The alpha-gal story: Lessons learned from connecting the dots

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Presentation transcript:

The alpha-gal story: Lessons learned from connecting the dots John W. Steinke, PhD, Thomas A.E. Platts-Mills, MD, PhD, FRS, Scott P. Commins, MD, PhD Journal of Allergy and Clinical Immunology Volume 135, Issue 3, Pages 589-596 (March 2015) DOI: 10.1016/j.jaci.2014.12.1947 Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Carbohydrate structure of N-linked glycans on the Fab portion of cetuximab, as determined by using mass spectrometry. Alpha-gal (red), mannose (blue), N-acetylglucosamine (green), and N-glycolyl neuraminic acid (black) are shown. Percentages represent the proportion of the indicated structures found on the Fab region of cetuximab. Adapted from Qian et al.11 Journal of Allergy and Clinical Immunology 2015 135, 589-596DOI: (10.1016/j.jaci.2014.12.1947) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Relationship of IgE to alpha-gal with IgE to Amblyomma americanum (lone star tick). Levels of specific IgE to alpha-gal and A americanum were measured by using ImmunoCAP, and the correlation between the 2 types of IgE was determined by using Spearman correlation (rs = 0.66, P < .001). Journal of Allergy and Clinical Immunology 2015 135, 589-596DOI: (10.1016/j.jaci.2014.12.1947) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Summary of alpha-gal sensitization leading to clinical symptoms of red meat allergy. The southeastern section of the United States is where most of the reactions to red meat have been reported. This region overlaps with the distribution of the lone star tick. The current hypothesis is that persons are bitten by lone star ticks carried by deer into rural and urban areas. After a period of time, IgE to alpha-gal develops. Once IgE to alpha-gal reaches sufficient levels, ingestion of red meat can trigger reactions. Several of the images used in this figure are licensed under a Creative Commons CC BY-NC 2.0 (Attribution-NonCommercial 2.0 Generic) license (Cow: https://flic.kr/p/adgjhp by user Plashing Vole; Deer: https://flic.kr/p/jeZwq7 by user Cherry Bream; Sheep: https://flic.kr/p/4WirD by user Lauren; Tick: https://flic.kr/p/cdnNaY by user Katja Schulz; Pig: https://flic.kr/p/N7gpc by user Anne). Journal of Allergy and Clinical Immunology 2015 135, 589-596DOI: (10.1016/j.jaci.2014.12.1947) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions