The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome.
The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome.
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DOI：
10.2147/itt.s276872
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发表时间：
2022
影响因子：
7.2
通讯作者：
中科院分区：
文献类型：
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阿尔法-半乳糖综合征是一种非传统的食物过敏，其特征是IgE介导的对半乳糖-α-1，3-半乳糖(α-GAL)的超敏反应，而不是对食物蛋白质的过敏反应。在这篇综述中，我们讨论了阿尔法-半乳糖综合征如何重塑我们目前对食物过敏发病机制的概念。甲型半乳糖免疫球蛋白E的发展与扁虱叮咬有关，尽管其他寄生虫可能会促进对甲型半乳糖的敏化。我们回顾了阿尔法-半乳糖综合征致敏和效应阶段所涉及的免疫细胞群，并描述了目前对摄取α-半乳糖过敏反应可延迟数小时的理解。我们回顾了阿尔法-半乳糖综合征的治疗基础，即避免，但也讨论了抗组胺药、肥大细胞稳定剂的使用，以及补充和替代疗法、生物制品和口服免疫疗法在治疗这种疾病中的新兴作用。阿尔法-盖尔综合征影响含有或源自哺乳动物产品的药物和医疗器械的安全性和耐受性，并影响远远超出食物选择的生活质量。
Alpha-gal syndrome is an unconventional food allergy, characterized by IgE-mediated hypersensitivity responses to the glycan galactose-alpha-1,3-galactose (alpha-gal) and not to a food-protein. In this review, we discuss how alpha-gal syndrome reframes our current conception of the mechanisms of pathogenesis of food allergy. The development of alpha-gal IgE is associated with tick bites though the possibility of other parasites promoting sensitization to alpha-gal remains. We review the immune cell populations involved in the sensitization and effector phases of alpha-gal syndrome and describe the current understanding of why allergic responses to ingested alpha-gal can be delayed by several hours. We review the foundation of management in alpha-gal syndrome, namely avoidance, but also discuss the use of antihistamines, mast cell stabilizers, and the emerging role of complementary and alternative therapies, biological products, and oral immunotherapy in the management of this condition. Alpha-gal syndrome influences the safety and tolerability of medications and medical devices containing or derived from mammalian products and impacts quality of life well beyond food choices.