MMWR Morb Mortal Wkly Rep. 2023 Jul 28;72(30):809-814. doi: 10.15585/mmwr.mm7230a1.
Alpha-gal syndrome (AGS) is an emerging, tick bite-associated immunoglobulin E-mediated allergic condition characterized by a reaction to the oligosaccharide galactose-alpha-1,3-galactose (alpha-gal), which is found in mammalian meat and products derived from mammals, including milk, other dairy products, and some pharmaceutical products. Symptoms range from mild (e.g., a rash or gastrointestinal upset) to severe (anaphylaxis); onset typically occurs ≥2 hours after exposure to alpha-gal. No treatment or cure is currently available. Despite the potential life-threating reactions associated with AGS, most patients perceive that health care providers (HCPs) have little or no knowledge of AGS. A U.S. web-based survey of 1,500 HCPs revealed limited knowledge of AGS, identified areas for continuing medical education, and described self-reported diagnostic and management practices. Overall, 42% of surveyed HCPs had never heard of AGS, and among those who had, fewer than one third knew how to diagnose the condition. Two thirds of respondents indicated that guidelines for the diagnosis and management of AGS would be useful clinical resources. Limited awareness and knowledge of AGS among HCPs likely contributes to underdiagnosis of this condition and inadequate patient management, and underestimates of the number of AGS patients in the United States, which currently relies on laboratory testing data alone.
阿尔法半乳糖综合征(AGS)是一种新出现的、与蜱虫叮咬相关的免疫球蛋白 E 介导的过敏症,其特征是对在哺乳动物肉和源自哺乳动物的产品(包括牛奶、其他乳制品和一些药物产品)中发现的寡糖半乳糖-α-1,3-半乳糖(alpha-gal)产生反应。症状范围从轻微(例如皮疹或胃肠道不适)到严重(过敏反应);发病通常在接触 alpha-gal 后≥2 小时发生。目前尚无治疗或治愈方法。尽管 AGS 可能与危及生命的反应有关,但大多数患者认为医疗保健提供者(HCPs)对 AGS 知之甚少或一无所知。一项针对 1500 名 HCPs 的美国网络调查显示,他们对 AGS 的了解有限,确定了继续医学教育的领域,并描述了自我报告的诊断和管理实践。总体而言,42%的调查 HCPs 从未听说过 AGS,而在听说过的人中,不到三分之一的人知道如何诊断这种疾病。三分之二的受访者表示,AGS 的诊断和管理指南将是有用的临床资源。HCPs 对 AGS 的认识和了解有限,可能导致对这种疾病的诊断不足和患者管理不当,并低估了美国 AGS 患者的数量,目前仅依赖实验室检测数据。