Galactose-α-1,3-Galactose-Specific IgE Is Associated with Anaphylaxis but Not Asthma

被引:60
作者
Cornmins, Scott P. [1 ]
Kelly, Libby A. [1 ]
Ronmark, Eva [2 ]
James, Hayley R. [1 ]
Pochan, Shawna L. [1 ]
Peters, Edward J. [3 ]
Lundback, Bo [4 ]
Nganga, Lucy W. [5 ]
Cooper, Philip J. [6 ,7 ]
Hoskins, Janelle M. [8 ]
Eapen, Saju S. [9 ]
Matos, Luis A. [9 ]
McBride, Dane C. [9 ]
Heymann, Peter W. [1 ]
Woodfolk, Judith A. [1 ]
Perzanowski, Matthew S. [10 ]
Platts-Mills, Thomas A. E. [1 ]
机构
[1] Univ Virginia, Div Allergy & Immunol, Charlottesville, VA USA
[2] Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden
[3] Allergy & Asthma Consultants, Austin, TX USA
[4] Univ Gothenburg, Sahlgrenska Acad, Krefting Res Ctr, Dept Med, Gothenburg, Sweden
[5] Kenya Govt Med Res Ctr, Ctr Resp Dis, Nairobi, Kenya
[6] Univ San Francisco Quito, Cumbaya, Quito, Ecuador
[7] Univ Liverpool, Liverpool Sch Trop Med, Liverpool L3 5QA, Merseyside, England
[8] Univ N Carolina, Chapel Hill, NC USA
[9] Asthma & Allergy Ctr Lynchburg, Lynchburg, VA USA
[10] Columbia Univ, Mailman Sch Publ Hlth, New York, NY USA
基金
瑞典研究理事会;
关键词
alpha-gal; red meat allergy; ticks; total serum IgE; ectoparasite; HOUSE-DUST MITE; SKIN-TEST REACTIVITY; IMMUNOGLOBULIN-E; SERUM IGE; QUANTITATIVE MEASUREMENT; ALLERGEN EXPOSURE; POLLEN ALLERGENS; MAMMALIAN MEAT; CAT; SENSITIZATION;
D O I
10.1164/rccm.201111-2017OC
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Rationale: IgE antibodies to the mammalian oligosaccharide galactose-alpha-1,3-galactose (alpha-gal) are common in the southeastern United States. These antibodies, which are induced by ectoparasitic ticks, can give rise to positive skin tests or serum assays with cat extract. Objectives: To evaluate the relationship between IgE antibodies to alpha-gal and asthma, and compare this with the relationship between asthma and IgE antibodies to Fel d 1 and other protein allergens. Methods: Patients being investigated for recurrent anaphylaxis, angioedema, or acute urticaria underwent spirometry, exhaled nitric oxide, questionnaires, and serum IgE antibody assays. The results were compared with control subjects and cohorts from the emergency department in Virginia (n = 130), northern Sweden (n = 963), and rural Kenya (n = 131). Measurements and Main Results: Patients in Virginia with high-titer IgE antibodies to a-gal had normal lung function, low levels of exhaled nitric oxide, and low prevalence of asthma symptoms. Among patients in the emergency department and children in Kenya, there was no association between IgE antibodies to a-gal and asthma (odds ratios, 1.04 and 0.75, respectively). In Sweden, IgE antibodies to cat were closely correlated with IgE antibodies to Fel d 1 (r = 0.83) and to asthma (P < 0.001). Conclusions: These results provide a model of an ectoparasite-induced specific IgE response that can increase total serum IgE without creating a risk for asthma, and further evidence that the main allergens that are causally related to asthma are those that are inhaled.
引用
收藏
页码:723 / 730
页数:8
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