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
. 2025 Jan;80(1):297-308.
doi: 10.1111/all.16360. Epub 2024 Oct 23.

Increasing prevalence of galactose-α-1,3-galactose sensitization in the Danish general adult population

Katja Biering Leth-Møller  1 , Marianne van Hage  2   3 , Danijela Apostolovic  2   3 , Jennifer Astrup Sørensen  4 , Christian Vestergaard  5 , Flemming Madsen  1 , Lene Jung Kjær  6 , Torben Hansen  7 , Anna Jonsson  7 , Simon Francis Thomsen  4   8 , Allan Linneberg  1   9
Affiliations

Increasing prevalence of galactose-α-1,3-galactose sensitization in the Danish general adult population

Katja Biering Leth-Møller et al. Allergy. 2025 Jan.

Abstract

Background: Alpha-gal syndrome is a novel food allergy to the oligosaccharide galactose-α-1,3-galactose (alpha-gal) present in mammalian meat. Tick bites are considered an important route of sensitization to alpha-gal. Data on alpha-gal sensitization in the general population is scant. We utilized a unique data source of repeated population-based health examination studies to assess prevalence, time trends, risk factors, and characteristics of alpha-gal sensitization.

Methods: Alpha-gal sensitization was assessed in >11.000 adults from four health examination studies of randomly invited residents in the Copenhagen region conducted in 1990-1991, 2011-2012, 2012-2015, and 2016-2017. Alpha-gal sensitization was defined as serum specific IgE (sIgE) to alpha-gal ≥0.1 kUA/L; ≥0.35 kUA/L; ≥0.7 kUA/L; ≥3.5 kUA/L. The population was characterized according to genetically determined ABO blood group, aeroallergen sensitization, and pets at home.

Results: The prevalence of sIgE to alpha-gal ≥0.1 kUA/L was 1.3% in 1990-1991, 3.7% in 2012-2015 and 3.2% in 2016-2017. Of those sensitized to alpha-gal >97% reported to consume red meat at least once a week, even for sIgE to alpha-gal ≥3.5 kUA/L. Male sex, older age, aeroallergen sensitization, cat at home, and blood group A were associated with increased odds of alpha-gal sensitization. The known protective effect of blood group B was confirmed.

Conclusion: In this general adult population, the prevalence of alpha-gal sensitization had doubled from 1990-1991 to 2016-2017. This could potentially be due to increased tick exposure and an increased atopic predisposition.

Keywords: alpha‐gal syndrome; blood group a; epidemiology; galactose‐alpha‐1,3‐galactose; red meat allergy; tick bites.

PubMed Disclaimer

Conflict of interest statement

Katja Biering Leth‐Møller has received a lecture fee from Thermo Fisher Scientific. Marianne van Hage has received lecture fees from Thermo Fisher Scientific and Astra Zeneca outside the submitted work. Christian Vestergaard has received speaker honorarium/participated in Add Borads/been investigator for Abbvie, Pfizer, Sanofi, Leo Pharma, OM pharma, Pierre Fabre, Almirall, Astra Zeneca, Eli Lilly, Novartis. Flemming Madsen has received a travel grant from Orion Pharma. With no relation to the present manuscript, Simon Francis Thomsen has received research support from Janssen, LEO Pharma, Novartis, Sanofi and UCB, and has been a speaker/consultant for Abbvie, Almirall, Eli Lilly, Janssen, LEO Pharma, Novartis, Pfizer, Sanofi, Symphogen, UCB, and Union therapeutics. Danijela Apostolovic, Jennifer Astrup Sørensen, Lene Jung Kjær, Torben Hansen, Anna Jonsson, and Allan Linneberg and have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Correlations between IgE levels (sIgE) to alpha‐gal and to (A) beef, (B) pork, (C) lamb, (D) cow's milk, (E) cat, and (F) grass among participants with sIgE alpha‐gal >0.1 kUA/L. IgE levels are plotted on a logarithmic scale with 0.01 added to all values to include IgE values of 0. The strength and direction of the correlation is expressed as Spearman's rank correlation coefficient.
FIGURE 2
FIGURE 2
Crude prevalence and 95% confidence interval of alpha‐gal sensitization by time of assessment (participation in the health examination study) at different cut‐offs of specific IgE (sIgE) alpha‐gal.
See this image and copyright information in PMC

References

    1. Commins SP, Satinover SM, Hosen J, et al. Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose‐alpha‐1,3‐galactose. J Allergy Clin Immunol. 2009;123(2):426‐433. doi:10.1016/j.jaci.2008.10.052 - DOI - PMC - PubMed
    1. Thompson J, Carpenter A, Kersh G, Wachs T, Commins S, Salzer J. Geographic distribution of suspected alpha‐gal syndrome cases—United States, January 2017–December 2022. MMWR Morb Mortal Wkly Rep. 2023;72:815‐820. 10.15585/mmwr.mm7230a2 - DOI - PMC - PubMed
    1. Commins SP, James HR, Kelly LA, et al. The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose‐alpha‐1,3‐galactose. J Allergy Clin Immunol. 2011;127(5):1286‐1293. doi:10.1016/j.jaci.2011.02.019 - DOI - PMC - PubMed
    1. Kiewiet MBG, Apostolovic D, Starkhammar M, Grundstrom J, Hamsten C, van Hage M. Clinical and serological characterization of the alpha‐gal syndrome‐importance of atopy for symptom severity in a European cohort. J Allergy Clin Immunol Pract. 2020;8(6):2027‐2034. doi:10.1016/j.jaip.2020.02.016 - DOI - PubMed
    1. Apostolovic D, Rodrigues R, Thomas P, Starkhammar M, Hamsten C, van Hage M. Immunoprofile of alpha‐gal‐ and B‐antigen‐specific responses differentiates red meat‐allergic patients from healthy individuals. Allergy. 2018;73(7):1525‐1531. doi:10.1111/all.13400 - DOI - PubMed

Supplementary concepts