The story of α-Gal in Germany and France begins with immediate-type allergies following the consumption of pork kidney. The aim of the present article is to outline the clinical spectrum of α-Gal-related food allergy and demonstrate how geographically local phenomena may be helpful in our understanding of this complex disease. According to the current state of knowledge, tick bites are ascribed a central role in the development of type-I sensitization to α-Gal. Reports of the regular occurrence of anaphylaxis due to techniques used to remove adult ticks of the Ixodes holocyclus species from the host are restricted to Australia. Local allergic reactions to tick bites are regularly reported on a global basis. g., cetuximab or gelatin-based colloids) and thirdly, by allergic reactions to tick bites. 1): Firstly, as a food allergy with type-I allergic reactions of typically delayed onset following the ingestion of mammalian meat and innards secondly, as drug allergy, particularly in the case of parenteral administration of drugs obtained from cells or tissue from mammals (e. The term α-Gal syndrome is clinically defined by three facets of this allergy ( Fig. α-Gal syndrome was recently proposed as a new term to better describe this novel disease that occurs worldwide. As a result, this disaccharide is immunogenic in humans. However, in the course of evolution, primates and humans have lost the enzyme required for α-Gal production, galactosyltransferase. α-Gal is a typical component of glycoproteins in mammals. The identification of immunoglobulin E (IgE)-mediated immediate-type reactions to the disaccharide galactose-α-1,3-galactose (α-Gal) fundamentally altered our understanding of the allergenic potential of carbohydrate structures and formed the starting point for further discoveries in the area of immediate-type allergy. However, clinical observations and challenge testing in this constellation reveal that individual sensitivity in α-Gal patients is highly variable and which broadens our basic understanding of α-Gal syndrome. This clinically distinct type of presentation can be explained using the concept of food-dependent exercise-induced anaphylaxis (FDEIA). The phenomenon of a delayed-onset immediate-type allergy with a latency of 3–6 h following ingestion of mammalian meat is considered pathognomonic for α-Gal syndrome. These allergic reactions manifest as classic immediate-type allergies with a typical latency of under 1 h. It was recently shown that immediate-type allergies to pork kidney and other mammalian innards belong to the spectrum of α-Gal syndrome. The main focus of the present article is on α-Gal as an eliciting allergen in food allergy. Its classification as a syndrome is proposed on the basis of its clinical relevance in three different fields of allergy: food, drugs, and tick bites. The term α-Gal syndrome describes a novel IgE-mediated immediate-type allergy to the disaccharide galactose-α-1,3-galactose (α-Gal).
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