A dynamic relationship between two regional causes of IgE-mediated anaphylaxis: ?-Gal syndrome and imported fire ant - 04/02/21
Abstract |
Background |
A syndrome of mammalian meat allergy relating to IgE specific for galactose-α–1,3-galactose (α-Gal) was first reported 10 years ago in the southeastern United States and has been related to bites of the lone star tick (Amblyomma americanum).
Objective |
Here we investigated the epidemiology of the “α-Gal syndrome” in the United States and sought additional evidence for the connection to tick bites.
Methods |
A survey of allergists was conducted by using a snowball approach. A second tier of the survey included questions about anaphylaxis to imported fire ants (IFAs). History of tick bites and tick-related febrile illness were assessed as part of a case-control study in Virginia. Antibody assays were conducted on sera from subjects reporting allergic reactions to mammalian meat or IFA.
Results |
In North America the α-Gal syndrome is recognized across the Southeast, Midwest, and Atlantic Coast, with many providers in this area managing more than 100 patients each. The distribution of cases generally conformed to the reported range of A americanum, although within this range there was an inverse relationship between α-Gal cases and cases of IFA anaphylaxis that were closely related to the territory of IFA. The connection between tick bites and α-Gal sensitization was further supported by patients' responses to a questionnaire and the results of serologic tests.
Conclusions |
The α-Gal syndrome is commonly acquired in adulthood as a consequence of tick bites and has a regional distribution that largely conforms to the territory of the lone star tick. The epidemiology of the syndrome is expected to be dynamic and shifting north because of climate change and ecologic competition from IFA.
Le texte complet de cet article est disponible en PDF.Key words : Tick, galactose-α-1,3-galactose, mammalian meat allergy, α-Gal syndrome, IgE, anaphylaxis, imported fire ant
Abbreviations used : A americanum, α-Gal, IFA, RMSF, SFG, UVA
Plan
| Supported by the National Institutes of Health (grant NIH R37 AI-20565 [to T.P.M.]). |
|
| Disclosure of potential conflict of interest: T.A.E. Platts-Mills and T. Merritt have a patent on an IgE assay to α-Gal, and T. Platts-Mills has received assay support from Thermo Fisher/Phadia. J. Wilson has received research support from Thermo Fisher/Phadia. S. Commins has been on the speaker’s bureau for Genentech. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 147 - N° 2
P. 643 - février 2021 Retour au numéro
Article précédent
- Cardiovascular changes during peanut-induced allergic reactions in human subjects
- Monica Ruiz-Garcia, Joan Bartra, Olaya Alvarez, Ashna Lakhani, Shalinee Patel, Alistair Tang, Marcus Sim, Mohamed H. Shamji, Isabel Skypala, E. N. Clare Mills, Alexander R. Lyon, Carl Hayward, Stephen R. Durham, Paul J. Turner, Robert J. Boyle
- Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry
- Wojciech Francuzik, Franziska Ruëff, Andrea Bauer, Maria Beatrice Bilò, Victoria Cardona, George Christoff, Sabine Dölle-Bierke, Luis Ensina, Montserrat Fernández Rivas, Thomas Hawranek, Jonathan O'B Hourihane, Thilo Jakob, Nicos G. Papadopoulos, Claudia Pföhler, Iwona Poziomkowska-G?sicka, Xavier Van der Brempt, Kathrin Scherer Hofmeier, Regina Treudler, Nicola Wagner, Bettina Wedi, Margitta Worm
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?