Allergy Asthma Immunol Res.  2015 Jan;7(1):92-94. 10.4168/aair.2015.7.1.92.

Delayed Anaphylaxis to Red Meat Associated With Specific IgE Antibodies to Galactose

• Wen L
• Zhou J
• Yin J
• Sun JL
• Sun Y
• Wu K
• Katial R

• KMID: 2260158
• DOI: http://doi.org/10.4168/aair.2015.7.1.92

Abstract

A novel delayed anaphylactic reaction to red meat, associated with tick bites and IgE antibodies against galactose-alpha-1, 3-galactose (alpha-gal), was reported in 2009 in the US, Australia and Europe. In this case, serum specific IgE to galactose-alpha-1, 3-galactose (>100 kU/L) and IgE to multiple non-primate mammalian proteins were positive. However, the pathogenesis of this disease remains unclear. We report the first case in Asia of delayed anaphylactic reaction to red meat, which was induced by bites from the hard tick, Hematophagous ixodidae. We confirmed the increased concentration of IgE reactive epitopes in non-primate mammalian organs, which may be rich in alpha-gal proteins in lymphatic and endothelial tissues. All confirmed ticks associated with this disorder in the literature and in our case belonged to the hard tick family. We hypothesize that hard tick saliva is enriched with blood-type substances, such as oligosaccharides, from the non-primate mammal victim's blood after days to weeks of blood sucking, which sensitizes humans through the injection route while blood sucking.

Keyword

Food allergy; anaphylaxis; red meat allergy; tick

MeSH Terms

Anaphylaxis*
Antibodies*
Asia
Australia
Epitopes
Europe
Food Hypersensitivity
Galactose*
Humans
Immunoglobulin E*
Ixodidae
Mammals
Meat*
Oligosaccharides
Saliva
Tick Bites
Ticks
Antibodies
Epitopes
Galactose
Immunoglobulin E
Oligosaccharides

Figure

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  Fig. 1 Positive intracutaneous test to cow's milk, pork, beef and lamb (arrows).

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  Fig. 2 Western blot analysis of the antigen-binding characteristics of serum specific IgE antibodies with pork, organs and bovine thyroglobulin using sera from the patient and a negative control. Lane M: molecular weight markers. Lane A1, B1, C1, D1, E1, F1, G1: protein profiles of pork extracts, porcine liver, porcine intestines, porcine kidney, bovine kidney, bovine heart, and bovine thyroglobulin, respectively (Amido Black 10B staining of the blotted membrane following SDS-PAGE performed on a 12.5% polyacrylamide gel with 20 µg of sample in each lane). Lanes A2, B2, C2, D2, E2, F2, G2: Immunoblotting patterns of protein extracts using negative control serum in accordance with the above order. A3, B3, C3, D3, E3, F3, G3: Immunoblotting patterns of protein extracts with the patient serum in accordance with the above order.

• 

  Fig. 3 (A) The adult tick captured from the patient's outdoor dog. (B) Tick under the microscope.

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