IgE to the Mammalian Oligosaccharide Galactose-α-1,3-Galactose Is Associated With Increased Atheroma Volume and Plaques With Unstable Characteristics—Brief Report

Wilson, Jeffrey M.; Nguyen, Anh; Schuyler, Alexander J.; Commins, Scott P.; Taylor, Angela M.; Platts-Mills, Thomas A.E.; McNamara, Coleen A.

doi:10.1161/atvbaha.118.311222

Cited by 78 publications

(82 citation statements)

References 20 publications

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“…Allergen-positive patients have been identified to have higher titers of anti-gal IgG, with more IgG subtype 1 and less IgG subtype 2 than allergen negative populations 44 . Furthermore, allergen-positive patients manifest a significant difference in coronary artery disease when compared to an allergen-negative cohort 38 . This suggests that IgE sensitization to alpha gal may be a novel modifiable risk factor for coronary atherosclerosis, especially in patients 65-years and younger.…”

Section: Prevalence Of Ige Anti-gal Antibodiesmentioning

confidence: 99%

“…The reported prevalence of individuals in the United States with elevated allergen-specific titers of anti-gal IgE (i.e. allergen positive) has been reported to be in the range of 8% to 46%, with highest prevalence within the geographic distribution of the Lone Star tick ( Figure 1) 21,[38][39][40][41] . Similar prevalence rates have been reported in other regions around the world (Table 1) 27,42,43 .…”

Section: Prevalence Of Ige Anti-gal Antibodiesmentioning

confidence: 99%

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Alpha-gal syndrome: Implications for cardiovascular disease

Bianchi¹,

Walters²,

Fitch

et al. 2020

gcsp

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Alpha-gal syndrome (AGS) refers to a potentially life-threatening allergy to the molecule galactose-α1,3galactose (gal), which is expressed on most mammalian tissues but, importantly, is not expressed by humans. This syndrome can manifest as an allergic reaction to mammalian meat products, but other sources of mammalian tissue can also provoke an immune response, including injectable and implantable medical products. This syndrome has been linked to coronary atherosclerosis, and medical products that express gal are routinely used in cardiology and cardiac surgery. This article seeks to discuss potential implications of alpha syndrome as it relates to cardiovascular health and to heighten awareness in the cardiovascular community about this emerging public health issue. Prevalence of galactose-α1,3-galactoseMost mammalian species (including New World monkeys, cows, pigs, goats, horses, sheep, rabbits and mice) express the galactose-α1,3-galactose (gal) disaccharide sugar on cells and tissue surfaces 1-4 . Gal expression results from the catalytic activity of the α1,3-galactosyltransferase enzyme encoded by the glycoprotein α1,3galactosyltransferase gene (GGTA1) 1-3, 5 . Certain mammalian species, such as catarrhines (humans, apes, and Old World monkeys), do not have a functional GGTA1 gene 6-8 and correspondingly do not express gal 1, 3, 4 . Additionally, gal has been documented to be absent in fish, amphibians, reptiles, and birds 3,9,10 . The function of gal is unknown 3 , but it is clearly not essential for survival 1, 3 .

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Section: Prevalence Of Ige Anti-gal Antibodiesmentioning

confidence: 99%

Section: Prevalence Of Ige Anti-gal Antibodiesmentioning

confidence: 99%

Alpha-gal syndrome: Implications for cardiovascular disease

Bianchi¹,

Walters²,

Fitch

et al. 2020

gcsp

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“…6 Wilson et al showed that individuals with IgE antibodies against α-Gal develop bigger atheroma plaques. 7 They suggest that chronic ingestion of α-Gal-carrying mammalian products, especially glycolipids, might cause the release of inflammatory products from mast cells bearing anti-α-Gal IgE antibodies and that this might lead to the formation of bigger plaques. In addition, they suggest that other cells might also be involved in the development of atheroma plaques and that this could happen via the binding of anti-α-Gal IgG1 antibodies to mammalian glycolipids.…”

Section: Our Data Showing the Presence Of High Amounts Of α-Gal-specificmentioning

confidence: 99%

Individuals with IgE antibodies to α‐Gal and CCD show specific IgG subclass responses different from subjects non‐sensitized to oligosaccharides

Román‐Carrasco

Hemmer²,

Klug

et al. 2020

Clin Experimental Allergy

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“…In a cohort of adults who were enrolled without regard to allergic history, we recently reported that the severity of coronary artery disease was greater in subjects who were sensitized to a-Gal. 50 This finding prompts several questions but raises the possibility that IgE to glycolipid food allergens could have severe long-term consequences in addition to their contribution to anaphylaxis. Our working hypothesis is that chronic consumption of mammalian products could act in an antigen-dependent manner to stimulate tissue-resident mast cells, including those in the walls of coronary arteries, in subjects who make IgE to a-Gal.…”

Section: Recent Insights Into Food Allergymentioning

confidence: 99%

α-Gal and other recent findings that have informed our understanding of anaphylaxis

Wilson

Platts-Mills

2020

Annals of Allergy, Asthma & Immunology

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A B S T R A C TObjective: To summarize the current understanding of anaphylaxis, with an emphasis on major findings that have been reported within the last 10 years. Data Sources: Queries relating to anaphylaxis, immunoglobulin E (IgE), and mast cells were conducted with PubMed and Google Scholar, searching for primary articles and review papers. Study Selections: We focused on articles written in English and which were reported in major allergy and immunology journals. Results: Anaphylaxis represents an extreme manifestation of a form of allergic immunity that appears to have evolved to protect against "toxic" threats that present at skin and mucosal barriers. The factors that have contributed to a rise in anaphylaxis are increasingly appreciated to relate to changes in hygiene and microbial ecology that have occurred with industrialization. Induction of allergen-specific IgG4 is often part of the allergic response and is associated with protection against anaphylaxis. The recognition of the a-Gal syndrome suggests that carbohydrates can be epitopes that are relevant to anaphylaxis and that IgEmediated reactions do not always occur "immediately." Conclusion: Our understanding of anaphylaxis has advanced significantly over the past 10 years. It is anticipated that ongoing research will build on this foundation to further advance our knowledge of anaphylaxis and also translate into clinically meaningful therapies.Ó 2019 Published by Elsevier Inc. on behalf of American College of Allergy, Asthma & Immunology. InstructionsCredit can now be obtained, free for a limited time, by reading the review article and completing all activity components. Please note the instructions listed below:Review the target audience, learning objectives and all disclosures.Complete the pre-test.Read the article and reflect on all content as to how it may be applicable to your practice.Complete the post-test/evaluation and claim credit earned. At this time, physicians will have earned up to 1.0 AMA PRA Category 1 Credit TM . Minimum passing score on the post-test is 70%. Overall Purpose Participants will be able to demonstrate increased knowledge of the clinical treatment of allergy/asthma/immunology and how new information can be applied to their own practices.Disclosures: TPM has a patent on an IgE assay to a-Gal and has received assay support from Phadia/Thermo-Fisher; JW has received research support from Phadia/Thermo-Fisher.

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IgE to the Mammalian Oligosaccharide Galactose-α-1,3-Galactose Is Associated With Increased Atheroma Volume and Plaques With Unstable Characteristics—Brief Report

Abstract: Supplemental Digital Content is available in the text.

Cited by 78 publications

References 20 publications

Alpha-gal syndrome: Implications for cardiovascular disease

Alpha-gal syndrome: Implications for cardiovascular disease

Individuals with IgE antibodies to α‐Gal and CCD show specific IgG subclass responses different from subjects non‐sensitized to oligosaccharides

α-Gal and other recent findings that have informed our understanding of anaphylaxis

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