosaccharide galactose‐alpha‐1,3‐galactose (alpha‐gal), can also involve reactions to visceral organs, dairy, gelatin and other products, including medications sourced from non‐primate mammals. Thus, fittingly, this allergic disorder is now called the alpha‐gal syndrome (AGS). The syndrome is strikingly regional, reflecting the important role of tick bites in sensitization, and is more common in demographic groups at risk of tick exposure. Reactions in AGS are delayed, often by 2–6 h after ingestion of mammalian meat. In addition to classic allergic symptomatology such as urticaria and anaphylaxis, AGS is increasingly recognized as a cause of isolated gastrointestinal morbidity and alpha‐gal sensitization has also been linked with cardiovascular disease. The unusual link with tick bites may be explained by the fact that allergic cells and mediators are mobilized to the site of tick bites and play a role in resistance against ticks and tick‐borne infections. IgE directed to alpha‐gal is likely an incidental consequence of what is otherwise an adaptive immune strategy for host defense against endo‐ and ectoparasites, including ticks.

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Section: Epidemiology Relationship To Ticks and Other Risk Factorsmentioning

confidence: 99%

Tick bites, IgE to galactose‐alpha‐1,3‐galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha‐gal syndrome

Wilson,

Erickson,

Levin

et al. 2024

Allergy

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“…Currently, the seventeen countries where there are registries of hard ticks as the causative agent of the αGal syndrome include Australia [ Ixodes holocyclus ( 29 )] and the United States [ Amblyomma Americanum ( 30 )]. In Europe, the endemic tick is Ixodes ricinus , found in Germany ( 31 ), France ( 32 ), Spain ( 33 ), Belgium ( 34 ), Switzerland ( 35 ), Sweden ( 36 ), United Kingdom ( 37 ), Italy ( 38 ) and Norway ( 39 ). The list of affected countries also includes Korea [ Ixodes nipponensis ( 40 )], Japan [ Haemaphysalis longicornis ( 41 )], Panama [ Ixodes cajennense ( 42 )], Brazil [ Amblyomma sculptum ( 43 )], Ivory Coast [ Amblyomma variegatum ( 44 )] and South Africa ( 45 ).…”

Section: Introductionmentioning

confidence: 99%

Poly-L-Lysine-Based αGal-Glycoconjugates for Treating Anti-αGal IgE-Mediated Diseases

Olivera-Ardid¹,

Bello-Gil²,

Tuzikov

et al. 2022

Front. Immunol.

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Anti-αGal IgE antibodies mediate a spreading allergic condition known as αGal-syndrome (AGS). People exposed to hard tick bites are sensitized to αGal, producing elevated levels of anti-αGal IgE, which are responsible for AGS. This work presents an immunotherapy based on polymeric αGal-glycoconjugates for potentially treating allergic disorders by selectively inhibiting anti-αGal IgE antibodies. We synthesized a set of αGal-glycoconjugates, based on poly-L-lysine of different degrees of polymerization (DP1000, DP600, and DP100), to specifically inhibit in vitro the anti-αGal IgE antibodies in the serum of αGal-sensitized patients (n=13). Moreover, an animal model for αGal sensitization in GalT-KO mice was developed by intradermal administration of hard tick’ salivary gland extract, mimicking the sensitization mechanism postulated in humans. The in vitro exposure to all polymeric glycoconjugates (5-10-20-50-100 µg/mL) mainly inhibited anti-αGal IgE and IgM isotypes, with a lower inhibition effect on the IgA and IgG, respectively. We demonstrated a differential anti-αGal isotype inhibition as a function of the length of the poly-L-lysine and the number of αGal residues exposed in the glycoconjugates. These results defined a minimum of 27 αGal residues to inhibit most of the induced anti-αGal IgE in vitro. Furthermore, the αGal-glycoconjugate DP1000-RA0118 (10 mg/kg sc.) showed a high capacity to remove the anti-αGal IgE antibodies (≥75% on average) induced in GalT-KO mice, together with similar inhibition for circulating anti-αGal IgG and IgM. Our study suggests the potential clinical use of poly-L-lysine-based αGal-glycoconjugates for treating allergic disorders mediated by anti-αGal IgE antibodies.

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Sensitisation and allergic reactions to alpha-1,3-galactose in Podlasie, Poland, an area endemic for tick-borne infections

Rutkowski

Sowa

Mroczko

et al. 2022

Infectious Diseases

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Allergy in frequent travelers: the alpha-gal story and the first UK case series

Cited by 5 publications

References 9 publications

Tick bites, IgE to galactose‐alpha‐1,3‐galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha‐gal syndrome

Tick bites, IgE to galactose‐alpha‐1,3‐galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha‐gal syndrome

Poly-L-Lysine-Based αGal-Glycoconjugates for Treating Anti-αGal IgE-Mediated Diseases

Sensitisation and allergic reactions to alpha-1,3-galactose in Podlasie, Poland, an area endemic for tick-borne infections

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