ABSTRACT

Introduction

The α-Gal syndrome (AGS) is a type of allergy characterized by an IgE antibody response against the carbohydrate Galα1-3Galβ1-4GlcNAc-R (α-Gal). Tick bites are recognized as the most important cause of anti-α-Gal IgE antibody increase in humans. Several risk factors have been associated with the development of AGS, but their integration into a standardized disease diagnosis has proven challenging.

Areas covered

Herein we discuss the current AGS diagnosis based on anti-α-Gal IgE titers and propose an algorithm that considers all co-factors in the clinical history of α-Gal-sensitized patients to be incorporated into the AGS diagnosis. The need for identification of host-derived gene markers and tick-derived proteins for the diagnosis of the AGS is also discussed.

Expert opinion

The current AGS diagnosis based on anti-α-Gal IgE titers has limitations because not all patients sensitized to α-Gal and with anti-α-Gal IgE antibodies higher than the cutoff (0.35 IU/ml) develop anaphylaxis to mammalian meat and AGS. The basophil activation test proposed to differentiate between patients with AGS and asymptomatic α-Gal sensitization cannot be easily implemented as a generalized clinical test. In coming years, the algorithm proposed here could be used in a mobile application for easier AGS diagnosis in the clinical practice.

中文翻译：

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α-gal 综合征：理解对 α-gal 的敏感性和临床反应的挑战。

摘要

介绍

α-Gal 综合征 (AGS) 是一种过敏症，其特征是对碳水化合物 Galα1-3Galβ1-4GlcNAc-R (α-Gal) 的 IgE 抗体反应。蜱叮咬被认为是人类抗α-Gal IgE 抗体增加的最重要原因。一些风险因素与 AGS 的发展有关，但将它们整合到标准化的疾病诊断中已被证明具有挑战性。

覆盖区域

在此，我们讨论了基于抗α-Gal IgE 滴度的当前 AGS 诊断，并提出了一种算法，该算法将 α-Gal 致敏患者临床病史中的所有辅助因素纳入 AGS 诊断。还讨论了鉴定宿主衍生基因标记物和蜱衍生蛋白质以诊断 AGS 的必要性。

专家意见

当前基于抗α-Gal IgE 滴度的AGS 诊断存在局限性，因为并非所有对α-Gal 敏感且抗α-Gal IgE 抗体高于临界值（0.35 IU/ml）的患者都会对哺乳动物肉和AGS 产生过敏反应. 用于区分 AGS 和无症状 α-Gal 致敏患者的嗜碱性粒细胞活化试验不能轻易地作为普遍的临床试验实施。未来几年，这里提出的算法可用于移动应用程序，以便在临床实践中更轻松地诊断 AGS。