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Galactose α-1,3-galactose phenotypes: Lessons from various patient populations
Michael Levin1, Danijela Apostolovic2, Tilo Biedermann3
1Division of Paediatric Allergy, University of Cape Town, Cape Town, South Africa.
Objective:
To review published studies on galactose α-1,3-galactose (α-gal), a carbohydrate epitope found on proteins and lipids in nonprimate mammals and present in foods (particularly organ or fat-rich red meat) and medications, where it causes delayed-onset and immediate-onset anaphylaxis.
Data Sources:
A literature search for the terms galactose α-1,3-galactose and α-gal using PubMed and Embase was performed.
Study Selections:
Studies on α-gal were included in this review.
Results:
Several species of ticks contain α-gal epitopes and possibly salivary adjuvants that promote high titer sensitization and clinical reactivity. Risk factors for α-gal syndrome include exposure to ticks of particular species. Age and sex differences seen in various cohorts possibly reflect the prevalence of these exposures that vary according to setting.
Conclusion:
The reason and mechanisms for delayed onset of food-related anaphylaxis and the preponderance of abdominal reactions are not clear but may involve the kinetics of allergen digestion and processing or immunologic presentation via a different mechanism from usual immediate-type food allergy.
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