Meat allergy associated with galactosyl--(1,3)-galactose (-Gal)Closing diagnostic gaps by anti--Gal IgE immune profiling

作者：Jappe U^*; Minge S; Kreft B; Ludwig A; Przybilla B; Walker A; Varga R; Seidel P; Biedermann T; Anemueller 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

来源：Allergy, 2018, 73(1): 93-105.

DOI：10.1111/all.13238

• alpha-Gal
• bovine thyroglobulin
• cetuximab
• delayed anaphylaxis
• meat allergy

BackgroundGlycoproteins and glycolipids of some mammalian species contain the disaccharide galactosyl--(1,3)-galactose (-Gal). It is known that -Gal is immunogenic in humans and causes glycan-specific IgG and also IgE responses with clinical relevance. -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 -Gal-containing analytes are examined in singleplex and multiplex assays to resolve individual sensitization patterns with IgE against -Gal.
MethodsThree serum groups, -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 -Gal-containing analytes CTX, bovine thyroglobulin (Bos d TG), and human serum albumin (HSA)-conjugated -Gal.
ResultsSingleplex allergy diagnostics using the -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 -Gal reveals individual IgE sensitization profiles for -Gal-containing analytes. An -Gal-associated IgE cross-reactivity profile (IgE against CTX, Bos d TG, and HSA--Gal) was identified, which is associated with MA.
ConclusionsDetection of individual sensitization patterns with different -Gal-containing analytes provides the basis for an individual allergy diagnosis for -Gal-sensitized patients. Higher amounts of -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.

• 出版日期2018-1