Porcine or bovine valve replacement in 3 patients with IgE antibodies to the mammalian oligosaccharide galactose-alpha-1,3-galactose

Mozzicato, Susan; Tripathi, Anju; Posthumus, Jonathon; Platts-Mills, Thomas A.E.; Commins, Scott P.

doi:10.1016/j.jaip.2014.04.016

Cited by 65 publications

(51 citation statements)

References 7 publications

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“…Most recently, three patients with known alpha-gal IgE titers experienced perioperative anaphylactic reactions after implantation of bioprosthetic valves. 4 All three patients recovered well after appropriate treatment.…”

Section: Discussionmentioning

confidence: 80%

“…Post‐mortem examination demonstrated eosinophilic infiltration of the valve and progressively increasing IgE levels, including to pork, although alpha‐gal IgE was never tested. Most recently, three patients with known alpha‐gal IgE titers experienced perioperative anaphylactic reactions after implantation of bioprosthetic valves . All three patients recovered well after appropriate treatment.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Premature Bioprosthetic Aortic Valve Degeneration Associated with Allergy to Galactose‐Alpha‐1,3‐Galactose

et al. 2016

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 98%

Premature Bioprosthetic Aortic Valve Degeneration Associated with Allergy to Galactose‐Alpha‐1,3‐Galactose

et al. 2016

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“…A case report of three patients with IgE Ab to alpha-gal who had bovine or porcine valve replacement complicated by an allergic reaction in the immediate post-operative period was recently published [31•]. While the number of patients with delayed reactions to mammalian meat who require heart valve replacement is likely a quite small number, this issue is one that allergists should be aware of in order to provide patients with appropriate guidance.…”

Section: Additional Clinical Implications Of Ige Ab To Alpha-galmentioning

confidence: 99%

Delayed Anaphylaxis Involving IgE to Galactose-alpha-1,3-galactose

Platts-Mills

Schuyler

Hoyt

et al. 2015

Curr Allergy Asthma Rep

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Hypersensitivity in the allergic setting refers to immune reactions, stimulated by soluble antigens that can be rapidly progressing and, in the case of anaphylaxis, are occasionally fatal. As the number of known exposures associated with anaphylaxis is limited, identification of novel causative agents is important in facilitating both education and other allergen-specific approaches that are crucial to long-term risk management. Within the last 10 years several seemingly separate observations were recognized to be related, all of which resulted from the development of antibodies to a carbohydrate moiety on proteins where exposure differed from airborne allergens but which were nevertheless capable of producing anaphylactic and hypersensitivity reactions. Our recent work has identified these responses as being due to a novel IgE antibody directed against a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose (alpha-gal). This review will present the history and biology of alpha-gal and discuss our current approach to management of the mammalian meat allergy and delayed anaphylaxis.

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“…Tryptase levels were positive in only 3 patients, but BAT responses correlated with the timing of clinical symptoms, suggesting that reactions occurred as the proteins entered the bloodstream. Additional studies regarding alpha-gal noted that patients might have allergic reactions to initial placement of porcine or bovine heart valves 35 and that pork kidney apparently has high levels of or very accessible alpha-gal and is likely to elicit reactions more often than red meat and would especially be a risk for those with red meat allergy. 36 …”

Section: Diagnosismentioning

confidence: 99%

Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2014

Sicherer

Leung

2015

Journal of Allergy and Clinical Immunology

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This review highlights some of the research advances in anaphylaxis; hypersensitivity reactions to foods, drugs, and insects; and allergic skin diseases that were reported in the Journal in 2014. Studies on food allergy suggest worrisomely high rates of peanut allergy and food-induced anaphylaxis-related hospitalizations. Evidence is mounting to support the theory that environmental exposure to peanut, such as in house dust, especially with an impaired skin barrier attributed to atopic dermatitis (AD) and loss of function mutations in the filaggrin gene, is a risk factor for sensitization and allergy. Diagnostic tests are improving, with early studies suggesting the possibility of developing novel cellular tests with increased diagnostic utility. Treatment trials continue to show the promise and limitations of oral immunotherapy, and mechanistic studies are elucidating pathways that might define the degree of efficacy of this treatment. Studies have also provided insights into the prevalence and characteristics of anaphylaxis and insect venom allergy, such as suggesting that baseline platelet-activating factor acetylhydrolase activity levels are related to the severity of reactions. Advances in drug allergy include identification of HLA associations for penicillin allergy and a microRNA biomarker/mechanism for toxic epidermal necrolysis. Research identifying critical events leading to skin barrier dysfunction and the polarized immune pathways that drive AD have led to new therapeutic approaches in the prevention and management of AD.

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Porcine or bovine valve replacement in 3 patients with IgE antibodies to the mammalian oligosaccharide galactose-alpha-1,3-galactose

Cited by 65 publications

References 7 publications

Premature Bioprosthetic Aortic Valve Degeneration Associated with Allergy to Galactose‐Alpha‐1,3‐Galactose

Premature Bioprosthetic Aortic Valve Degeneration Associated with Allergy to Galactose‐Alpha‐1,3‐Galactose

Delayed Anaphylaxis Involving IgE to Galactose-alpha-1,3-galactose

Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2014

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