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Review
. 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

Michael Levin  1 , Danijela Apostolovic  2 , Tilo Biedermann  3 , Scott P Commins  4 , Onyinye I Iweala  5 , Thomas A E Platts-Mills  6 , Eleonora Savi  7 , Marianne van Hage  2 , Jeffrey M Wilson  6
Affiliations
Review

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

Michael Levin et al. Ann Allergy Asthma Immunol. 2019 Jun.

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.

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References

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Supplementary concepts