Investigation into the α-Gal Syndrome: Characteristics of 261 Children and Adults Reporting Red Meat Allergy
Investigation into the α-Gal Syndrome: Characteristics of 261 Children and Adults Reporting Red Meat Allergy
复制标题
DOI：
10.1016/j.jaip.2019.03.031
复制
发表时间：
2019-09-01
影响因子：
9.4
通讯作者：
Platts-Mills, Thomas A. E.
中科院分区：
文献类型：
--
作者：
Wilson, Jeffrey M.;Schuyler, Alexander J.;Platts-Mills, Thomas A. E.
背景技术背景：红肉过敏在历史上被认为是一种罕见的特应性儿童疾病，但“α-Gal综合征”的发现，这涉及到低聚糖半乳糖-α-1，3-半乳糖的IgE目的：描述一大群自我报告对哺乳动物肉类过敏的受试者的临床和免疫学特征。方法：这是一项对261名儿童和成人（范围，5-82岁）进行的观察性研究，他们对哺乳动物肉类过敏反应进行了评价。结果：在245名受试者中检测到α-Gal特异性IgE >= 0.35 IU/mL，211名（81%）在食用哺乳动物肉后>= 2小时出现症状。成分检测支持95%的α-Gal综合征诊断，1.9%的猪-猫综合征，1.1%的原发性牛肉过敏。93%报告荨麻疹，60%报告过敏反应，64%报告胃肠道症状。在报告早发性或迟发性症状的受试者中，以及在有和没有过敏反应的受试者中，α-Gal特异性IgE和IgG水平相似。α-Gal特异性IgE水平和反应的严重程度在有和没有传统的特应性，儿童（n = 35）和成人（n = 226）之间相似。血型B倾向于在α-半乳糖致敏受试者中代表性不足;然而，α-半乳糖特异性IgE滴度在B抗原有症状的病例中很高。结论：α-半乳糖综合征是一种区域性常见的食物过敏形式，具有特征性但不普遍的症状发作延迟，包括胃肠道症状，可在生命中的任何时间发展，在其他非特应性个体中同样常见。(C)2019由Elsevier Inc.出版美国过敏、哮喘和免疫学会（American Academy of Allergy，Asthma & Immunology）
BACKGROUND: Red meat allergy has historically been understood as a rare disease of atopic children, but the discovery of the "alpha-Gal syndrome," which relates to IgE to the oligosaccharide galactose-alpha-1,3-galactose (alpha-Gal), has challenged that notion.OBJECTIVE: To describe the clinical and immunologic characteristics of a large group of subjects with self-reported allergy to mammalian meat.METHODS: This was an observational study of 261 children and adults (range, 5-82 years) who presented for evaluation for allergic reactions to mammalian meat. Results were based on serum assays and a detailed questionnaire.RESULTS: alpha-Gal specific IgE >= 0.35 IU/mL was detected in 245 subjects and symptom onset occurred >= 2 hours after eating mammalian meat in 211 (81%). Component testing supported a diagnosis of alpha-Gal syndrome in 95%, pork-cat syndrome in 1.9%, and primary beef allergy in 1.1%. Urticaria was reported by 93%, anaphylaxis by 60%, and gastrointestinal symptoms by 64%. Levels of IgE and IgG specific to alpha-Gal were similar in subjects who reported early-or delayed-onset symptoms, and in those with and without anaphylaxis. Levels of alpha-Gal specific IgE and severity of reactions were similar among those with and without traditional atopy, and among children (n = 35) and adults (n = 226). Blood group B trended toward being under-represented among alpha-Gal-sensitized subjects; however, alpha-Gal specific IgE titers were high in symptomatic cases with B-antigen.CONCLUSIONS: The alpha-Gal syndrome is a regionally common form of food allergy that has a characteristic but not universal delay in symptom onset, includes gastrointestinal symptoms, can develop at any time in life, and is equally common in otherwise nonatopic individuals. (C) 2019 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology