Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete •
In the world of allergology, alpha-gal syndrome remains one of the most fascinating discoveries over the last 15 years as it is triggered by specific IgE directed against the immunogenic sugar galactose-α‑1,3‑galactose (alpha-gal), found foremost in mammalian meat, milk and products derived thereof, potentially resulting in anaphylaxis. Also, mammalian-derived drugs and medical products have been identified as possible culprits. Nonetheless, tick bites remain the major cause of specific alpha-gal-sIgE. Herein, we summarize the current clinical knowledge and pathophysiology of alpha-gal syndrome in order to better understand this disease.
Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete •
Delayed immediate-type allergy to innards and red meat can be mediated by IgE antibodies to galactose-α-1, 3-galactose (α-Gal). Apart from humans and Old World apes, α-Gal is ubiquitously expressed in glycoproteins and glycolipids. Thus, as α-Gal is immunogenic for humans, they can be easily sensitized even through a tick bite. Anti-α-Gal IgG represents approximately 1% of total IgG; IgE antibodies to α-Gal are comparably rare. However, in these patients, consuming red meat and especially innards can lead to the development of immediate type reactions such as urticaria. Cetuximab is a humanized IgG1 antibody containing murine α-Gal. Therefore, allergic reactions may occur with its first administration.