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Delayed Anaphylaxis Involving IgE to Galactose-alpha-1,3-galactose

  • Basic and Applied Science (M Frieri and PJ Bryce, Section Editors)
  • Published:
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Abstract

Hypersensitivity in the allergic setting refers to immune reactions, stimulated by soluble antigens that can be rapidly progressing and, in the case of anaphylaxis, are occasionally fatal. As the number of known exposures associated with anaphylaxis is limited, identification of novel causative agents is important in facilitating both education and other allergen-specific approaches that are crucial to long-term risk management. Within the last 10 years, several seemingly separate observations were recognized to be related, all of which resulted from the development of antibodies to a carbohydrate moiety on proteins where exposure differed from airborne allergens but which were nevertheless capable of producing anaphylactic and hypersensitivity reactions. Our recent work has identified these responses as being due to a novel IgE antibody directed against a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose (alpha-gal). This review will present the history and biology of alpha-gal and discuss our current approach to management of the mammalian meat allergy and delayed anaphylaxis.

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Abbreviations

Ab:

Antibody

EGFR:

Epidermal growth factor receptor

Fab:

Fragment antigen binding

Fc:

Fragment crystallizable

Alpha-gal:

Galactose-α-1,3-galactose

RMSF:

Rocky Mountain spotted fever

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgments

These studies are primarily funded by NIH grants: K08-AI-1085190.

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Scott Commins declares that he is a consultant to Sanofi, receives fees from Genentech, and receives royalties from UpToDate. Thomas Platt-Mills declares a grant from NIH-NIAID. Alexander J. Schuyler and Alice Hoyt declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Internal Medicine, Divisions of Allergy, Asthma and Immunology, University of Virginia Health System, PO Box 801355, Charlottesville, VA, 22908, USA

    Thomas A. E. Platts-Mills, Alexander J. Schuyler, Alice E. W. Hoyt & Scott P. Commins

  2. Department of Pediatrics, Division of Gastroenterology, University of Virginia Health System, PO Box 801355, Charlottesville, VA, 22908, USA

    Scott P. Commins

Authors
  1. Thomas A. E. Platts-Mills
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  2. Alexander J. Schuyler
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  3. Alice E. W. Hoyt
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  4. Scott P. Commins
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Correspondence to Scott P. Commins.

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This article is part of the Topical Collection on Basic and Applied Science

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Platts-Mills, T.A.E., Schuyler, A.J., Hoyt, A.E.W. et al. Delayed Anaphylaxis Involving IgE to Galactose-alpha-1,3-galactose. Curr Allergy Asthma Rep 15, 12 (2015). https://doi.org/10.1007/s11882-015-0512-6

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  • DOI: https://doi.org/10.1007/s11882-015-0512-6

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