Ching Susan J, Susi Apryl, Ailsworth Samuel M, Workman Lisa J, Platts-Mills Thomas A E, Wilson Jeffrey M, Nylund Cade M
Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20814, USA.
J Clin Med. 2024 Nov 26;13(23):7162. doi: 10.3390/jcm13237162.
: IgE to galactose-alpha-1,3-galactose (alpha-gal) is associated with (lone star tick) bites, accounting for the regional distribution of the alpha-gal syndrome (AGS). Longitudinal studies describing risk factors for incident alpha-gal sensitization are lacking. The objective of this project was to assess the incidence of alpha-gal IgE seroconversion and identify associated demographic, occupational, and geographical risk factors among US military personnel. : Samples from the Department of Defense Serum Repository were evaluated at two time points at least 3 years apart. In total, 3000 service members stationed at 10 military installations within the tick range were included. Installation, sex, race and ethnicity, rank, military occupation, and branch of service were evaluated. Alpha-gal IgE seroconversion was defined as a change from <0.1 kU/L) to ≥0.1 kU/L. : Among the 2821 personnel who were alpha-gal IgE-negative at baseline, 138 (4.9%) seroconverted over a mean interval of 3.4 years. Seroconversion was more frequent in males (5.5% vs. 1.9%), White individuals (6.6% vs. 1.0% in Black people and 1.5% in Hispanics), and individuals in occupations with higher presumed outdoor exposure (e.g., infantry/law enforcement: 12.7% vs. administrative: 1.2%). Differences were not significant between sexes when accounting for military installation/occupation, but differences in race and ethnicity remained significant. : This study demonstrates that alpha-gal IgE seroconversion is occurring within the tick range and is associated with White race and ethnicity, and occupations with higher outdoor exposure. Further research is needed to elucidate the influence of race and ethnicity on alpha-gal sensitization and develop effective prevention and treatment strategies for AGS.
针对半乳糖-α-1,3-半乳糖（α-半乳糖）的IgE与孤星蜱叮咬有关，这解释了α-半乳糖综合征（AGS）的区域分布情况。目前缺乏描述α-半乳糖致敏危险因素的纵向研究。本项目的目的是评估美国军事人员中α-半乳糖IgE血清转化的发生率，并确定相关的人口统计学、职业和地理危险因素。从国防部血清库采集的样本在至少相隔3年的两个时间点进行评估。总共纳入了驻扎在孤星蜱分布范围内10个军事设施的3000名军人。对军事设施、性别、种族和民族、军衔、军事职业以及军种进行了评估。α-半乳糖IgE血清转化定义为从<0.1 kU/L变为≥0.1 kU/L。在基线时α-半乳糖IgE呈阴性的2821名人员中，有138人（4.9%）在平均3.4年的间隔期内发生了血清转化。血清转化在男性（5.5%对1.9%）、白人个体（6.6%对黑人的1.0%和西班牙裔的1.5%）以及假定户外暴露较高职业的个体（如步兵/执法人员：12.7%对行政人员：1.2%）中更为常见。在考虑军事设施/职业时，性别差异不显著，但种族和民族差异仍然显著。本研究表明，在孤星蜱分布范围内正在发生α-半乳糖IgE血清转化，并且与白种人和民族以及户外暴露较高的职业有关。需要进一步研究以阐明种族和民族对α-半乳糖致敏的影响，并制定针对AGS的有效预防和治疗策略。
