Steinke John W, Platts-Mills Thomas A E, Commins Scott P
Asthma and Allergic Diseases Center, Carter Immunology Center, Department of Medicine, University of Virginia Health System, Charlottesville, Va.
Asthma and Allergic Diseases Center, Carter Immunology Center, Department of Medicine, University of Virginia Health System, Charlottesville, Va.
J Allergy Clin Immunol. 2015 Mar;135(3):589-96; quiz 597. doi: 10.1016/j.jaci.2014.12.1947.
Anaphylaxis is a severe allergic reaction that can be rapidly progressing and fatal, and therefore establishing its cause is pivotal to long-term risk management. Our recent work has identified a novel IgE antibody response to a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose (alpha-gal). IgE to alpha-gal has been associated with 2 distinct forms of anaphylaxis: (1) immediate-onset anaphylaxis during first exposure to intravenous cetuximab and (2) delayed-onset anaphylaxis 3 to 6 hours after ingestion of mammalian food products (eg, beef and pork). Results of our studies and those of others strongly suggest that tick bites are a cause, if not the only significant cause, of IgE antibody responses to alpha-gal in the southern, eastern, and central United States; Europe; Australia; and parts of Asia. Typical immune responses to carbohydrates are considered to be T-cell independent, whereas IgE antibody production is thought to involve sequential class-switching that requires input from T cells. Therefore, establishing the mechanism of the specific IgE antibody response to alpha-gal will be an important aspect to address as this area of research continues.
过敏反应是一种严重的过敏反应，可迅速发展并导致死亡，因此确定其病因对于长期风险管理至关重要。我们最近的研究发现了一种针对哺乳动物寡糖表位半乳糖-α-1,3-半乳糖（α-半乳糖）的新型IgE抗体反应。针对α-半乳糖的IgE与两种不同形式的过敏反应有关：（1）首次接触静脉注射西妥昔单抗时立即发生的过敏反应，以及（2）摄入哺乳动物食品（如牛肉和猪肉）后3至6小时出现的迟发性过敏反应。我们的研究结果以及其他研究结果强烈表明，在美国南部、东部和中部、欧洲、澳大利亚以及亚洲部分地区，蜱虫叮咬是导致对α-半乳糖产生IgE抗体反应的一个原因，如果不是唯一的重要原因的话。对碳水化合物的典型免疫反应被认为是不依赖T细胞的，而IgE抗体的产生被认为涉及需要T细胞输入的连续类别转换。因此，随着该研究领域的不断深入，确定针对α-半乳糖的特异性IgE抗体反应机制将是一个重要的研究方向。
