Benders-Guedj Marie, Köberle Martin, Hofmann Heidelore, Biedermann Tilo, Darsow Ulf
Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany.
Allergol Select. 2023 Aug 22;7:140-148. doi: 10.5414/ALX02424E. eCollection 2023.
Tick bite-induced IgE-mediated reactions to the oligosaccharide galactose α-1,3-galactose (alpha-gal) are increasingly recognized. This study investigated alpha-gal sensitization in three groups with different tick bite exposure.
Specific IgE antibodies to alpha-gal and total IgE were investigated in 485 patients with Lyme borreliosis with different disease manifestations and compared to a control group of 200 randomly selected patients without increased exposure to tick bites. A group of 232 hunters and forest workers served as a model for multiple tick bites.
Specific IgE (sIgE) antibodies to alpha-gal (> 0.1 kU/L) were found in 12.6% of all borreliosis samples compared to the control group with 9% (relative risk 1.4; 95% CI 0.85 - 2.3; not significant (n.s.). The highest prevalence of sIgE to alpha-gal was observed in hunters and forest service employees (22.8%, relative risk 2.5; 95% CI 1.5 - 4.2; p < 0.001). Higher age and elevated total IgE were also associated with alpha-gal sensitization.
IgE sensitization to alpha-gal tends to be more frequent in tick-exposed patients with borreliosis than in controls (n.s.). Moreover, hunters and forest workers show an even higher rate of elevated IgE to alpha-gal. Thus, frequent tick contact may result in alpha-gal sensitization. In the area of Munich, the prevalence of alpha-gal sensitization appears lower than in the state of Baden-Württemberg and lower than in the USA, which may be due to the difference in tick species or the frequency of tick exposure. This study could show that alpha-gal sensitization and presumably alpha-gal syndrome does not seem to be a modern problem but existed already more than 30 years ago.
蜱叮咬引起的针对寡糖半乳糖α-1,3-半乳糖（α-半乳糖）的IgE介导反应日益受到关注。本研究调查了三组不同蜱叮咬暴露情况人群中的α-半乳糖致敏情况。
对485例有不同疾病表现的莱姆病患者检测了针对α-半乳糖的特异性IgE抗体和总IgE，并与200例随机选择的无蜱叮咬暴露增加的对照组患者进行比较。一组232名猎人及林业工人作为多次蜱叮咬的模型。
在所有莱姆病样本中，12.6%检测到针对α-半乳糖的特异性IgE（sIgE）抗体（>0.1 kU/L），而对照组为9%（相对风险1.4；95%置信区间0.85 - 2.3；无显著性差异（n.s.））。在猎人和林业员工中观察到α-半乳糖sIgE的患病率最高（22.8%，相对风险2.5；95%置信区间1.5 - 4.2；p<0.001）。年龄较大和总IgE升高也与α-半乳糖致敏有关。
莱姆病蜱暴露患者中IgE对α-半乳糖的致敏倾向比对照组更常见（无显著性差异）。此外，猎人和林业工人中IgE对α-半乳糖升高的比例更高。因此，频繁接触蜱可能导致α-半乳糖致敏。在慕尼黑地区，α-半乳糖致敏的患病率似乎低于巴登-符腾堡州，也低于美国，这可能是由于蜱种差异或蜱暴露频率不同所致。本研究表明，α-半乳糖致敏以及推测的α-半乳糖综合征似乎并非现代才出现的问题，而是在30多年前就已存在。
