Tick bite as a risk factor for alpha-gal–specific immunoglobulin E antibodies and development of alpha-gal syndrome

Details

• Alternative Title:
  Ann Allergy Asthma Immunol
• Personal Author:
  Kersh, Gilbert J. ; Salzer, Johanna ; Jones, Emma S. ; Binder, Alison M. ; Armstrong, Paige A. ; Choudhary, Shailesh K. ; Commins, Grace K. ; Amelio, Claire L. ; Kato, Cecilia Y. ; Singleton, Joseph ; Biggerstaff, Brad J. ; Beard, Charles B. ; Petersen, Lyle R. ; Commins, Scott P.
• Description:
  Background:
  
  The disaccharide galactose-α-1,3-galactose (alpha-gal) is expressed in mammals other than humans, apes, and old-world monkeys. In humans, elevated immunoglobulin E (IgE) antibodies specific for alpha-gal can result in allergic hypersensitivity known as alpha-gal syndrome (AGS). Case reports and series suggest that tick bites can induce alpha-gal–specific IgE (sIgE) antibodies.
  
  Objective:
  
  To evaluate tick exposure as a risk factor for AGS and elevated alpha-gal sIgE level.
  
  Methods:
  
  We conducted a case-control study comparing patients with AGS from a North Carolina allergy clinic with controls who were patients at a nearby internal medicine clinic. Cases and controls were administered a questionnaire to obtain information about demographics, home environment, outdoor activities, and recollection of tick bite. Serum samples taken at the time of enrollment were tested for total IgE, alpha-gal sIgE, and antibodies to other tick-borne pathogens.
  
  Results:
  
  The patients with AGS were more likely to recall finding a tick on themselves (odds ratio [OR], 11.20; 95% confidence interval [CI], 4.97–25.15), live near wooded forest (OR, 2.27; 95% CI, 0.92–5.55), and spend 17 or more hours per week outdoors in wooded areas (OR, 5.58; 95% CI, 2.56–12.19). The patients with AGS were also more likely to report 4 or more tick bites (OR, 33.05; 95% CI, 9.92–155.12) and reactions at the site of tick bites (OR, 7.93; 95% CI, 3.74–16.80). Furthermore, elevated alpha-gal sIgE level was observed in 33% of the controls and was associated with tick exposure in the controls (OR, 4.25; 95% CI, 2.21–8.18).
  
  Conclusion:
  
  The results define tick bite as a risk factor for AGS and elevated alpha-gal sIgE level.
  
  
• Subjects:
  Allergens Animals Article Case-Control Studies Food Hypersensitivity Galactose Humans Immunoglobulin E Risk Factors Tick Bites Ticks

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• Source:
  Ann Allergy Asthma Immunol. 130(4):472-478
• Pubmed ID:
  36574585
• Pubmed Central ID:
  PMC10148555
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  130
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:044274c73f4eb7f3c12e2d9f74f35ec51bf6b528ecdaa267203908cf34ed47ad
• Download URL:
  https://stacks.cdc.gov/view/cdc/127701/cdc_127701_DS1.pdf
• File Type:
  [PDF - 577.14 KB ]