Tick-host conflict: immunoglobulin E antibodies to tick proteins in patients with anaphylaxis to tick bite

Abstract

Tick-borne infectious diseases and allergies are a growing problem worldwide. Tick bite allergy has been associated with the direct effect of immunoglobulin E (IgE) response to tick salivary antigens, or secondary to the induction of allergy to red meat consumption through IgE antibodies against the carbohydrate α-Gal (Gal α 1-3Gal β 1-(3)4GlcNAc-R). However, despite the growing burden of this pathology, the proteins associated with anaphylaxis to tick bite have not been characterized. To address this question, a comparative proteomics approach was used to characterize tick proteins producing an IgE antibody response in a healthy individual with record of tick bites, which had not resulted in any allergic reactions, and two patients with anaphylactic reactions to Rhipicephalus bursa or Hyalomma marginatum tick bites. Both patients and the healthy individual were red meat tolerant. The results supported a patient-specific IgE antibody response to tick species responsible for the anaphylaxis to tick bite. Both patients and the healthy individual serologically recognized tick proteins with and without α-Gal modifications, with proteins differentially recognized by patients but not control sera. These proteins could be used as potential antigens for diagnostics, treatment and prevention of tick bite-induced allergies.

Tick anaphylaxis in Japan

“…5 Nevertheless, the tick-derived, IgE-reactive proteins from tick anaphylaxis patients having no history of red meat allergy did not necessarily include alphagal. 6 Indeed, the severity of clinical manifestations in this study did not correlate with the presence of anti-alphagal IgE antibody, suggesting that other antigens responsible for tick anaphylaxis may exist.…”

Prevalence of type I sensitization to alpha‐gal in forest service employees and hunters: Is the blood type an overlooked risk factor in epidemiological studies of the α‐Gal syndrome?

“…In agreement with these findings, the frequency of blood group B in Europe, the United States, and Australia where the α‐Gal syndrome is increasingly being reported is lower than in Africa and Asia where reports of this allergy are scarce (Figure ). The presence of blood group B will reduce the capacity of the immune system to produce anti‐α‐Gal antibodies, presumably due to tolerance to α‐Gal, which is very similar to blood group B antigen . These results support that the allergy to α‐Gal should also be considered in the context of the susceptibility to infectious diseases caused by pathogens with α‐Gal on their surface .…”

“…The α‐Gal syndrome is a tick‐related allergy, affecting individuals mainly in Europe, the United States, and Australia. The sensitization mediated by the IgE response to tick‐produced proteins with α‐Gal modifications could result in anaphylactic reactions to tick bite and/or red meat consumption . Fischer and colleagues characterized the risk factors associated with the α‐Gal syndrome in forest service employees and hunters from Germany.…”

Anaphylactic Shock

“…Vespid venom additionally activates complement in an IgE independent mechanism, which may potentiate anaphylaxis [28]. In addition to hymenoptera venom, bites from rattlesnakes [29], hamsters [30], and ticks [31] have been implicated as causes of anaphylaxis. Fatal cases due stings are more often due to shock than respiratory distress, arrest typically occurs 10-15 min after exposure [26].…”