Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec;78(12):3241-3251.
doi: 10.1111/all.15840. Epub 2023 Aug 7.

Oral immunotherapy in alpha-gal red meat allergy: Could specific IgE be a potential biomarker in monitoring management?

D Ünal  1 , D Eyice-Karabacak  1 , A Kutlu  2 , S Demir  1 , C Tüzer  1 , A F Arslan  1 , S R Işık  3 , A Gelincik  1
Affiliations

Oral immunotherapy in alpha-gal red meat allergy: Could specific IgE be a potential biomarker in monitoring management?

D Ünal et al. Allergy. 2023 Dec.

Abstract

Background: Oral immunotherapy (OIT) is a promising treatment for food allergies. Our aim was to establish the long-term safety and efficacy of a novel red meat (RM) OIT in galactose-alpha-1,3-galactose (alpha-gal) allergy in adults.

Methods: Out of 20 patients with confirmed RM allergy, five (41.66%) underwent an early OIT, seven (58.33%) underwent a delayed protocol and eight patients who were not desensitized formed the patient control group. 15 and 27 day RM OIT for early-onset and delayed-onset alpha-gal allergy were administered, respectively. Desensitized patients were recommended to continue eating at least 100 g RM every day for 6 months and every other day in the following 6 months. After a year, the consumption was recommended 2/3 times in a week. Patients were followed up with skin tests with commercial beef and lamb extracts, fresh raw/cooked beef and lamb and cetuximab and also with serum alpha-gal specific Immunoglobulin-E (sIgE) in the first and fifth years.

Results: All patients who underwent OIT became tolerant to RM. During the 5 year follow-up, the median alpha-gal sIgE concentration gradually decreased in nine patients who consumed RM uneventfully while remained unchanged in the control group (p = .016). In two patients, rare tick bites acted as inducers of hypersensitivity reactions with concomitant elevation of alpha-gal sIgE concentrations whereas one patient with low follow-up alpha-gal sIgE concentrations consumed RM uneventfully after frequent tick bites.

Conclusions: Our study showed the long-term safety and efficacy of alpha-gal OIT. Additionally, alpha-gal sIgE seems to be a potential biomarker to monitor OIT.

Keywords: alpha-gal allergy; delayed-onset; early-onset; long-term efficacy; oral immunotherapy.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Román-Carrasco P, Hemmer W, Cabezas-Cruz A, Hodžic A, de la Fuente J, Swoboda I. The α-gal syndrome and potential mechanisms. Front Allergy. 2021;16(2):783279.
    1. Sharma SR, Karim S. Tick saliva and the alpha-gal syndrome: finding a needle in a haystack. Front Cell Infect Microbiol. 2021;20(11):68026.
    1. Platts-Mills TAE, Li RC, Keshavarz B, Smith AR, Wilson JM. Diagnosis and management of patients with the α-gal syndrome. J Allergy Clin Immunol Pract. 2020;8(1):15-23.
    1. Steinke JW, Pochan SL, James HR, Platts-Mills TAE, Commins SP. Altered metabolic profile in patients with IgE to galactose-alpha-1,3-galactose following in vivo food challenge. J Allergy Clin Immunol. 2016;138(5):1465-1467.
    1. Platts-Mills TAE, Schuyler AJ, Tripathi A, Commins SP. Anaphylaxis to the carbohydrate side chain alpha-gal. Immunol Allergy Clin North Am. 2015;35(2):247-260.

Supplementary concepts

LinkOut - more resources