Anaphylactic reactions to oligosaccharides in red meat: a syndrome in evolution.

Hana Saleh, Scott Embry, Andromeda Nauli, Seif Atyia, Guha Krishnaswamy
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引用次数: 61

Abstract

Objective: While most allergic responses to food are directed against protein epitopes and occur within 30 minutes of ingesting the allergen, recent studies suggest that delayed reactions may occur, sometimes mediated by IgE antibodies directed against carbohydrate moieties. The objective of this review is to summarize the clinical features and management of delayed hypersensitivity reactions to mammalian meat mediated by IgE antibodies to galactose-alpha 1,3-galactose (alpha-gal), an oligosaccharide.

Methods: A PubMed search was conducted with MeSH terms: galactosyl-(1,3) galactose, oligosaccharides, cetuximab, allergy/hypersensitivity, and anaphylaxis. Reported cases with alpha-gal-mediated reactions were reviewed. This research study was approved by the Institutional Review Board of East Tennessee State University.

Results: Thirty-two cases of adults presenting with red-meat induced allergy thought to be related to oligosaccharides have been reported in the literature so far, making this a rare and evolving syndrome. Most of these patients demonstrated delayed reactions to beef, as was seen in the case reported by us in this manuscript. IgE specific to alpha-gal was identified in most patients with variable response to skin testing with beef and pork. Inhibition studies in some cases showed that the IgE antibodies to beef were directed towards alpha-gal in the meat rather than the protein. The patients often reported history of tick bites, the significance of which is unclear at present. Reactions to cetuximab, a monoclonal antibody, are mediated by a similar mechanism, with IgE antibodies directed against an alpha-gal moiety incorporated in the drug structure.

Conclusion: Alpha-gal is an oligosaccharide recently incriminated in delayed anaphylactic reactions to mammalian meats such as to beef, pork, and lamb. It appears that anaphylactic reactions to the anti-cancer biological agent, cetuximab, may be linked mechanistically to the same process. More studies are required to understand the underlying molecular basis for these delayed reactions in specific, and their broader implications for host defense in general.

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对红肉中低聚糖的过敏反应:进化中的一种综合征。
目的:虽然大多数对食物的过敏反应是针对蛋白质表位的,并在摄入过敏原30分钟内发生,但最近的研究表明,延迟反应可能发生,有时由针对碳水化合物部分的IgE抗体介导。本文综述了由半乳糖- α 1,3-半乳糖(α -gal)寡糖IgE抗体介导的哺乳动物肉类迟发性超敏反应的临床特点和处理方法。方法:在PubMed上进行检索,检索词为:半乳糖-(1,3)半乳糖、低聚糖、西妥昔单抗、过敏/超敏反应和过敏反应。本文回顾了α -gal介导反应的报告病例。本研究由东田纳西州立大学机构审查委员会批准。结果:到目前为止,文献中已经报道了32例成人红肉过敏病例,这些病例被认为与低聚糖有关,这是一种罕见且不断发展的综合征。这些患者中的大多数表现出对牛肉的延迟反应,正如我们在这份手稿中报告的病例所看到的那样。在大多数对牛肉和猪肉皮肤试验有不同反应的患者中发现了α -gal特异性IgE。在某些情况下的抑制研究表明,针对牛肉的IgE抗体针对的是肉中的α -半乳糖而不是蛋白质。患者常报告蜱虫叮咬史,其意义目前尚不清楚。对西妥昔单抗(一种单克隆抗体)的反应是由类似的机制介导的,IgE抗体直接针对药物结构中的α -半乳糖片段。结论:α -半乳糖是一种寡糖,最近与哺乳动物肉类(如牛肉、猪肉和羊肉)的延迟性过敏反应有关。看来,对抗癌生物制剂西妥昔单抗的过敏反应可能与同一过程有机制联系。需要更多的研究来了解这些延迟反应的潜在分子基础,以及它们对宿主防御的广泛影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical and Molecular Allergy
Clinical and Molecular Allergy Medicine-Immunology and Allergy
CiteScore
8.20
自引率
0.00%
发文量
11
审稿时长
13 weeks
期刊介绍: Clinical and Molecular Allergy is an open access, peer-reviewed, online journal that publishes research on human allergic and immunodeficient disease (immune deficiency not related to HIV infection/AIDS). The scope of the journal encompasses all aspects of the clinical, genetic, molecular and inflammatory aspects of allergic-respiratory (Type 1 hypersensitivity) and non-AIDS immunodeficiency disorders. However, studies of allergic/hypersensitive aspects of HIV infection/AIDS or drug desensitization protocols in AIDS are acceptable. At the basic science level, this includes original work and reviews on the genetic and molecular mechanisms underlying the inflammatory response.
期刊最新文献
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