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The alpha-gal story: lessons learned from connecting the dots.
J Allergy Clin Immunol 2015; 135(3):589-96; quiz 597JA

Abstract

Anaphylaxis is a severe allergic reaction that can be rapidly progressing and fatal, and therefore establishing its cause is pivotal to long-term risk management. Our recent work has identified a novel IgE antibody response to a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose (alpha-gal). IgE to alpha-gal has been associated with 2 distinct forms of anaphylaxis: (1) immediate-onset anaphylaxis during first exposure to intravenous cetuximab and (2) delayed-onset anaphylaxis 3 to 6 hours after ingestion of mammalian food products (eg, beef and pork). Results of our studies and those of others strongly suggest that tick bites are a cause, if not the only significant cause, of IgE antibody responses to alpha-gal in the southern, eastern, and central United States; Europe; Australia; and parts of Asia. Typical immune responses to carbohydrates are considered to be T-cell independent, whereas IgE antibody production is thought to involve sequential class-switching that requires input from T cells. Therefore, establishing the mechanism of the specific IgE antibody response to alpha-gal will be an important aspect to address as this area of research continues.

Authors+Show Affiliations

Asthma and Allergic Diseases Center, Carter Immunology Center, Department of Medicine, University of Virginia Health System, Charlottesville, Va.Asthma and Allergic Diseases Center, Carter Immunology Center, Department of Medicine, University of Virginia Health System, Charlottesville, Va. Electronic address: tap2z@virginia.edu.Asthma and Allergic Diseases Center, Carter Immunology Center, Department of Medicine, University of Virginia Health System, Charlottesville, Va.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25747720

Citation

Steinke, John W., et al. "The Alpha-gal Story: Lessons Learned From Connecting the Dots." The Journal of Allergy and Clinical Immunology, vol. 135, no. 3, 2015, pp. 589-96; quiz 597.
Steinke JW, Platts-Mills TA, Commins SP. The alpha-gal story: lessons learned from connecting the dots. J Allergy Clin Immunol. 2015;135(3):589-96; quiz 597.
Steinke, J. W., Platts-Mills, T. A., & Commins, S. P. (2015). The alpha-gal story: lessons learned from connecting the dots. The Journal of Allergy and Clinical Immunology, 135(3), pp. 589-96; quiz 597. doi:10.1016/j.jaci.2014.12.1947.
Steinke JW, Platts-Mills TA, Commins SP. The Alpha-gal Story: Lessons Learned From Connecting the Dots. J Allergy Clin Immunol. 2015;135(3):589-96; quiz 597. PubMed PMID: 25747720.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The alpha-gal story: lessons learned from connecting the dots. AU - Steinke,John W, AU - Platts-Mills,Thomas A E, AU - Commins,Scott P, PY - 2014/10/09/received PY - 2014/11/21/revised PY - 2014/12/10/accepted PY - 2015/3/10/entrez PY - 2015/3/10/pubmed PY - 2015/5/1/medline KW - Anaphylaxis KW - delayed reaction to red meat KW - galactose-alpha-1,3-galactose SP - 589-96; quiz 597 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 135 IS - 3 N2 - Anaphylaxis is a severe allergic reaction that can be rapidly progressing and fatal, and therefore establishing its cause is pivotal to long-term risk management. Our recent work has identified a novel IgE antibody response to a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose (alpha-gal). IgE to alpha-gal has been associated with 2 distinct forms of anaphylaxis: (1) immediate-onset anaphylaxis during first exposure to intravenous cetuximab and (2) delayed-onset anaphylaxis 3 to 6 hours after ingestion of mammalian food products (eg, beef and pork). Results of our studies and those of others strongly suggest that tick bites are a cause, if not the only significant cause, of IgE antibody responses to alpha-gal in the southern, eastern, and central United States; Europe; Australia; and parts of Asia. Typical immune responses to carbohydrates are considered to be T-cell independent, whereas IgE antibody production is thought to involve sequential class-switching that requires input from T cells. Therefore, establishing the mechanism of the specific IgE antibody response to alpha-gal will be an important aspect to address as this area of research continues. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/25747720/The_alpha_gal_story:_lessons_learned_from_connecting_the_dots_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(15)00076-7 DB - PRIME DP - Unbound Medicine ER -