Carbohydrate epitopes currently recognized as targets for IgE antibodies

Abstract

Until recently, glycan epitopes have not been documented by the WHO/IUIS Allergen Nomenclature Sub-Committee. This was in part due to scarce or incomplete information on these oligosaccharides, but also due to the widely held opinion that IgE to these epitopes had little or no relevance to allergic symptoms. Most IgE-binding glycans recognized up to 2008 were considered to be "classical" cross-reactive carbohydrate determinants (CCD) that occur in insects, some helminths and throughout the plant kingdom. Since 2008, the prevailing opinion on lack of clinical relevance of IgEbinding glycans has been subject to a reevaluation. This was because IgE specific for the mammalian disaccharide galactose-alpha-1,3-galactose (alpha-gal) was identified as a cause of delayed anaphylaxis to mammalian meat in the United States, an observation that has been confirmed by allergists in many parts of the world. Several experimental studies have shown that oligosaccharides with one or more terminal alpha-gal How to cite this article: Platts-Mills TA, Hilger C, Jappe U, et al. Carbohydrate epitopes currently recognized as targets for IgE

Update of the S2k guideline on the management of IgE-mediated food allergies

“…Increased test sensitivity [lower limit of quantitation (“LoQ”) [ 43 ] by certain single allergens, especially if they are underrepresented or absent in the (food) extract (examples: historically the soy protein Gly m 4 [ 44 ], wheat gluten Tri a 19, apple protein Mal d 1, sugar epitope galactose-α-1,3-galactose on proteins and glycolipids in mammalian meat) [ 45 ],…”

Molecular Allergy Diagnosis in Clinical Practice: Frequently Asked Questions

“…The first description of the presence of IgE to Cross-reactive Carbohydrate Determinants (CCDs) was made in 1981 by Aalberse RC et al [45]. Now it its clear thar anti-CCD IgE has little or no clinical relevance but it is a confusion factor for in vitro diagnosis [46]. sIgE to CCD bearing proteins mainly recognize a core of the amino sugar (1,3 fucose) linked to N-acetylglucosamine (GlcNAc) named N-Glycans, the main structures related are MUXF and MMXF glycans.…”

“…A potential disadvantage of the latter approach is to decrease test sensitivity [47]. Gal (1,3 galactose) also belong to N-glycans but in contrast to typical CCDs it has been reported to be associated with severe allergic reactions to meat [46].…”

Lessons in Innate and Allergic Immunity From Dust Mite Feces and Tick Bites

“…A factor creating special interest was that these reactions were most common in an area focused on Tennessee, Oklahoma, North Carolina, Arkansas, and Virginia. Investigation of pretreatment sera from patients treated with cetuximab in Tennessee established that the reactions were almost exclusively in patients with pre-existing IgE antibodies specific for α-Gal epitopes that were expressed on this mAb ( 63 ). Following up on the regional connection, we realized that this was similar to the reported map of maximum incidence of Rocky Mountain Spotted Fever (RMSF) and best explained by the prevalence of a tick which is primarily carried by deer which have been allowed to infest the suburban areas of the Eastern United States ( 64 , 65 ).…”