title: Sensitization to the mammalian oligosaccharide galactose-alpha-1,3-galactose (alpha-gal): experience in a Flemish case series.
abstract: BACKGROUND
  Recent observations have disclosed that the galactose-alpha (1,3)-galactose (alpha-gal) moiety of non-primate glycoproteins can constitute a target for meat allergy.
  
  
  OBJECTIVE
  To describe adults with allergic reactions to mammalian meat, dairy products and gelatin. To investigate whether patients could demonstrate sensitization to activated recombinant human coagulation factor VII ectapog alpha that is produced in baby hamster kidney cells.
  
  
  METHODS
  Ten adults with mammalian meat, dairy products and gelatin allergies were examined using quantification of specific IgE and/or skin prick test for red meat, milk, milk components, gelatin, cetuximab and eptacog alpha.
  
  
  RESULTS
  Most patients demonstrate quite typical clinical histories and serological profiles, with anti-alpha-gal titers varying from less than 1% to over 25% of total serum IgE. All patients demonstrate negative sIgE for gelatin, except the patient with a genuine gelatin allergy. All patients also demonstrated a negative sIgE to recombinant milk components casein, lactalbumin and lactoglobulin. Specific IgE to eptacog was positive in 5 out of the 9 patients sensitized to alpha-gal and none of the 10 control individuals.
  
  
  CONCLUSIONS
  This series confirms the importance of the alpha-gal carbohydrate moiety as a potential target for allergy to mammalian meat, dairy products and gelatin (oral, topical or parenteral) in a Flemish population of meat allergic adults. It also confirms in vitro tests to mammalian meat generally to be more reliable than mammalian meat skin tests, but that diagnosis can benefit from skin testing with cetuximab. Specific IgE to gelatin is far too insensitive to diagnose alphaa-gal related gelatin allergy. IgE binding studies indicate a potential risk of alpha-gal-containing human recombinant proteins produced in mammalians.
authors.affiliation: Immunology, Allergology, Rheumatology, University of Antwerp, Antwerpen, Belgium. immuno@ua.ac.be
authors.forename: D G
authors.initials: DG
authors.lastname: Ebo
authors.forename: M
authors.initials: M
authors.lastname: Faber
authors.forename: V
authors.initials: V
authors.lastname: Sabato
authors.forename: J
authors.initials: J
authors.lastname: Leysen
authors.forename: A
authors.initials: A
authors.lastname: Gadisseur
authors.forename: C H
authors.initials: CH
authors.lastname: Bridts
authors.forename: L S
authors.initials: LS
authors.lastname: De Clerck
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001530:Belgium; D006224:Cricetinae; D003611:Dairy Products; D015942:Factor VIIa / Q000276:immunology; D005260:Female; D005512:Food Hypersensitivity / Q000276:immunology*; D005780:Gelatin; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D008322:Mammals; D008460:Meat; D008875:Middle Aged; D011994:Recombinant Proteins / Q000276:immunology; D012882:Skin Tests; D014312:Trisaccharides / Q000276:immunology*
chemical_list: D011994:Recombinant Proteins; D014312:Trisaccharides; C076569:alpha-galactosyl epitope; D007073:Immunoglobulin E; D005780:Gelatin; C103587:recombinant FVIIa; D015942:Factor VIIa