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. 2023 Jul 1;118(7):1276-1281.
doi: 10.14309/ajg.0000000000002219. Epub 2023 Feb 16.

Alpha-Gal Sensitization in a US Screening Population Is Not Associated With a Decreased Meat Intake or Gastrointestinal Symptoms

Sarah K McGill  1 , Scott P Commins  2 , Anne F Peery  1 , Joseph Galanko  1 , Temitope O Keku  1 , Nicholas J Shaheen  1 , Chelsea Anderson  1 , Robert S Sandler  1
Affiliations

Alpha-Gal Sensitization in a US Screening Population Is Not Associated With a Decreased Meat Intake or Gastrointestinal Symptoms

Sarah K McGill et al. Am J Gastroenterol. .

Abstract

Introduction: Patients with alpha-gal syndrome, a delayed reaction to mammalian meat, can present with isolated gastrointestinal (GI) symptoms. We aimed to estimate the frequency of alpha-gal sensitization in a Southeastern US population and determine the association between sensitization and mammalian product dietary intake or GI symptoms.

Methods: We performed a cross-sectional study of participants who underwent a screening colonoscopy at our center between 2013 and 2015. We quantified serum alpha-gal immunoglobulin E antibodies in participants who were prospectively enrolled at screening colonoscopy and compared diet intake and lower GI symptoms reported in standardized questionnaires among those with elevated versus no alpha-gal IgE antibodies.

Results: Alpha-gal IgE antibodies were common-31.4% of screening colonoscopy participants (127 of 404) had elevated serum alpha-gal IgE >0.1 kU/L. Alpha-gal-sensitized participants endorsed similar rates of abdominal pain compared with those without alpha-gal antibodies (33% vs 38%, adjusted odds ratio 0.9, 95% confidence interval 0.7-1.3). Mammalian meat consumption did not differ based on alpha-gal sensitization status (average 1.43 servings/d in sensitized subjects vs 1.50 in alpha-gal IgE-negative subjects, P = 0.9). Alpha-gal-sensitized participants with levels ≥10 (n = 21) were overrepresented in the lowest quartiles of mammalian meat consumption, but not among those with GI symptoms in general. Participants with high alpha-gal antibody levels >2 kU/L (n = 45) or ≥10 U/L (n = 21) did not have a reduced mean daily mammalian meat intake compared with seronegative people.

Discussion: Elevated alpha-gal IgE antibodies were common and not associated with a reduced mammalian meat intake, abdominal pain, or diarrhea. Seropositivity did not predict symptomatic alpha-gal sensitization in this general screening population. Other host factors likely contribute to the phenotypic expression of alpha-gal syndrome.

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Conflict of interest statement

The following authors report that they have no disclosures relevant to this publication: SKM, AFP, TOK, JG, NJS, RS. SPC discloses: research support from the NIH and CDC and author royalties from Uptodate.

Figures

Figure 1.
Figure 1.
Dietary intake of alpha-gal-containing foods among alpha-gal IgE+ (n=127) and negative (n=277) individuals.
See this image and copyright information in PMC

References

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    1. Croglio MP, Commins SP, McGill SK. Isolated Gastrointestinal Alpha-gal Meat Allergy Is a Cause for Gastrointestinal Distress Without Anaphylaxis. Gastroenterology 2021;160:2178–2180 e1. - PMC - PubMed

Publication types

Supplementary concepts