Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Ann Allergy Asthma Immunol. 2023 Apr;130(4):472-478. doi: 10.1016/j.anai.2022.11.021. Epub 2022 Nov 26.
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.
To evaluate tick exposure as a risk factor for AGS and elevated alpha-gal sIgE level.
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.
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).
The results define tick bite as a risk factor for AGS and elevated alpha-gal sIgE level.
二糖半乳糖-α-1,3-半乳糖（alpha-gal）仅在人类、猿类和旧世界猴以外的哺乳动物中表达。在人类中，针对 alpha-gal 的免疫球蛋白 E（IgE）抗体升高会导致一种称为 alpha-gal 综合征（AGS）的过敏超敏反应。病例报告和系列研究表明，蜱叮咬可诱导 alpha-gal 特异性 IgE（sIgE）抗体。
评估蜱叮咬作为 AGS 和 alpha-gal sIgE 水平升高的危险因素。
我们进行了一项病例对照研究，比较了北卡罗来纳过敏诊所的 AGS 患者和附近内科诊所的对照患者。病例和对照均接受问卷调查，以获取人口统计学、家庭环境、户外活动和蜱叮咬回忆方面的信息。入组时采集的血清样本检测总 IgE、alpha-gal sIgE 和其他蜱传病原体的抗体。
AGS 患者更有可能回忆起自己身上发现蜱虫（比值比 [OR]，11.20；95%置信区间 [CI]，4.97-25.15）、居住在树木繁茂的森林附近（OR，2.27；95% CI，0.92-5.55）和每周在树木繁茂的地区户外活动 17 小时或以上（OR，5.58；95% CI，2.56-12.19）。AGS 患者也更有可能报告 4 次或更多次蜱虫叮咬（OR，33.05；95% CI，9.92-155.12）和蜱虫叮咬部位的反应（OR，7.93；95% CI，3.74-16.80）。此外，在 33%的对照者中观察到 alpha-gal sIgE 水平升高，并且在对照者中与蜱暴露相关（OR，4.25；95% CI，2.21-8.18）。
结果定义蜱叮咬为 AGS 和 alpha-gal sIgE 水平升高的危险因素。
