Further Evidence For Tick Bites As A Cause Of The IgE Responses To Alpha-gal That Underlie A Major Increased In Delayed Anaphylaxis To Meat

James, Hayley R.; Commins, Scott P.; Kelly, Libby A.; Pochan, S.L.; Workman, Lisa J.; Mullins, Raymond J; Platts‐Mills, Thomas A.E.

doi:10.1016/j.jaci.2010.12.967

Cited by 4 publications

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“…Favorable seasonal conditions in years with a high tick population hereby increase the prevalence of alpha-gal sensitization by multiple tick bites in risk groups. Moreover, the tick population increases with the deer and rodent population as previously reported from Sweden and the USA, and blood type may also be a confounder [ 25 , 26 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 95%

Hochrisikogruppen für eine Alpha-Gal-Sensibilisierung

Benders-Guedj,

Köberle,

Hofmann

et al. 2023

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Background: Tick bite-induced IgE-mediated reactions to the oligosaccharide galactose α-1,3-galactose (alpha-gal) are increasingly recognized. This study investigated alpha-gal sensitization in three groups with different tick bite exposure. Materials and methods: Specific IgE antibodies to alpha-gal and total IgE were investigated in 485 patients with Lyme borreliosis with different disease manifestations and compared to a control group of 200 randomly selected patients without increased exposure to tick bites. A group of 232 hunters and forest workers served as a model for multiple tick bites. Results: Specific IgE (sIgE) antibodies to alpha-gal (> 0.1 kU/L) were found in 12.6% of all borreliosis samples compared to the control group with 9% (relative risk 1.4; 95% CI 0.85 – 2.3; not significant (n.s.). The highest prevalence of sIgE to alpha-gal was observed in hunters and forest service employees (22.8%, relative risk 2.5; 95% CI 1.5 – 4.2; p < 0.001). Higher age and elevated total IgE were also associated with alpha-gal sensitization. Conclusion: IgE sensitization to alpha-gal tends to be more frequent in tick-exposed patients with borreliosis than in controls (n.s.). Moreover, hunters and forest workers show an even higher rate of elevated IgE to alpha-gal. Thus, frequent tick contact may result in alpha-gal sensitization. In the area of Munich, the prevalence of alpha-gal sensitization appears lower than in the state of Baden-Württemberg and lower than in the USA, which may be due to the difference in tick species or the frequency of tick exposure. This study could show that alpha-gal sensitization and presumably alpha-gal syndrome does not seem to be a modern problem but existed already more than 30 years ago.

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Section: Discussionmentioning

confidence: 95%

Hochrisikogruppen für eine Alpha-Gal-Sensibilisierung

Benders-Guedj,

Köberle,

Hofmann

et al. 2023

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“…Since then, Platts-Mills, Commins and coworkers [ 5 , 6 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ] together with our colleagues around the world [ 2 , 3 , 7 , 10 , 12 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ], have gathered extensive data and provided elegant proofs of the clinical observation by van Nunen et al [ 2 , 3 ], that tick bites are associated with the development of mammalian meat allergy.…”

Section: Mammalian Meat Allergy/anaphylaxis Following Tick Bitesmentioning

confidence: 99%

“…The most reasonable explanation for the increasing prevalence of mammalian meat allergy in both Australia and the US is an increase in host numbers (bandicoots and other small native mammals flourishing in Australia [ 37 ] and the increase in the white tailed deer population in south-eastern US [ 13 ]).…”

Section: Mammalian Meat Allergy/anaphylaxis Following Tick Bitesmentioning

confidence: 99%

Tick-induced allergies: mammalian meat allergy, tick anaphylaxis and their significance

Nunen

2015

Asia Pacific Allergy

115

118

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Serious tick-induced allergies comprise mammalian meat allergy following tick bites and tick anaphylaxis. Mammalian meat allergy is an emergent allergy, increasingly prevalent in tick-endemic areas of Australia and the United States, occurring worldwide where ticks are endemic. Sensitisation to galactose-α-1,3-galactose (α-Gal) has been shown to be the mechanism of allergic reaction in mammalian meat allergy following tick bite. Whilst other carbohydrate allergens have been identified, this allergen is unique amongst carbohydrate food allergens in provoking anaphylaxis. Treatment of mammalian meat anaphylaxis involves avoidance of mammalian meat and mammalian derived products in those who also react to gelatine and mammalian milks. Before initiating treatment with certain therapeutic agents (e.g., cetuximab, gelatine-containing substances), a careful assessment of the risk of anaphylaxis, including serological analysis for α-Gal specific-IgE, should be undertaken in any individual who works, lives, volunteers or recreates in a tick endemic area. Prevention of tick bites may ameliorate mammalian meat allergy. Tick anaphylaxis is rare in countries other than Australia. Tick anaphylaxis is secondarily preventable by prevention and appropriate management of tick bites. Analysis of tick removal techniques in tick anaphylaxis sufferers offers insights into primary prevention of both tick and mammalian meat anaphylaxis. Recognition of the association between mammalian meat allergy and tick bites has established a novel cause and effect relationship between an environmental exposure and subsequent development of a food allergy, directing us towards examining environmental exposures as provoking factors pivotal to the development of other food allergies and refocusing our attention upon causation of allergy in general.

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“…The most reasonable explanation for the increasing prevalence of mammalian meat allergy in both Australia and the USA is an increase in host numbers (bandicoots and other small native mammals flourishing in Australia and the increase in the white-tailed deer population in south-eastern USA) [12].…”

Section: Central Americamentioning

confidence: 99%

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

Nunen

2014

Curr Treat Options Allergy

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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.

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Further Evidence For Tick Bites As A Cause Of The IgE Responses To Alpha-gal That Underlie A Major Increased In Delayed Anaphylaxis To Meat

Cited by 4 publications

References 0 publications

Hochrisikogruppen für eine Alpha-Gal-Sensibilisierung

Hochrisikogruppen für eine Alpha-Gal-Sensibilisierung

Tick-induced allergies: mammalian meat allergy, tick anaphylaxis and their significance

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

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