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Ann Allergy Asthma Immunol. 2019 Jun;122(6):598-602. doi: 10.1016/j.anai.2019.03.021. Epub 2019 Mar 26.

Galactose α-1,3-galactose phenotypes: Lessons from various patient populations.

Author information

1
Division of Paediatric Allergy, University of Cape Town, Cape Town, South Africa. Electronic address: Michael.levin@uct.ac.za.
2
Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden.
3
Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
4
Departments of Medicine & Pediatrics, University of North Carolina, Chapel Hill, North Carolina.
5
Department of Medicine, Division of Rheumatology, Allergy, and Immunology, University of North Carolina, Chapel Hill, North Carolina.
6
Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Virginia.
7
Allergy Unit, Piacenza Hospital, Piacenza, Italy.

Abstract

OBJECTIVE:

To review published studies on galactose α-1,3-galactose (α-gal), a carbohydrate epitope found on proteins and lipids in nonprimate mammals and present in foods (particularly organ or fat-rich red meat) and medications, where it causes delayed-onset and immediate-onset anaphylaxis.

DATA SOURCES:

A literature search for the terms galactose α-1,3-galactose and α-gal using PubMed and Embase was performed.

STUDY SELECTIONS:

Studies on α-gal were included in this review.

RESULTS:

Several species of ticks contain α-gal epitopes and possibly salivary adjuvants that promote high titer sensitization and clinical reactivity. Risk factors for α-gal syndrome include exposure to ticks of particular species. Age and sex differences seen in various cohorts possibly reflect the prevalence of these exposures that vary according to setting.

CONCLUSION:

The reason and mechanisms for delayed onset of food-related anaphylaxis and the preponderance of abdominal reactions are not clear but may involve the kinetics of allergen digestion and processing or immunologic presentation via a different mechanism from usual immediate-type food allergy.

PMID:
30922956
PMCID:
PMC6839685
[Available on 2020-06-01]
DOI:
10.1016/j.anai.2019.03.021
[Indexed for MEDLINE]

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