The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome
Jessica D Macdougall,1,2,* Kevin O Thomas,1,2,* Onyinye I Iweala1,2 1Department of Medicine, Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, Chapel Hill, NC, 27599, USA; 2Department of Pediatrics, University of North Carolina Food Allergy Initia...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-09-01
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| Series: | ImmunoTargets and Therapy |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-meat-of-the-matter-understanding-and-managing-alpha-gal-syndrome-peer-reviewed-fulltext-article-ITT |
| _version_ | 1798036064934297600 |
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| author | Macdougall JD Thomas KO Iweala OI |
| author_facet | Macdougall JD Thomas KO Iweala OI |
| author_sort | Macdougall JD |
| collection | DOAJ |
| description | Jessica D Macdougall,1,2,* Kevin O Thomas,1,2,* Onyinye I Iweala1,2 1Department of Medicine, Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, Chapel Hill, NC, 27599, USA; 2Department of Pediatrics, University of North Carolina Food Allergy Initiative, Division of Allergy and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA*These authors contributed equally to this workCorrespondence: Onyinye I Iweala, Department of Medicine, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB#7280, Chapel Hill, NC, 27599-7280, USA, Tel +1-984-974-2645, Fax +1-984-974-2660, Email onyinye.iweala@med.unc.eduAbstract: 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.Keywords: mammalian meat, red meat allergy, galactose-alpha-1, 3-galactose, tick |
| first_indexed | 2024-04-11T21:07:09Z |
| format | Article |
| id | doaj.art-b6fb02cbb83a4d91b41d770219b7683e |
| institution | Directory Open Access Journal |
| issn | 2253-1556 |
| language | English |
| last_indexed | 2024-04-11T21:07:09Z |
| publishDate | 2022-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | ImmunoTargets and Therapy |
| spelling | doaj.art-b6fb02cbb83a4d91b41d770219b7683e2022-12-22T04:03:15ZengDove Medical PressImmunoTargets and Therapy2253-15562022-09-01Volume 11375478283The Meat of the Matter: Understanding and Managing Alpha-Gal SyndromeMacdougall JDThomas KOIweala OIJessica D Macdougall,1,2,* Kevin O Thomas,1,2,* Onyinye I Iweala1,2 1Department of Medicine, Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, Chapel Hill, NC, 27599, USA; 2Department of Pediatrics, University of North Carolina Food Allergy Initiative, Division of Allergy and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA*These authors contributed equally to this workCorrespondence: Onyinye I Iweala, Department of Medicine, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB#7280, Chapel Hill, NC, 27599-7280, USA, Tel +1-984-974-2645, Fax +1-984-974-2660, Email onyinye.iweala@med.unc.eduAbstract: 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.Keywords: mammalian meat, red meat allergy, galactose-alpha-1, 3-galactose, tickhttps://www.dovepress.com/the-meat-of-the-matter-understanding-and-managing-alpha-gal-syndrome-peer-reviewed-fulltext-article-ITTmammalian meatred meat allergygalactose-alpha-13-galactosetick |
| spellingShingle | Macdougall JD Thomas KO Iweala OI The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome ImmunoTargets and Therapy mammalian meat red meat allergy galactose-alpha-1 3-galactose tick |
| title | The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome |
| title_full | The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome |
| title_fullStr | The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome |
| title_full_unstemmed | The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome |
| title_short | The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome |
| title_sort | meat of the matter understanding and managing alpha gal syndrome |
| topic | mammalian meat red meat allergy galactose-alpha-1 3-galactose tick |
| url | https://www.dovepress.com/the-meat-of-the-matter-understanding-and-managing-alpha-gal-syndrome-peer-reviewed-fulltext-article-ITT |
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