Oral immunotherapy in alpha‐gal red meat allergy: Could specific <scp>IgE</scp> be a potential biomarker in monitoring management?

Ünal, D.; Eyice‐Karabacak, D.; Kutlu, A.; Demir, S.; Tüzer, C.; Arslan, A. F.; Işık, S. R.; Gelincik, A.

doi:10.1111/all.15840

Cited by 8 publications

(4 citation statements)

References 60 publications

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We had read the article entitled "Oral immunotherapy in alphagal red meat allergy: Could specific IgE be a potential biomarker in monitoring management?" by D. Ünal et al 1 We appreciate the authors for this successful research and would like to point out some suggestions.Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

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mentioning

confidence: 88%

Correspondence to “Oral immunotherapy in alpha‐gal red meat allergy: Could specific IgE be a potential biomarker in monitoring management?”

Chen,

Lin,

et al. 2024

Allergy

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mentioning

confidence: 88%

Correspondence to “Oral immunotherapy in alpha‐gal red meat allergy: Could specific IgE be a potential biomarker in monitoring management?”

Chen,

Lin,

et al. 2024

Allergy

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“…There is no cure for AGS. Recently, a small oral immunotherapy (OIT) study for early and delayed-onset red meat allergy was reported ( 173 ). Five patients underwent an early OIT and seven a delayed protocol and the patients were followed for up to five years.…”

Section: Managementmentioning

confidence: 99%

“…The patients should be informed about the relevance of tick bites on the onset of the disease and that further tick bites increase IgE levels to a-Gal, while avoidance of tick bites decreases their IgE levels to a-Gal. There are cases whose IgE levels to a-Gal became negative (or significantly dropped) after tick avoidance and they were able to reintroduce mammalian meat in their diet (115,163,172). AGS patients should wear long trousers and long-sleeved shirts in wooded and grassy areas and use insect repellents.…”

Section: Managementmentioning

confidence: 99%

The α-Gal epitope - the cause of a global allergic disease

Perusko,

Grundström,

Eldh

et al. 2024

Front. Immunol.

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The galactose-α-1,3-galactose (α-Gal) epitope is the cause of a global allergic disease, the α-Gal syndrome (AGS). It is a severe form of allergy to food and products of mammalian origin where IgE against the mammalian carbohydrate, α-Gal, is the cause of the allergic reactions. Allergic reactions triggered by parenterally administered α-Gal sources appear immediately, but those triggered via the oral route appear with a latency of several hours. The α-Gal epitope is highly immunogenic to humans, apes and old-world monkeys, all of which produce anti-α-Gal antibodies of the IgM, IgA and IgG subclasses. Strong evidence suggests that in susceptible individuals, class switch to IgE occurs after several tick bites. In this review, we discuss the strong immunogenic role of the α-Gal epitope and its structural resemblance to the blood type B antigen. We emphasize the broad abundance of α-Gal in different foods and pharmaceuticals and the allergenicity of various α-Gal containing molecules. We give an overview of the association of tick bites with the development of AGS and describe innate and adaptive immune response to tick saliva that possibly leads to sensitization to α-Gal. We further discuss a currently favored hypothesis explaining the mechanisms of the delayed effector phase of the allergic reaction to α-Gal. We highlight AGS from a clinical point of view. We review the different clinical manifestations of the disease and the prevalence of sensitization to α-Gal and AGS. The usefulness of various diagnostic tests is discussed. Finally, we provide different aspects of the management of AGS. With climate change and global warming, the tick density is increasing, and their geographic range is expanding. Thus, more people will be affected by AGS which requires more knowledge of the disease.

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“…153 A few case reports have suggested OIT may be safe and effective in AGS, which is supported by a recently published series of 12 cases that underwent successful OIT. [154][155][156]…”

Section: Iag Nos Is and Manag Ementmentioning

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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Oral immunotherapy in alpha‐gal red meat allergy: Could specific IgE be a potential biomarker in monitoring management?

Cited by 8 publications

References 60 publications

Correspondence to “Oral immunotherapy in alpha‐gal red meat allergy: Could specific IgE be a potential biomarker in monitoring management?”

Correspondence to “Oral immunotherapy in alpha‐gal red meat allergy: Could specific IgE be a potential biomarker in monitoring management?”

The α-Gal epitope - the cause of a global allergic disease

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

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