What Are The Symptoms Of Alpha Gal Syndrome
Alpha-gal syndrome was not truly understood until two decades ago because of one reason the time between consumption of mammal meat and the allergic reaction. If alpha-gal syndrome is present, you may not experience food allergy symptoms for several hours after consuming the food! If you notice any of the following symptoms, seek help immediately:
- Anaphylactic shock
- Asthma-like symptoms such as wheezing or shortness of breath
- Digestive issues such as stomach cramps, diarrhea, nausea, or vomiting
- Headaches
Tick Bite Host Response And Development Of Ags
Figure;2 Proposed model of -gal sensitization from tick bites. Skin is comprised of three layers: epidermis, dermis, and hypodermis. Antigen-presenting cells , including Langerhans cells and dermal Dendritic cells residing in epidermis and dermis, respectively, respond to tick-secreted antigens, such as glycoproteins, glycolipids, and tick cement-containing -gal moieties. After antigen exposure, APCs process antigen, migrate to skin-draining lymph nodes, and participate in allergen sensitization. During this process, naïve T cells are primed through presentation of tick -gal antigens by LCs and dermal DCs within skin-draining lymph nodes. Activated CD4+ T cells subsequently traffic to the skin through blood and lymphatic vessels. Cognate T cell help, provided by T follicular helper cells, to -gal-specific B cells leads to germinal center responses, positive clonal selection of B cells via recognition of native antigens retained by follicular dendritic cells , and the development of memory B cells and plasma cells. After clonal selection, B cells migrate to the tick bite site on the skin to manifest allergic responses by presenting antigens to T cells, secreting proinflammatory cytokines, and secreting -gal-specific antibodies that ultimately triggers activation of mast cells and basophils and allergic response.
Symptoms Of Alpha Gal Allergy
The symptoms of alpha gal allergy vary from person to person. Many have a delayed reaction which could even be in the form of anaphylaxis shock. Symptoms may manifest anytime within 3-4 hours of eating red meat. These typically include:
- Urticaria
- Swelling of lips, eyes, throat etc
- Watery eyes
- Increased heart rate
- Low blood pressure
Doctors are only learning more about the symptoms of alpha gal allergy now as the condition is getting greater media coverage.
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Mammalian Sources Of Exposure To Alpha
Alpha-gal is found in the meat, organs, tissues, cells, and fluids of all mammals;except for humans, great apes, and Old World monkeys . It is also found in products made from mammals or that contain ingredients made from them . These include,;but are not limited to:
Mammalian meat, organs, and other parts of mammals
These include some of the riskiest sources of alpha-gal. Examples include:
- Mammalian meats 01931-3/fulltext” rel=”nofollow”>1), such as beef, pork, lamb, bison, venison, goat, horse, rabbit, squirrel, kangaroo,;antelope, buffalo, camel, guinea pig, bats, whales, etc.
- If you are not sure which animals are mammals, there is a guide;here.
What Causes Alpha Gal Allergy
People are not born with an alpha-gal allergy. By and large, most people develop the allergy as an adult. Bites from ticks;cause alpha gal allergies. Ticks contain alpha gal, and a bite from a tick makes the immune system respond to the alpha gal as a defense mechanism.
Antibodies which your body produces to shield you from the tick bite stay in the body from then on. These antibodies which the body synthesizes against the tick bite will react to the alpha gal when you consume meat in which it is present.
If you dwell in a place where lone star ticks are widespread, you are at a huge risk of developing the allergy.
Experts dont know how long after the tick bite, the allergy commences and lasts. Further bites are known to cause a return of the allergy even if it becomes inactive.
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How Do I Protect Myself From Developing Alpha
Before You Go Outdoors
Know where to expect ticks.;Ticks live in grassy, brushy, or wooded areas, or even on animals. Spending time outside walking your dog, camping, gardening, or hunting could;bring you in close contact with ticks. Many people get ticks in their own yard or neighborhood.
Treat clothing and gear;with products containing 0.5% permethrin. Permethrin can be used to treat boots, clothing and camping gear and remain protective through several washings. Alternatively, you can buy permethrin-treated clothing and gear.
Use;Environmental Protection Agency registered insect repellents;containing DEET, picaridin, IR3535, Oil of Lemon Eucalyptus , para-menthane-diol , or 2-undecanone. EPAs helpful;search tool;can help you find the product that best suits your needs. Always follow product instructions.
- Do not use insect repellent on babies younger than 2 months old.
- Do not use products containing OLE or PMD on children under 3 years old.
Avoid Contact with Ticks
- Avoid wooded and brushy areas with high grass and leaf litter.
- Walk in the center of trails.
After You Come Indoors
Examine gear and pets.;Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and daypacks.
- Under the arms
- In and around the ears
- Inside belly button
- In and around the hair
- Between the legs
Treatment And Prevention Of Alpha Gal Allergy
The symptoms of alpha gal allergy are managed using over-the-counter antihistamines. In case of strong reactions, you may have to discuss with your health care provider and you may need epinephrine shots. It is very vital that the diagnosis is made quickly and the treatment regimen started promptly.
If you discover and ascertain that you have an alpha gal allergy, you must confer with your health care provider as well as a nutritionist; set to work to identify and recognize your specific triggers. By and large, you need to steer clear of all kinds of red meat. Dairy products as well as some poultry products also contain alpha gal; you must isolate your specific trigger and steadily avoid it.
In case, your symptoms are very serious when you have an allergic reaction, you should start carrying a handy epinephrine treatment with you in case of an emergency. Also, ensure that your family, friends and co-workers, know what to do in an eventuality of a severe allergic reaction.
Whats more, make sure, ticks do not bite you; use an insect repellent when you go exploring forest areas, and wear long trousers and sleeves when in the woods. Also check your scalp, hair, arms, and ears repeatedly for ticks which could be trying to fasten onto your body. Importantly, know the correct method;to eliminate and throw off a tick if you do get bitten.
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What Is The Treatment For Tick Bite
The prevention of tick bites is paramount through both using insect repellents and avoiding forested areas.
People with tick bite-induced red meat allergy should avoid red meat and other substances with alpha-gal.
The treatment of the allergic response includes antihistamines, oral steroids, and, in the case of anaphylaxis, adrenaline.
The use of desensitisation by exposing the patient to large amounts of alpha-gal is undergoing investigation .
What Are The Symptoms Of An Alpha Gal Allergy
The symptoms and the severity of these depend on the amount of alpha gal present in the body and the response that it can trigger.;The wide variety of allergic responses ranges from mild to death from anaphylaxis .
The;response;time of;the allergic reaction;usually occurs after 3 to 6 hours after ingesting the animal product, usually red meat, or having been exposed to a product that contains alpha gal.
It should be remembered that an allergy to alpha gal occurs three to six hours after eating red meat.;Birds do not cause it.
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Symptoms Of A Reaction
Falk: What is the reaction that patients get three or four hours later? What does it feel like?
Commins: Their reactions often start with itching, particularly the palms and soles. We have patients tell us repeatedly that their hands begin to itch and turn red. Then they often get systemic hives all over their skin. Then the process seems to snowball. It starts with skin and itching and hives and redness, perhaps swelling, then often tell us that they feel light-headed so we think their blood sugar is dropping. Often there is a gastrointestinal component to this as wellso really severe abdominal cramping, diarrhea, nausea, vomitingall the hallmarks of an anaphylactic allergy reaction that you might see in a child who has a milk, egg or peanut allergy.
Falk: Unhappily then, you can imagine someone who has a burger or steak for dinner, would think everything is fine, would go to bed, and what would wake them up?
Commins: Typically the itching. You have described a very prototypical allergic reaction for the alpha-gal allergy, which is certainly very different from the typical allergic response. This idea that patients experience allergic reactions after midnight is really in keeping with the alpha-gal allergy and unlike most other food allergies.
Falk: People are then woken up, out of sleep, itching away What are they supposed to do?
Falk: So, this really is a Lets go to the emergency room kind of moment.
A Leading Cause Of Anaphylaxis
- Roughly 60% of people with AGS have anaphylactic reactions and 30-40% have cardiac and respiratory symptoms .
- In one recent study of anaphylaxis, AGS was found to be the number one trigger, accounting for 33% of cases with a definitive cause. The number two cause was all other food allergies combined at 28% .
- In the same study, recognition of AGS led to a reduction in the percentage of anaphylaxis cases without a definitive cause from 59% to 35% of total cases.;
- In a second study, nine percent of all patients referred with unexplained anaphylaxis were found to have AGS .
Figure 1. Etiologies of anaphylaxis based on proposed definitive cause. Alpha-gal, galactose-a-1,3-galactose.
;Pattanaik D, Lieberman P, Lieberman J, Pongdee T, Keene AT. The changing face of anaphylaxis in adults and adolescents. Annals of Allergy, Asthma & Immunology. 2018 Nov 1;121:594-7.
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What Are The Symptoms Of Alpha
As with other food allergies, signs or symptoms of an allergy to alpha-gal may include:
- Hives and itching
- Swelling of your lips, face or eyelids
- Shortness of breath, cough or wheezing
- Abdominal pain, nausea, diarrhea or vomiting
The most severe reaction,;anaphylaxis, can present as a combination of several of these symptoms, may include low blood pressure, and is potentially fatal.Because these symptoms are delayed, you may only wake up with them in the middle of the night after an evening meal.
What Areas Of The Us Are Affected By Alpha
The incidence of tick bites is much higher in the southern and eastern US, the traditional habitat for the tick. However, cases are now increasingly reported in the northern and western states. And it is a phenomenon that has been observed worldwide, with different ticks responsible for similar cases of red meat allergy in many other countries such as Sweden, South Africa and Australia.
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The Next Morning I Made An Appointment With A Doctor To Get Checked Out
Id recently read a random article on alpha-gal syndrome , a food allergy to red meats and products made from mammals that most often begins when youre bitten by a Lone Star tick. Because these ticks have a sugar molecule called alpha-gal in their saliva, scientists believe their bite can trigger mild to severe immune system reactions in some people. Unlike other food allergies, which often pop up as soon as youre exposed to a trigger like peanuts, AGS can take three to six hours to cause a reaction .
Knowing I lived in an area where these ticks and this mysterious condition were increasingly common, I wondered if Id developed it and asked the doctor to test me for it. Like many doctors, shed never heard of AGS and initially thought I was talking about Lyme disease, another tick-borne illness.
I insisted alpha-gal syndrome was something different, and she and her assistant went to their computers and began researching it immediately. The doctor called the lab to figure out how to test for it and drew my blood.
Who Gets Tick Bite
The incidence of tick bite-induced red meat allergy is unknown . It is associated with a history of tick bites, atopy, and cat ownership . Multiple tick bites increase the risk.
The allergy arises in people exposed to the ticks due to geographic location or occupation. For example, forestry service employees and hunters in certain countries are at higher risk of carrying alpha-galspecific immunoglobulin E and developing red meat allergy compared to the general population in the same region .
Systemicmastocytosis can increase the risk of acquiring tick bite-induced red meat allergy .
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What Are The Symptoms Of Ags
-
AGS reactions can include:
- Dizziness or faintness
- Severe stomach pain
AGS can be severe, and even life-threatening. Seek immediate emergency care if you are having a severe allergic reaction.
Delayed Allergic Reaction To Red Meat
Why does a person with alpha-gal allergy experience a reaction several hours after eating red meat, instead of like a peanut allergy which can happen immediately?
Theres two main answers to thatthe first of which is that alpha-gal is a sugar. So much of what we know about allergies in general center on proteins. Part of this, is that we believe that the response to the sugar is in some ways a weaker response than we might see for proteins. Secondly, the most severe reactions tend to happen with fattier forms of meat. The digestion of fat is very different from the way that sugars or proteins are absorbed. The digestion of fat is a process that takes three to hours to deliver fat to the bloodstream.
Typically, allergic reactions to mammalian meat occurs 2-6 hoursafter ingesting the meats, and can be severe. Whats interesting, is that these allergic reactions to mammalian meat dont typically occur until 1 to 3 months after being bitten by an infected tick!
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How To Get Tested For Alpha
If youre experiencing symptoms that feel out of the ordinarysay your stomach hurts at midnight after eating red meat and you have a history of tick bites ask your doctor if it could possibly be alpha-gal.
Then, he or she will ask about your history of tick exposure, any signs and symptoms you may be dealing with, and how long it takes for these issues to appear after youve eaten red meat. If alpha-gal allergy is suspected, your doctor will do a blood test to measure the amount of alpha-gal antibodies in your blood. A skin test may also be issued, where your doctor or allergist will expose a small amount of your skin to red meat to see if any hives form, according to the Mayo Clinic.
Is It A Lifelong Allergy
While there is not option to treat this allergy with immunotherapy to desensitize patients to the allergy, it may go way the patient avoids red meat. Our physicians can monitor the IgE blood test levels and help patients determine if it is possible to reintroduce red meat safely. However, many patients live this this allergy for years.
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What Causes Tick Bite
The details of how a tick bite leads to allergic reactions to red meat and other substances are not completely understood.
The species of ticks that cause alpha-gal allergy include:
- The lone star tick found in the United States
- The castor bean tick found in Europe
- The paralysis tick found in Australia
- The hard tick species Ixodes australiensis, found in Australia
- An unknown tick species found in South Africa and other regions .
The tick injects saliva containing alpha-gal into the skin of its victim. Sensitisation to alpha-gal is associated with the development of specific IgE antibodies to the carbohydrate. The component of alpha-gal that causes sensitisation is not known .
The symptoms of the subsequent reaction to red meat are typical of most food allergies, except that the reaction is delayed by several hours and the antigen is a carbohydrate in the meat rather than a protein. More severe reactions can occur in people exposed to multiple tick bites.
Red meat is defined as all meats obtained from mammals and includes beef, pork, and lamb. The meat is red because of the high concentrations of myoglobin, a protein that transports oxygen to the muscles. Meat obtained from birds, such as chicken or turkey, is white meat and lacks alpha-gal so does not generate an allergic response.
Other substances can cause the same allergic response, including:
Signs + Symptoms Of Anaphylaxis
Signs and symptoms of a severe allergic reaction and anaphylaxis typically includes truncal hives, but may also include swelling, vomiting, diarrhea, trouble breathing and a rather significant drop in blood pressure. Be sure to dial 9-1-1 for anyone who is having trouble breathing especially if you suspect anaphylactic shock!
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