BACKGROUND: Glycoproteins and glycolipids of some mammalian species contain the disaccharide galactosyl-alpha-(1,3)-galactose (alpha-Gal). It is known that alpha-Gal is immunogenic in humans and causes glycan-specific IgG and also IgE responses with clinical relevance. alpha-Gal is part of the IgE-reactive monoclonal therapeutic antibody cetuximab (CTX) and is associated with delayed anaphylaxis to red meat. In this study, different alpha-Gal-containing analytes are examined in singleplex and multiplex assays to resolve individual sensitization patterns with IgE against alpha-Gal. METHODS: Three serum groups, alpha-Gal-associated meat allergy (MA) patients, idiopathic anaphylaxis (IA) patients with suspected MA, and non-meat-allergic healthy control individuals (HC), were analyzed via singleplex allergy diagnostics and a newly established immunoblot diagnostic system. The new dot blot detection system resolved individual IgE sensitization profiles for alpha-Gal-containing analytes CTX, bovine thyroglobulin (Bos d TG), and human serum albumin (HSA)-conjugated alpha-Gal. RESULTS: Singleplex allergy diagnostics using the alpha-Gal analytes CTX and Bos d TG confirms the history of MA patients in 91% and 88% of the cases, respectively. A novel dot blot-based assay system for the detection of IgE against alpha-Gal reveals individual IgE sensitization profiles for alpha-Gal-containing analytes. An alpha-Gal-associated IgE cross-reactivity profile (IgE against CTX, Bos d TG, and HSA-alpha-Gal) was identified, which is associated with MA. CONCLUSIONS: Detection of individual sensitization patterns with different alpha-Gal-containing analytes provides the basis for an individual allergy diagnosis for alpha-Gal-sensitized patients. Higher amounts of alpha-Gal in pork and beef innards compared to muscle meat as indicated by a higher staining intensity are a plausible explanation for the difference in allergic symptom severity.
- Jappe, U.
- Minge, S.
- Kreft, B.
- Ludwig, A.
- Przybilla, B.
- Walker, A.
- Varga, R.
- Seidel, P.
- Biedermann, T.
- Anemuller, W.
- Kromminga, A.
- Rueff, F.
- Merk, H.
- Wagner, N.
- Treudler, R.
- Worm, M.
- Waldmann, I.
- Saloga, J.
- Becker, W. M.
- Goldmann, T.
- Platts-Mills, T. A.
- Homann, A.
Keywords
- Adult
- Aged
- Allergens/*immunology
- Anaphylaxis/diagnosis/immunology
- Case-Control Studies
- Cross Reactions/immunology
- Female
- Food Hypersensitivity/*diagnosis/*immunology
- Galactose/chemistry/*immunology
- Humans
- Immunochemistry
- Immunoglobulin E/*immunology
- Male
- Meat/*adverse effects
- Middle Aged
- Red Meat/adverse effects
- Young Adult
- alpha-Gal
- bovine thyroglobulin
- cetuximab
- delayed anaphylaxis
- meat allergy