The red meat allergy syndrome in Sweden

Abstract

SummaryIn the last decade, a novel type of food allergy presenting with severe allergic reactions several hours a er consumption of red meat has been recognized.e allergic responses are due to IgE antibodies directed against the carbohydrate epitope galactose-α-1,3-galactose (α-Gal) found in mammalian meat.is review presents the red meat allergy syndrome in Sweden, discusses the features of the immune response to carbohydrates, and highlights the presence of heat stable α-Gal-containing proteins in meat.e number of diagnosed red meat allergy cases in Sweden has increased signi cantly over the past few years. All patients have been tick bitten. Our recent work has shown that α-Gal is present in the Euro pean tick Ixodes ricinus (I. ricinus), thus potentially explaining the strong association between anti-α-Gal IgE and tick bites, with development of red meat allergy as a secondary phenomenon. Further studies using immunoproteomics have identi ed novel α-Gal-containing meat proteins that bound IgE from red meat allergic patients. Four of these proteins were stable to thermal processing pointing to the fact that the allergenicity of red meat proteins is preserved in cooked meat. In keeping with the fact that the α-Gal epitope is structurally related to the blood group B antigen, a positive association with the B-negative blood groups among our red meat allergic patients was noted. A selective IgE reactivity to the pure carbohydrate moiety was observed when investigating the speci city of the α-Gal immune response. IgE from red meat allergic patients does not recognize the other major mammalian carbohydrate, N-glycolylneuraminic acid (Neu5Gc), also present in high amounts in red meat. Furthermore, neither common cross-reactive carbohydrate determinants (CCDs) from plants nor venoms are targets of the IgE response in these patients.Taken together, the α-Gal carbohydrate has shown to be a potentially clinically relevant allergen that should be taken into account in the diagnosis of food allergy. Many new ndings in the eld of red meat allergy have been obtained during the past years, but further e orts to understand the process of digestion, absorption, and delivery of α-Gal-containing molecules to the circulation are needed. e red meat allergy syndrome in Sweden. Allergo Cite this as

Meat allergy associated with galactosyl‐α‐(1,3)‐galactose (α‐Gal)—Closing diagnostic gaps by anti‐α‐Gal IgE immune profiling

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“…Clinical reactions against the therapeutic monoclonal antibody cetuximab (CTX) used for cancer treatment are severe, sometimes even fatal, and are associated with IgE against galactosyl‐α‐(1,3)‐galactose (α‐Gal) . Meat allergy (MA) with particular clinical features was first observed in the USA and Australia and has also been investigated in Sweden, Italy, Austria, and Germany . It has been found that anti‐α‐Gal IgE plays a prominent role in MA and severe allergy symptoms that sometimes develop with a delay of several hours .…”

Evolution of sialic acids: Implications in xenotransplant biology

“…In addition to the evolutionary perspective, Neu5Gc has other consequences on human health . Despite the fact that humans lost the ability to synthesize Neu5Gc, small amounts can be found on human epithelial and endothelial cells .…”

A dynamic relationship between two regional causes of IgE-mediated anaphylaxis: α-Gal syndrome and imported fire ant

“…20 In this cold and arid region that straddles the Arctic Circle ticks are rare and there has been little report of mammalian meat allergy. 30,31 Of the 90 subjects who reported cat ownership, none had IgE to a-Gal (see Table E4 in this article's Online Repository at www.jacionline.org), and among the subjects in a cohort of 413 that was investigated, only a single subject (0.2%) had a level of IgE to a-Gal of at least 0.35 IU/mL.…”