Current Allergy and Asthma Reports

, Volume 13, Issue 1, pp 72–77 | Cite as

Delayed Anaphylaxis to Red Meat in Patients with IgE Specific for Galactose alpha-1,3-Galactose (alpha-gal)

ANAPHYLAXIS AND DRUG ALLERGY (P LIEBERMAN AND S SPECTOR, SECTION EDITORS)

Abstract

Anaphylaxis is a severe allergic reaction that can be rapidly progressing and fatal. In instances where the triggering allergen is not known, establishing the etiology of anaphylaxis is pivotal to long-term risk management. Our recent work has identified a novel IgE antibody (Ab) response to a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose (alpha-gal), that has been associated with two distinct forms of anaphylaxis: (1) immediate onset anaphylaxis during first exposure to intravenous cetuximab, and (2) delayed onset anaphylaxis 3–6 h after ingestion of mammalian food products (e.g., beef and pork). The results of our studies strongly suggest that tick bites are a cause, if not the only significant cause, of IgE Ab responses to alpha-gal in the southern, eastern and central United States. Patients with IgE Ab to alpha-gal continue to emerge and, increasingly, these cases involve children. This IgE Ab response cross-reacts with cat and dog but does not appear to pose a risk for asthma; however, it may impair diagnostic testing in some situations.

Keywords

Anaphylaxis Delayed anaphylaxis Alpha-gal Galactose Food allergy IgE Mammalian meat Tick bites Asthma Red meat 

Abbreviations

alpha-gal

galactose-α-1,3-galactose

Ab

antibody

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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Scott P. Commins
    • 2
    • 3
  • Thomas A. E. Platts-Mills
    • 1
    • 3
  1. 1.Department of Internal Medicine, Division of Allergy and ImmunologyUniversity of Virginia Health SystemCharlottesvilleUSA
  2. 2.Department of Internal Medicine & Pediatrics, Division of Allergy and ImmunologyUniversity of Virginia Health SystemCharlottesvilleUSA
  3. 3.Division of Allergy, Asthma, and ImmunologyUniversity of Virginia Health SystemCharlottesvilleUSA

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