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Review
. 2013 Aug;13(4):354-9.
doi: 10.1097/ACI.0b013e3283624560.

Tick bites and red meat allergy

Scott P Commins  1 , Thomas A E Platts-Mills
Affiliations
Review

Tick bites and red meat allergy

Scott P Commins et al. Curr Opin Allergy Clin Immunol. 2013 Aug.

Abstract

Purpose of review: A novel form of anaphylaxis has been described that is due to IgE antibody (Ab) directed against a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose (alpha-gal). Ongoing work regarding the cause and distribution of this IgE response is reviewed.

Recent findings: Our recent work has identified a novel IgE Ab response that has been associated with two distinct forms of anaphylaxis: immediate-onset anaphylaxis during first exposure to intravenous cetuximab and delayed-onset anaphylaxis 3-6 h after ingestion of mammalian food products (e.g. beef and pork). Further studies strongly suggested that tick bites were a cause, if not the only significant cause, of IgE Ab responses to alpha-gal in the United States and internationally.

Summary: Large numbers of patients with IgE Ab to alpha-gal continue to be identified in the USA and globally. Clinicians should be aware of this IgE response as the reactions often appear to be idiopathic because of the significant delay between eating mammalian meat and the appearance of symptoms.

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Conflict of interest statement

Conflicts of interest

S.P.C. and T.A.E.P.-M. report ongoing support for IgE assays from Thermo Fisher. T.A.E.P.M. has a patent for the use of IgE assays to identify the risk of anaphylaxis with recombinant molecules. He is also a consultant to Viracor-IBT Laboratories.

Figures

FIGURE 1
FIGURE 1
Classification of the Arachnida, a class within the phylum Arthropoda. †Known to cause sensitization unrelated to alpha-gal. *Amblyomma americanum, Ixodes ricinus, and Ixodes holocyclus have been reported to induce IgE to alpha-gal. ‡Ixodes holocyclus and Argas reflexus have been associated with anaphylaxis at the time of a tick bite.
FIGURE 2
FIGURE 2
Change in total IgE and alpha-gal-specific IgE over the weeks following approximately 50 bites from larval ticks in a patient.
See this image and copyright information in PMC

References

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