Relationship between red meat allergy and sensitization to gelatin and galactose-⍺-1,3-galactose - 28/04/12
, Hayley James, BS d, Thomas A.E. Platts-Mills, MD, PhD, FRS d, Scott Commins, MD, PhD d
Corresponding author: Raymond James Mullins, MBBS, PhD, FRACP, FRCPA, Clinical Immunology and Allergy, Suite 1, John James Medical Centre 175 Strickland Crescent, Deakin, ACT 2600, Australia.Abstract |
Background |
We have observed patients clinically allergic to red meat and meat-derived gelatin.
Objective |
We describe a prospective evaluation of the clinical significance of gelatin sensitization, the predictive value of a positive test result, and an examination of the relationship between allergic reactions to red meat and sensitization to gelatin and galactose-⍺-1,3-galactose (⍺-Gal).
Methods |
Adult patients evaluated in the 1997-2011 period for suspected allergy/anaphylaxis to medication, insect venom, or food were skin tested with gelatin colloid. In vitro (ImmunoCAP) testing was undertaken where possible.
Results |
Positive gelatin test results were observed in 40 of 1335 subjects: 30 of 40 patients with red meat allergy (12 also clinically allergic to gelatin), 2 of 2 patients with gelatin colloid–induced anaphylaxis, 4 of 172 patients with idiopathic anaphylaxis (all responded to intravenous gelatin challenge of 0.02-0.4 g), and 4 of 368 patients with drug allergy. Test results were negative in all patients with venom allergy (n = 241), nonmeat food allergy (n = 222), and miscellaneous disorders (n = 290). ImmunoCAP results were positive to ⍺-Gal in 20 of 24 patients with meat allergy and in 20 of 22 patients with positive gelatin skin test results. The results of gelatin skin testing and anti–⍺-Gal IgE measurements were strongly correlated (r = 0.46, P < .01). ⍺-Gal was detected in bovine gelatin colloids at concentrations of approximately 0.44 to 0.52 μg/g gelatin by means of inhibition RIA.
Conclusion |
Most patients allergic to red meat were sensitized to gelatin, and a subset was clinically allergic to both. The detection of ⍺-Gal in gelatin and correlation between the results of ⍺-Gal and gelatin testing raise the possibility that ⍺-Gal IgE might be the target of reactivity to gelatin. The pathogenic relationship between tick bites and sensitization to red meat, ⍺-Gal, and gelatin (with or without clinical reactivity) remains uncertain.
Le texte complet de cet article est disponible en PDF.Key words : Food allergy, anaphylaxis, red meat, ⍺-galactose, gelatin, colloid
Abbreviations used : ⍺-Gal, FA, IDT, SPT
Plan
| Supported in part by National Institutes of Health grants RO1 AI-20565, K08 AI085190, and R21 AI087985. |
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| Disclosure of potential conflict of interest: T. A. E. Platts-Mills is a consultant for IBT/Viracor and has received honoraria and research support from Phadia/Thermo-Fisher. S. Commins is on the Cornerstone Therapeutics speakers’ bureau and has received research support from the National Institutes of Health. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 129 - N° 5
P. 1334 - mai 2012 Retour au numéro
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