由tick咬引起的哺乳动物肉过敏

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Chemical structure of Galactose-alpha-1,3-galactose (Wikimedia commons)
Chemical structure of Galactose-alpha-1,3-galactose (Wikimedia commons)

人们对肉类产物的严重过敏反应(包括过敏反应),因为滴答物会导致人体对哺乳动物碳水化合物“α-伽拉尔”产生免疫反应。到目前为止,在澳大利亚和美国已经确定了这种不寻常的状况,但是,受影响的人的数量很大,似乎正在增加。

Galactose-alpha-1,3,-galactose (alpha-gal) is a carbohydrate compound readily synthesised in the mammalian body by the glycosylation enzyme alpha-1,3-galactosyltransferase. The gene responsible for producing this enzyme is inactivated in humans, apes and Old World primates and alpha-gal is not found in the human body and, as such, is seen as “foreign” by the immune system.

Although the mechanism is currently unknown, it has been suggested that ticks that previously fed on other mammals may introduce alpha-gal to the human body when people are bitten by a tick. As alpha-gal is not recognised, the human body mounts an immune response which includes the production of human IgE antibody specific for alpha-gal.

The reaction may not be instantaneous and there may be no symptoms of allergy for several months after the tick bite. Then symptoms may be mild to severe and life threatening, including angioedema (swelling), urticarial (hives) and anaphylaxis, and occurs a few hours after eating meat such a beef or pork which contains the oligosaccharide alpha-gal.

tick叮咬与肉过敏之间的联系是由Sheryl van Nunen教授和同事在悉尼皇家北岸医院的

ixodes全胶囊成年女性附着在人皮肤表面(Wikimedia Commons)
Ixodes holocyclusadult female attached to human skin surface (Wikimedia commons)

Australia. They published an abstract in theInternal Medicine Journalwhere they describe 25 adults with positive skin prick tests and/or red-meat specific antibodies in their serum, 23 of which had previously had allergic reactions (14 with severe anaphylaxis) after eating red meat. In addition, 24/25 of these individuals had a history of being bitten by a tick.

随后,在2008, Prof. Thomas Platts-Mills and colleagues in the US found that patients treated withCetuximab(a monoclonal antibody produced in a mouse cell line and used for the treatment of cancer) also suffered severe allergic reactions and that this was due to an IgE response to the oligosaccharide galactose-alpha-1,3,-galactose (alpha-gal) found on the murine portion of the heavy chain of Cetuximab. The study also showed that allergic reactions to Cetuximab were largely due to IgE antibodies that were already present in pre-treatment samples from these patients, thus demonstrating that Cetuximab itself was not responsible for the initial antibody response.

In addition, a number of patients with alpha-gal IgE antibodies also reported having episodes of anaphylaxis and angioedema after the ingestion of beef or pork. These findings coupled with the regional variation in the prevalence of pre-treatment IgE antibodies(between 0.6% and 20.8%)suggested that some environmental exposure (possibly tick bites) was responsible for causing the allergic reaction to alpha-gal.

The link between tick bites and allergy to alpha-gal was further supported in2009when the same group reported that of 24 patients who were suffering from anaphylaxis, angioedema or urticaria after the ingestion of red meat, and who also had alpha-gal specific IgE antibodies, 80% had also reported being bitten by ticks. Since the initial identification of the relationship between tick bites, alpha-gal and red meat allergy, the scale of the problem has become increasingly apparent in the US and Australia, with additional cases identified in Spain and Sweden.

Amblyomma_americanum_tick
Amblyomma Americanumadult female (Wikimedia commons)

范·纳嫩(Van Nunen)教授友善地谈到了她对澳大利亚问题的看法。“我偶尔从1980年代开始诊断出投诉的人,但是自2003年左右以来,它变得越来越普遍。

“In my practice alone, I have diagnosed over 500 patients (between 1985 and March 2014, with the great majority having presented from 2003 onwards).

“I currently diagnose an average of two people per week with the complaint.”

Therefore, the condition is relatively common in Prof. Van Nunen’s referral area and furthermore, it appears to be on the increase. In Australia, the condition is thought to be caused by the Australian paralysis tick,Ixodes holocyclus,在东海岸的一个狭窄乐队中发现。像欧洲和北美同行(I. ricinus, I. scapularis, I. pacificus)该壁虱具有国际化的宿主范围,其中包括各种哺乳动物物种,当机会出现时,可以导致观察到的过敏。

The tick induced mammalian meat allergy is also a serious problem in theUS, where the lone star tick,Amblyomma Americanum, is thought to be responsible. In excess of 1000 cases are known in Virginia alone and it estimated that over 5000 people may have the condition in the South Eastern US where the tick is present. In some cases the antibody response reduces to a level where people may be able to eat red meat again but, in many cases, people have to avoid eating red meat and are restricted to a diet where chicken and fish are the only meat products they are able to consume.

工作正在进行识别wh的确切机制ereby tick bites induce this allergic response and recently alpha-gal has been identified in the gastrointestinal tract ofIxodes ricinusinSweden, suggesting a possible route of introduction. Whether the condition is simply better recognised, as a result of increased awareness and immunological testing, or whether this condition is truly on the rise, possibly as a result of local climate change, increased host abundance (e.g. deer in the US) or increased recreational activities (walking/biking) contributing to increased contact rates between ticks and humans, remains to be seen.

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[…] its mosquito vectors have topped the bill, but the topics have been very diverse, ranging from a meat allergy caused by tick bites to bumble bee diseases and covering a variety of epidemiological topics, modelling, helminth […]

斯蒂芬

艾伦(Alan)应该提到,在美国中部,澳大利亚西海岸和南非西海岸发现了tick虫的MMA,并蔓延。随着壁虱咬合和出现的症状之间的空中旅行和距离较大的距离,该区域现在必须很大。

有更多比被“发现”y scientists in 2007 and hopefully they are still researching.

My symptoms started in 2003 after a tick bite and tick bite fever. It was progressive covering all mammal meat with the exception of pork. I knew it was my defence system against the red blood cell virus and at first thought the trigger was taurine and even stopped drinking Red Bull.

我的前瞻性面临的真正危险是,如果没有药物或epipen捕获(例如,在用哺乳动物含量的餐厅用餐后),那么乘坐汽车的化学家就不会被红色的交通信号灯阻止,并且没有放慢的速度尖锐的弯曲。

The question is also why now after millennia of mammal gorging?

Nicholas Gambier

I have worked on a cattle ranch in Zimbabwe and was frequently bitten by ticks. I developed allergy to red meat and dairy products which I have had now for more than 40 years, but it seems to be diminishing in the case of dairy products. Can I look forward to it eventually disappearing?

注释are closed.