Background

A syndrome of mammalian meat allergy relating to IgE specific for galactose-α–1,3-galactose (α-Gal) was first reported 10 years ago in the southeastern United States and has been related to bites of the lone star tick (Amblyomma americanum).

Objective

Here we investigated the epidemiology of the “α-Gal syndrome” in the United States and sought additional evidence for the connection to tick bites.

Methods

A survey of allergists was conducted by using a snowball approach. A second tier of the survey included questions about anaphylaxis to imported fire ants (IFAs). History of tick bites and tick-related febrile illness were assessed as part of a case-control study in Virginia. Antibody assays were conducted on sera from subjects reporting allergic reactions to mammalian meat or IFA.

Results

In North America the α-Gal syndrome is recognized across the Southeast, Midwest, and Atlantic Coast, with many providers in this area managing more than 100 patients each. The distribution of cases generally conformed to the reported range of A americanum, although within this range there was an inverse relationship between α-Gal cases and cases of IFA anaphylaxis that were closely related to the territory of IFA. The connection between tick bites and α-Gal sensitization was further supported by patients' responses to a questionnaire and the results of serologic tests.

Conclusions

The α-Gal syndrome is commonly acquired in adulthood as a consequence of tick bites and has a regional distribution that largely conforms to the territory of the lone star tick. The epidemiology of the syndrome is expected to be dynamic and shifting north because of climate change and ecologic competition from IFA.

中文翻译：

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IgE介导的过敏反应的两个区域原因之间的动态关系：α-Gal综合征和进口火蚁

背景

10 年前在美国东南部首次报道了一种与半乳糖-α-1,3-半乳糖 (α-Gal) 特异性 IgE 相关的哺乳动物肉类过敏综合征，并与孤星蜱叮咬有关。）。

客观的

在这里，我们调查了美国“α-Gal 综合征”的流行病学，并寻找与蜱叮咬有关的更多证据。

方法

使用滚雪球法对过敏症患者进行了调查。第二层调查包括有关进口火蚁 (IFA) 过敏反应的问题。作为弗吉尼亚州病例对照研究的一部分，对蜱叮咬史和蜱相关发热疾病进行了评估。对来自报告对哺乳动物肉或 IFA 过敏反应的受试者的血清进行抗体测定。

结果

在北美，α-Gal 综合征在东南部、中西部和大西洋沿岸得到认可，该地区的许多提供者各自管理 100 多名患者。病例分布基本符合美洲A型报告范围，但在该范围内，α-Gal病例与与IFA地域密切相关的IFA过敏反应病例呈负相关。患者对问卷的回答和血清学检测结果进一步支持了蜱叮咬和 α-Gal 致敏之间的联系。

结论

α-Gal 综合征通常在成年期由于蜱叮咬而获得，并且其区域分布在很大程度上符合孤星蜱的领土。由于气候变化和来自 IFA 的生态竞争，预计该综合征的流行病学将是动态的并向北移动。