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Wagner, N., Jappe, U., Podda, M. and Hartmann, K. (2012). Anaphylaxis to red meat: galactose-alpha-1,3-galactose (alpha-Gal) - an interesting allergen. Allergologie, 35 (11). S. 559 - 563. DEISENHOFEN-MUENCHEN: DUSTRI-VERLAG DR KARL FEISTLE. ISSN 0344-5062

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Abstract

Anaphylaxis to red meat: galactose-alpha-1,3-galactose (alpha-Gal) - an interesting allergen Meat allergy comprises symptoms as contact dermatitis, rhinitis/allergic asthma, urticaria and severe anaphylaxis. Clinical manifestations may occur in both, children and adults. Different routes of sensitization are hypothesized. Few meat allergens have been identified so far, some of them only poorly characterized. Galactose-alpha-1,3-galactose (alpha-Gal), a carbohydrate structure expressed on cells and tissues of non-primate mammals was shown to be the culprit allergen for hypersensitivity reactions only to red meat (i.e. pork, beef, lamb etc.). Symptoms develop characteristically in adults with a delay of 3 to 10 hours after consuming red meat. IgE-mediated allergy to alpha-Gal may, therefore, be one so far unidentified cause of idiopathic anaphylaxis. Interestingly, alpha-Gal was first identified as allergenic epitope causing of hypersensitivity reactions to cetuximab. Cetuximab is a monoclonal chimeric antibody, approved for therapy of metastasizing EGFR-expressing colon carcinoma and squamous cell carcinoma of head and neck, which is produced in a mouse myeloma cell line, resulting in expression of alpha-Gal on the fab-region of cetuximab, binding IgE antibodies specific for alpha-Gal. Anaphylaxis to cetuximab is reported to occur overall in 3% of patients. In certain geographic areas of the USA, however, incidence of alpha-Gal-associated hypersensitivity to cetuximab seems to be much higher. It could be shown that the sting of an endemic tick, Amblyomma americanum, can induce the production of IgE-antibodies to alpha-Gal and might, therefore, explain geographic differences in sensitization to alpha-Gal. As a commercial test for IgE-antibodies to alpha-Gal is now available, patients should be tested for pre-existing antibodies before the first application of cetuximab.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wagner, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jappe, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Podda, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartmann, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-479452
DOI:	10.5414/ALX01518
Journal or Publication Title:	Allergologie
Volume:	35
Number:	11
Page Range:	S. 559 - 563
Date:	2012
Publisher:	DUSTRI-VERLAG DR KARL FEISTLE
Place of Publication:	DEISENHOFEN-MUENCHEN
ISSN:	0344-5062
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MONOCLONAL-ANTIBODY THERAPY; INFUSION REACTIONS; FOOD ALLERGY; CETUXIMAB; ASSOCIATION; INTOLERANCE; FREQUENCY Multiple languages Allergy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47945