Transmitted via ticks: the alpha-gal syndrome

Since 2010, more than 100,000 cases of AGS have been reported in the US. This unusual allergy sometimes causes severe symptoms that appear within a few hours of eating meat. It is triggered by a tick bite. But how can a tick bite lead to such a severe meat allergy? And does this phenomenon, which is mainly known in North America, also occur in Germany and other parts of the world?

What causes the alpha-gal syndrome? While most allergens are specific proteins, the allergic reaction seen in AGS is directed against the sugar molecule galactose-alpha-1,3-galactose, abbreviated: alpha-gal. The body will have formed specific immunoglobulins (sIgE) against alpha-gal after previous contact. The sensitization of the immune system to the sugar causes an allergic reaction upon renewed contact through the consumption of mammalian meat (beef, pork, sheep, etc.). But why does the patient suddenly recognize alpha-gal as a foreign molecule that it has to fight, when the patient has previously eaten meat for years without any complications? According to current knowledge, the production of sIgE against alpha-gal is not triggered by the consumption of meat, but by tick bites.

If a tick bites a person, the alpha-gal can enter the bloodstream , stimulating the production of sIgE , and thus sensitizing the immune system. This sensitization alone does not cause any symptoms. Only after renewed contact with alpha-gal, for example after eating meat, does an allergic reaction then occur. How alpha-gal gets into ticks has not yet been finally clarified . The sugar could be a component of tick saliva. However, it could also have been ingest ed beforehand through biting a mammal, and then be passed on to humans. Or it could come from microorganisms, such as bacteria, that typically exist in ticks.

What are the symptoms? AGS can affect people of all ages. Symptoms usually start two to six hours after eating mammalian meat. Such a long delay is unusual, because most food allergies usually start immediately. The typical symptoms of AGS include:

– Urticaria with itchy or burning skin redness and pimples as well as swelling of the subcutaneous tissue (angioedema)

– Difficulties with breathing and swollen mucous membranes

– Nausea , vomiting

– Diarrhea

– Abdominal pain

– Swelling of the lips, tongue or throat

In extreme cases, AGS can lead to anaphylaxis.

How can I prevent it? Protective clothing (long trousers, closed shoes) and suitable tick sprays can offer a certain amount of protection against tick bites.

How is AGS treated? Due to the delayed symptoms after meat consumption , the connection is not immediately obvious for most patients, which is why they initially consider other causes. A positive blood test for alpha-gal-specific IgE must be available to diagnose AGS. As an alternative to the blood test, an intradermal allergy test, in which small amounts of the allergenic alpha-gal are injected under the skin, can also provide certainty. Avoiding the relevant meat products is the only way for those affected by AGS to permanently prevent allergic reactions. A minority of affected people should also avoid consumption of gelatine, and all sorts of milk products.

In exceptional cases, for example in people with persistent symptoms despite a change in diet, an additional drug therapy with antihistamines or anti-inflammatory drugs can be used to attenuate the allergic reaction. In the majority of people with AGS, the concentration of alpha-gal-specific IgE decreases over time, so that they can eat meat again without having an allergic reaction to it. However, they should avoid any further tick bites that cause the reactions to alpha-gal.

What about alpha-gal in Germany? In recent years, meat allergy cases have been reported from all parts of the world. The alpha-gal sugar has already been detected in various tick species around the world, including Ixodes ricinus. As there is no obligation to report cases of AGS in Germany, it is difficult to estimate the number of affected people. The European Foundation for Allergy Research reported around 100 cases in 2019. However, the number of unreported cases is likely to be higher. Therefore, if you experience an allergic reaction after eating beef or pork, even a few hours later, you should consult an allergist.

EXERCISE:

1. One treatment method might be to avoid the relevant meat products, and even avoid the consumption of all sorts of milk products or gelatine. A) True B) False

2. Symptoms for AGS usually start two to six hours after eating mammalian meat and include: A) Urticaria B) Difficulty breathing and swollen mucous membranes C) Nausea, vomiting D) diarrhea E) abdominal pain

3. While most allergens are specific proteins, the allergic reaction seen in AGS is directed against the sugar molecule galactose-alpha-1,3-galactose. The body has formed specific immunoglobulins (sIgE) against alpha-gal after previous contact. The sensitization of the immune system to the sugar causes an allergic reaction upon renewed contact through the consumption of mammalian meat. A) True B) False

You’ll find the answer below.

BIBLIOGRAPHY 1. www.dict.cc

2. www.geo.de

3. www.mayoclinic.org

4. www.nhs.uk

5. www.webster-dictionary.org

6. www.who.int

7. www.zeit.de

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTL. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten.

Kontakt: mail@lobitz-seminare.de

www.lobitz-seminare.de

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Lösung für Exercise:

1. A

2. A–E

3. A

Transmitted via ticks: the alpha-gal syndrome

What causes the alpha-gal syndrome?

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Transmitted via ticks: the alpha-gal syndrome

What causes the alpha-gal syndrome?

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