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Delayed anaphylaxis to alpha-gal, an oligosaccharide in mammalian meat.

Abstract

IgE-mediated hypersensitivity refers to immune reactions that can be rapidly progressing and, in the case of anaphylaxis, are occasionally fatal. To that end, identification of the associated allergen is important for facilitating both education and allergen avoidance that are essential to long-term risk reduction. As the number of known exposures associated with anaphylaxis is limited, discovery of novel causative agents is crucial to evaluation and management of patients with idiopathic anaphylaxis. Within the last 10 years several apparently separate observations were recognized to be related, all of which resulted from the development of antibodies to a carbohydrate moiety on proteins. Interestingly, the exposure differed from airborne allergens but was nevertheless capable of producing anaphylactic and hypersensitivity reactions. Our recent work has identified these responses as being due to a novel IgE antibody directed against a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose ("alpha-gal"). This review will present the historical summary of the identification of cetuximab hypersensitivity due to alpha-gal IgE and discuss the non-primate mammalian meat food allergy as well as current goals and directions of our research programs.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA; Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA. Electronic address: scommins@email.unc.edu.

    ,

    Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA; Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

    ,

    Department of Microbiology & Immunology, University of Virginia School of Medicine, Charlottesville, VA, USA.

    ,

    Department of Microbiology & Immunology, University of Virginia School of Medicine, Charlottesville, VA, USA; Carter Immunology Center, University of Virginia Health System, Charlottesville, VA, USA.

    Department of Microbiology & Immunology, University of Virginia School of Medicine, Charlottesville, VA, USA; Carter Immunology Center, University of Virginia Health System, Charlottesville, VA, USA; Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.

    Source

    MeSH

    Allergens
    Anaphylaxis
    Animals
    Cetuximab
    Drug Hypersensitivity
    Food Hypersensitivity
    Humans
    Hypersensitivity, Delayed
    Immunoglobulin E
    Meat
    Oligosaccharides
    Tick Bites
    Ticks

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Review

    Language

    eng

    PubMed ID

    26666477

    Citation

    Commins, Scott P., et al. "Delayed Anaphylaxis to Alpha-gal, an Oligosaccharide in Mammalian Meat." Allergology International : Official Journal of the Japanese Society of Allergology, vol. 65, no. 1, 2016, pp. 16-20.
    Commins SP, Jerath MR, Cox K, et al. Delayed anaphylaxis to alpha-gal, an oligosaccharide in mammalian meat. Allergol Int. 2016;65(1):16-20.
    Commins, S. P., Jerath, M. R., Cox, K., Erickson, L. D., & Platts-Mills, T. (2016). Delayed anaphylaxis to alpha-gal, an oligosaccharide in mammalian meat. Allergology International : Official Journal of the Japanese Society of Allergology, 65(1), pp. 16-20. doi:10.1016/j.alit.2015.10.001.
    Commins SP, et al. Delayed Anaphylaxis to Alpha-gal, an Oligosaccharide in Mammalian Meat. Allergol Int. 2016;65(1):16-20. PubMed PMID: 26666477.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Delayed anaphylaxis to alpha-gal, an oligosaccharide in mammalian meat. AU - Commins,Scott P, AU - Jerath,Maya R, AU - Cox,Kelly, AU - Erickson,Loren D, AU - Platts-Mills,Thomas, Y1 - 2015/11/21/ PY - 2015/10/09/received PY - 2015/10/21/accepted PY - 2015/12/16/entrez PY - 2015/12/17/pubmed PY - 2016/10/14/medline KW - Alpha-gal KW - Delayed anaphylaxis KW - Glycan KW - IgE KW - Red meat allergy SP - 16 EP - 20 JF - Allergology international : official journal of the Japanese Society of Allergology JO - Allergol Int VL - 65 IS - 1 N2 - IgE-mediated hypersensitivity refers to immune reactions that can be rapidly progressing and, in the case of anaphylaxis, are occasionally fatal. To that end, identification of the associated allergen is important for facilitating both education and allergen avoidance that are essential to long-term risk reduction. As the number of known exposures associated with anaphylaxis is limited, discovery of novel causative agents is crucial to evaluation and management of patients with idiopathic anaphylaxis. Within the last 10 years several apparently separate observations were recognized to be related, all of which resulted from the development of antibodies to a carbohydrate moiety on proteins. Interestingly, the exposure differed from airborne allergens but was nevertheless capable of producing anaphylactic and hypersensitivity reactions. Our recent work has identified these responses as being due to a novel IgE antibody directed against a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose ("alpha-gal"). This review will present the historical summary of the identification of cetuximab hypersensitivity due to alpha-gal IgE and discuss the non-primate mammalian meat food allergy as well as current goals and directions of our research programs. SN - 1440-1592 UR - https://www.unboundmedicine.com/medline/citation/26666477/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1323-8930(15)00197-5 DB - PRIME DP - Unbound Medicine ER -