Alpha-gal syndrome. Allergy to red meat and gelatin

Zurbano-Azqueta, L.; Antón-Casas, E.; Duque-Gómez, S.; Jiménez-Gómez, I.; Fernández-Pellón, L.; López-Gutiérrez, J.

doi:10.1016/j.rceng.2021.06.005

Cited by 5 publications

(6 citation statements)

References 18 publications

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“…After using MD, the percentage of patients with idiopathic anaphylaxis in the Registry decreased from 9.2% to 3.5%. The percentage of cases with identified causes (62% of the cases previously classified as idiopathic) in this analysis is higher compared to rates reported by other researchers [ 43 , 44 ]. When the syndrome of delayed anaphylaxis to red meat was described in 2009, the cases previously classified as “spontaneous” or “idiopathic” anaphylaxis were identified as anaphylaxis due to a known cause.…”

Section: Discussioncontrasting

confidence: 76%

“…They were exactly in the range of 0.5–38.8 IU/mL for omega-5-gliadin, 0.4—above 100 IU/mL for LTP, and 1.46—above 100 IU/mL for alpha-gal. According to the data available in the literature, for alpha-gal, a positive result is determined by an sIgE level of over 0.1 IU/mL [ 78 ], but often, the level is very high, and it exceeds 100 IU/mL [ 44 , 79 , 80 ].…”

Section: Discussionmentioning

confidence: 99%

“…The problem of anaphylaxis initially classified as idiopathic is important, as demonstrated by the facts. According to the literature data, the diagnosis of anaphylaxis in the course of alpha-gal allergy is delayed by 4 [ 83 ] to 10 years [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

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Idiopathic Anaphylaxis? Analysis of Data from the Anaphylaxis Registry for West Pomerania Province, Poland

Poziomkowska-Gęsicka

2022

IJERPH

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The most common causes of anaphylaxis, according to various authors and depending on the age of the studied groups, are: Hymenoptera venom, food, and medications. Unfortunately, we are not always able to indicate the cause of anaphylaxis. There are data in the literature where as many as 41% of all cases are idiopathic anaphylaxis. Since the introduction of new diagnostic methods such as molecular diagnostics (MD) in our centre, the percentage of idiopathic anaphylaxis in the Anaphylaxis Register has significantly decreased. The purpose of this study was to identify possible causes of idiopathic anaphylaxis in patients with a history of moderate to severe anaphylactic reactions. After using MD, the causative agent was found in another 29 people. The proportion of people with idiopathic anaphylaxis in the Registry decreased from 9.2% to 3.5%. There were no significant differences in the incidence, although men appear to be slightly more common in primary idiopathic anaphylaxis. The mean age of primary idiopathic anaphylaxis was 40 years, but this was as high as 51 for anaphylaxis with alpha-gal allergy. Exercise may or may not be present as a cofactor despite its established role, e.g., in wheat-dependent exercise-induced anaphylaxis (WDEIA). In most of the analyzed cases, i.e., 70%, the reaction took place within an hour. The longest time interval from exposure to the development of symptoms is in the case of alpha-gal allergy; in this analysis, it was at least 5 h after ingestion of the so-called “red meat”. Patients are not aware of the disease, or further attacks cannot be prevented. As many as 80% had idiopathic anaphylaxis prior to visiting the centre, and 80% developed anaphylaxis after visiting the centre, which emphasizes the need to not stop the medical team in their search for the causes. As many as 93% of cases required medical intervention, of which adrenaline was used only in 34.5%, antihistamines in 86%, systemic glucocorticosteroids (sCS) in 75%, and fluids in 62% of cases. A total of 83% of patients received an emergency kit for self-administration. Idiopathic anaphylaxis can be resolved as known-cause anaphylaxis after a thorough medical history and, if possible, without exposing the patient after using appropriate, modern in vitro diagnostic methods, including molecular diagnostics. The diagnosis of idiopathic anaphylaxis should extend the diagnosis to include alpha-gal syndrome, LTP syndrome and WDEIA.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Idiopathic Anaphylaxis? Analysis of Data from the Anaphylaxis Registry for West Pomerania Province, Poland

Poziomkowska-Gęsicka

2022

IJERPH

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“…30 The medical history is of importance in these cases and details like meat-associated delayed allergic reactions and tick bite-exposure represent crucial factors for uncovering AGS, which otherwise can be misdiagnosed as idiopathic anaphylaxis or chronic spontaneous angioedema. 7,30,31 Risk factors for developing sIgE to α-Gal are related to the probability of individual tick bite-exposure in certain environmental conditions, including practice of outdoor activities (eg, hunting or hiking), living in rural areas, pet-ownership, and certain jobs such as forest service employees. [32][33][34][35] The sIgE values tend to increase according to the number of tick bites per year and on how recent those bites are.…”

Section: Introductionmentioning

confidence: 99%

Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal Syndrome (AGS)

Vaz-Rodrigues¹,

Mazuecos²,

Fuente³

2022

JAA

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The α-Gal syndrome (AGS) is a pathognomonic immunoglobulin E (IgE)-mediated delayed anaphylaxis in foods containing the oligosaccharide galactose-α-1,3-galactose (α-Gal) such as mammalian meat or dairy products. Clinical presentation of AGS can also comprise immediate hypersensitivity due to anticancer therapy, gelatin-containing vaccines or mammalian serum-based antivenom. The IgE initial sensitization is caused by hard-bodied tick bites and symptomatic individuals typically develop delayed pruritus, urticaria, angioedema, anaphylaxis, malaise or gut-related symptoms. Due to inapparent presentation, delayed reactions and a wide variety of patients´ clinical history, the AGS diagnosis and treatment remain challenging. This review covers not only current diagnostic methods used for AGS such as the skin prick test (SPT), the oral food challenge (OFC), anti-α-Gal IgE levels measurement and the basophil activation test (BAT), but also potentially relevant next-generation diagnostic tools like the mast cell activation test (MAT), the histamine-release (HR) assay, omics technologies and model-based reasoning (MBR). Moreover, it focuses on the therapeutical medical and non-medical methods available and current research methods that are being applied in order to elucidate the molecular, physiological and immune mechanisms underlying this allergic disorder. Lastly, future treatment and preventive tools are also discussed, being of utmost importance for the identification of tick salivary molecules, with or without α-Gal modifications, that trigger IgE sensitivity as they could be the key for further vaccine development. Bearing in mind climate change, the tick-host paradigm will shift towards an increasing number of AGS cases in new regions worldwide, which will pose new challenges for clinicians in the future.

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“…Raising the awareness of healthcare professionals is crucial [12] . AGS remains under-diagnosed in tick-prone regions, and oral immunotherapy is promising [11] . Collaborative efforts are needed for the comprehensive management and awareness of AGS [11] .…”

mentioning

confidence: 99%

Addressing the emerging concern of tick-borne meat allergy in the U.S.: a call to action

Ahmed,

Jawaid,

Ayub

et al. 2024

International Journal of Surgery: Global Health

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Alpha-gal syndrome. Allergy to red meat and gelatin

Cited by 5 publications

References 18 publications

Idiopathic Anaphylaxis? Analysis of Data from the Anaphylaxis Registry for West Pomerania Province, Poland

Idiopathic Anaphylaxis? Analysis of Data from the Anaphylaxis Registry for West Pomerania Province, Poland

Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal Syndrome (AGS)

Addressing the emerging concern of tick-borne meat allergy in the U.S.: a call to action

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