, Volume 22, Issue 8, pp 559-561
Date: 06 Dec 2013

Tick bite induced IgE antibodies to alpha-gal and delayed anaphylactic reactions to mammalian derived foods

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Introduction and Background

Cross reactive carbohydrate determinants (CCD) on plant proteins are recognized as a target for IgE (immunoglobulin E) responses. However, in most cases IgE specific for these CCD are not associated with symptoms. In 2006, several oncology groups in the USA became aware that cetuximab was causing severe hypersensitivity reactions in a surprising number of patients [1]. Investigating these reactions, we showed that the patients who reacted had IgE specific for an oligosaccharide on the Fab (fragment, antigen binding) portion of the heavy chain. In collaboration with ImClone, it became clear that this epitope was galactose alpha-1, 3-galactose (alpha-gal) [2]. This sugar is a well-known blood group substance of the non-primate mammals [3]. Using the assay for IgE to alpha-gal we screened sera from the clinic and identified a group of patients who had repeated episodes of urticaria or anaphylaxis and who also had IgE to alpha-gal. In each case, the immediate cau

Conflicts of interest

These studies were supported by NIH/NIAID grants AI-20565, R21-1087985 and KO8-AI085190. Dr. Platts-Mills is in receipt of grant support from Phadia/Thermo Fisher and is a consultant to IBT/Viracor.