PMID- 35879928
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220727
IS  - 1178-6965 (Print)
IS  - 1178-6965 (Electronic)
IS  - 1178-6965 (Linking)
VI  - 15
DP  - 2022
TI  - Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal 
      Syndrome (AGS).
PG  - 957-970
LID - 10.2147/JAA.S265660 [doi]
AB  - The alpha-Gal syndrome (AGS) is a pathognomonic immunoglobulin E (IgE)-mediated 
      delayed anaphylaxis in foods containing the oligosaccharide 
      galactose-alpha-1,3-galactose (alpha-Gal) such as mammalian meat or dairy products. 
      Clinical presentation of AGS can also comprise immediate hypersensitivity due to 
      anticancer therapy, gelatin-containing vaccines or mammalian serum-based 
      antivenom. The IgE initial sensitization is caused by hard-bodied tick bites and 
      symptomatic individuals typically develop delayed pruritus, urticaria, 
      angioedema, anaphylaxis, malaise or gut-related symptoms. Due to inapparent 
      presentation, delayed reactions and a wide variety of patients  clinical history, 
      the AGS diagnosis and treatment remain challenging. This review covers not only 
      current diagnostic methods used for AGS such as the skin prick test (SPT), the 
      oral food challenge (OFC), anti-alpha-Gal IgE levels measurement and the basophil 
      activation test (BAT), but also potentially relevant next-generation diagnostic 
      tools like the mast cell activation test (MAT), the histamine-release (HR) assay, 
      omics technologies and model-based reasoning (MBR). Moreover, it focuses on the 
      therapeutical medical and non-medical methods available and current research 
      methods that are being applied in order to elucidate the molecular, physiological 
      and immune mechanisms underlying this allergic disorder. Lastly, future treatment 
      and preventive tools are also discussed, being of utmost importance for the 
      identification of tick salivary molecules, with or without alpha-Gal modifications, 
      that trigger IgE sensitivity as they could be the key for further vaccine 
      development. Bearing in mind climate change, the tick-host paradigm will shift 
      towards an increasing number of AGS cases in new regions worldwide, which will 
      pose new challenges for clinicians in the future.
CI  - (c) 2022 Vaz-Rodrigues et al.
FAU - Vaz-Rodrigues, Rita
AU  - Vaz-Rodrigues R
AD  - SaBio (Health and Biotechnology), Instituto de Investigacion en Recursos 
      Cinegeticos IREC (CSIC-UCLM-JCCM), Ciudad Real, 13005, Spain.
FAU - Mazuecos, Lorena
AU  - Mazuecos L
AD  - SaBio (Health and Biotechnology), Instituto de Investigacion en Recursos 
      Cinegeticos IREC (CSIC-UCLM-JCCM), Ciudad Real, 13005, Spain.
FAU - de la Fuente, Jose
AU  - de la Fuente J
AUID- ORCID: 0000-0001-7383-9649
AD  - SaBio (Health and Biotechnology), Instituto de Investigacion en Recursos 
      Cinegeticos IREC (CSIC-UCLM-JCCM), Ciudad Real, 13005, Spain.
AD  - Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, 
      Oklahoma State University, Stillwater, OK, 74078, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220718
PL  - New Zealand
TA  - J Asthma Allergy
JT  - Journal of asthma and allergy
JID - 101543450
PMC - PMC9307871
OTO - NOTNLM
OT  - AGS
OT  - IgE
OT  - alpha-Gal
OT  - alpha-Gal syndrome
OT  - food allergy
OT  - glycan
OT  - tick
COIS- The authors declare that they have no conflicts of interest in this work.
EDAT- 2022/07/27 06:00
MHDA- 2022/07/27 06:01
PMCR- 2022/07/18
CRDT- 2022/07/26 01:53
PHST- 2022/05/21 00:00 [received]
PHST- 2022/07/12 00:00 [accepted]
PHST- 2022/07/26 01:53 [entrez]
PHST- 2022/07/27 06:00 [pubmed]
PHST- 2022/07/27 06:01 [medline]
PHST- 2022/07/18 00:00 [pmc-release]
AID - 265660 [pii]
AID - 10.2147/JAA.S265660 [doi]
PST - epublish
SO  - J Asthma Allergy. 2022 Jul 18;15:957-970. doi: 10.2147/JAA.S265660. eCollection 
      2022.