Tick bites and red meat allergy

Commins, Scott P.; Platts-Mills, Thomas A.E.

doi:10.1097/aci.0b013e3283624560

Cited by 119 publications

(93 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The major allergen is not a protein but a mammalian oligosaccharide and removal of α‐gal dramatically reduces IgE binding to beef proteins 24. Several studies provided evidence that sensitization to α‐gal results from tick bites 11, 12, 25, 26. Consequently, delayed meat allergy is not a consequence of oral but cutaneous sensitization to the α‐gal epitope expressed on proteins present in the gastrointestinal tract of these arthropods 27.…”

Section: Discussionmentioning

confidence: 99%

The quantity and quality of α-gal-specific antibodies differ in individuals with and without delayed red meat allergy

Kollmann

Nagl

Ebner³

et al. 2016

Allergy

View full text Add to dashboard Cite

BackgroundIgG to galactose‐α‐1,3‐galactose (α‐gal) are highly abundant natural antibodies (Ab) in humans. α‐Gal‐specific IgE Ab cause a special form of meat allergy characterized by severe systemic reactions 3–7 h after consumption of red meat. We investigated 20 patients who experienced such reactions and characterized their α‐gal‐specific IgE and IgG responses in more detail.Methodsα‐Gal‐specific IgE was determined by ImmunoCAP. IgE reactivity to meat extract and bovine gamma globulin (BGG) was assessed by immunoblotting and ELISA, respectively. In some experiments, sera were pre‐incubated with α‐gal or protein G to deplete IgG Ab. α‐Gal‐specific IgG1–4 Ab in individuals with and without meat allergy were assessed by ELISA.ResultsIn immunoblots, BGG was the most frequently recognized meat protein. Binding of IgE and IgG to BGG was confirmed by ELISA and completely abolished after pre‐incubation with α‐gal. Neither the depletion of autologous α‐gal‐specific IgG Ab nor the addition of α‐gal‐specific IgG Ab from nonallergic individuals changed the IgE recognition of BGG of meat‐allergic patients. Meat‐allergic patients showed significantly higher α‐gal‐specific IgG1 and IgG3 Ab than nonallergic individuals, whereas the latter showed significantly higher levels of α‐gal‐specific IgG4 Ab.ConclusionPatients with delayed meat allergy display IgE and IgG Ab that selectively recognize the α‐gal epitope on BGG. Their enhanced α‐gal‐specific IgE levels are accompanied by high levels of α‐gal‐specific IgG1 devoid of IgE‐blocking activity. This subclass distribution is atypical for food allergies and distinct from natural α‐gal IgG responses in nonallergic individuals.

show abstract

Section: Discussionmentioning

confidence: 99%

The quantity and quality of α-gal-specific antibodies differ in individuals with and without delayed red meat allergy

Kollmann

Nagl

Ebner³

et al. 2016

Allergy

View full text Add to dashboard Cite

show abstract

“…Likewise, alpha-gal is present on proteins from epithelia and milk of other mammals (Table 1). 3,4 Some patients might report clinical reactions to dairy, but this does not seem to be widespread. 3,5,6 Abbreviation: alpha-gal, galactose-a-1,3-galactose.…”

Section: Cross-reactivitymentioning

confidence: 93%

“…Onset is typically in adults, although children are not excluded. 4,14 Kennedy et al 18 identified 45 pediatric patients with the allergy. In the United States, red meat typically includes beef, pork, and lamb.…”

Section: Diagnostic Approachmentioning

confidence: 98%

Delayed red meat allergy: clinical ramifications of galactose-α-1,3-galactose sensitization

Stewart

McMullan

LeBlanc

2015

Annals of Allergy, Asthma & Immunology

View full text Add to dashboard Cite

“…In both Australia and the USA, however, large numbers of patients with mammalian meat allergy following tick bites have been identified [8]. In her practice alone, van Nunen has diagnosed over 500 patients (between 1985 and March 2014, with the great majority having presented from 2003 onwards) within a referral base of 440,000 people (1/880), which includes the tick-endemic areas nearby.…”

Section: Central Americamentioning

confidence: 99%

“…In addition, Commins and Platts-Mills [8] have commented that Jappe is said to have identified patients with mammalian meat allergy and cetuximab and alphagal-specific IgE via serological studies and referenced her review of the topic [25].…”

Section: Germanymentioning

confidence: 99%

Galactose-Alpha-1,3-Galactose, Mammalian Meat and Anaphylaxis: A World-Wide Phenomenon?

Nunen

2014

Curr Treat Options Allergy

View full text Add to dashboard Cite

Opinion StatementMammalian meat allergy following tick bites is known to occur in Australia, North America, Europe, Asia, Africa and Central America. Over the last decade, the condition has become increasingly prevalent in tick-endemic areas of Australia and the USA. In mammalian meat-allergic individuals, gelatine allergy and/or cow's milk allergy may co-exist. Awareness of tick-induced allergies in health professionals and the general community is key to both a timely diagnosis and the prevention of mammalian meat allergy. Treatment of mammalian meat allergy is limited currently to avoidance of all mammalian meat, whilst gelatine allergy similarly mandates avoidance of mammalian-derived gelatine, especially intravenously administered gelatine-containing solutions. Adults with anaphylaxis to mammalian meat should have a convalescent tryptase estimation and investigations for mastocytosis should then be undertaken if the tryptase is significantly elevated. Before initiating treatment with certain therapeutic agents (e.g. cetuximab, gelatine-containing substances, bovine artificial blood), a careful assessment of the risk of anaphylaxis, including serological analysis for galactose-alpha-1,3-galactose-specific immunoglobulin E, should be undertaken in any individual who works, lives, volunteers or participates in leisure activities in a tick-endemic area, particularly where a history is obtained of a tick bite prior, or of mammalian meat or gelatine allergy. Strategies aimed at the prevention of tick bites are paramount for primary prevention and amelioration of mammalian meat allergy. Key points 1. Mammalian meat allergies are characterised by delayed anaphylaxis, urticaria and angioedema, occurring 2-10 h after the ingestion of mammalian meat and are commonly preceded by a tick bite. 2. Mammalian meat allergy may be confirmed by galactose-alpha-1,3-galactose and mammalian meat-specific immunoglobulin E estimations, cetuximab skin testing or skin prick testing with fresh, raw, organic meat extracts. 3. Confirmation of gelatine allergy requires intradermal testing if skin prick testing is negative and gelatine-specific immunoglobulin E is not detected. 4. Dietary exclusion of mammalian meat, mammalian gelatine and cow's milk products, as indicated by the individual clinical sensitivity profile, is the mainstay of treatment in allergy to galactose-alpha-1,3-galactose. 5. Mammalian meat-allergic patients should be aware of the risk of allergic reaction to cetuximab, gelatine and mammalian meat-containing therapeutic agents and health supplements and to check the ingredients carefully. 6. Search for co-existing mastocytosis when tryptase levels are elevated in convalescence. 7. Prevention of tick bites appears to limit the duration of the condition in some individuals and is essential to the primary prevention of mammalian meat allergy.

show abstract

Tick bites and red meat allergy

Cited by 119 publications

References 36 publications

The quantity and quality of α-gal-specific antibodies differ in individuals with and without delayed red meat allergy

The quantity and quality of α-gal-specific antibodies differ in individuals with and without delayed red meat allergy

Delayed red meat allergy: clinical ramifications of galactose-α-1,3-galactose sensitization

Galactose-Alpha-1,3-Galactose, Mammalian Meat and Anaphylaxis: A World-Wide Phenomenon?

Contact Info

Product

Resources

About