Skip to main content
Top
Published in: American Journal of Clinical Dermatology 4/2022

16-05-2022 | Tick | Review Article

Meat Allergy: A Ticking Time Bomb

Authors: Rohan Shah, Robert A. Schwartz

Published in: American Journal of Clinical Dermatology | Issue 4/2022

Login to get access

Abstract

Food allergies are relatively prevalent, but mammalian meat allergy remains uncommon and represents an important, potentially acute healthcare risk. This risk is partly because both clinicians and the public lack awareness of this serious allergy, which is unique in three important ways: it incurs a delayed reaction, it is induced by a carbohydrate rather than a protein, and it is linked to tick bites. Although various symptoms are possible, its unique presentation means that mammalian meat allergy is often presented to the dermatologist. We review this challenging subject, which is particularly salient considering the unique connection between ticks and mammalian meat allergy, the expanding tick territory, and the dependency by so many on meat products, not only in the diet but also in medications and medical devices.
Literature
1.
go back to reference Van Nunen SA. Tick-induced allergies: mammalian meat allergy and tick anaphylaxis. Med J Aust. 2018;208(7):316–21.CrossRef Van Nunen SA. Tick-induced allergies: mammalian meat allergy and tick anaphylaxis. Med J Aust. 2018;208(7):316–21.CrossRef
2.
go back to reference Platts-Mills TAE, Li RC, Keshavarz B, Smith AR, Wilson JM. Diagnosis and management of patients with the α-gal syndrome. J Allergy Clin Immunol Pract. 2020;8(1):15-23.e1.CrossRef Platts-Mills TAE, Li RC, Keshavarz B, Smith AR, Wilson JM. Diagnosis and management of patients with the α-gal syndrome. J Allergy Clin Immunol Pract. 2020;8(1):15-23.e1.CrossRef
3.
go back to reference Commins SP. Carbohydrates as allergens. Curr Allergy Asthma Rep. 2014;15(1):492.CrossRef Commins SP. Carbohydrates as allergens. Curr Allergy Asthma Rep. 2014;15(1):492.CrossRef
4.
go back to reference Van Nunen SA, O’Connor KS, Clarke LR, Boyle RX, Fernando SL. An association between tick bite reactions and red meat allergy in humans. Med J Aust. 2009;190(9):510–1.CrossRef Van Nunen SA, O’Connor KS, Clarke LR, Boyle RX, Fernando SL. An association between tick bite reactions and red meat allergy in humans. Med J Aust. 2009;190(9):510–1.CrossRef
5.
go back to reference Van Nunen SA, O'Connor KS, Fernando SL, Clarke LR, Boyle. The assoication between Ixodes Holocyclus tick bite reactions and red meat allergy. RJIMJ. 2007;37:510–511. Van Nunen SA, O'Connor KS, Fernando SL, Clarke LR, Boyle. The assoication between Ixodes Holocyclus tick bite reactions and red meat allergy. RJIMJ. 2007;37:510–511.
6.
go back to reference Sharma SR, Karim S. Tick saliva and the alpha-gal syndrome: finding a needle in a haystack. Front Cell Infect Microbiol. 2021;11:264. Sharma SR, Karim S. Tick saliva and the alpha-gal syndrome: finding a needle in a haystack. Front Cell Infect Microbiol. 2021;11:264.
7.
go back to reference Commins SP, Platts-Mills TA. Tick bites and red meat allergy. Curr Opin Allergy Clin Immunol. 2013;13(4):354–9.CrossRef Commins SP, Platts-Mills TA. Tick bites and red meat allergy. Curr Opin Allergy Clin Immunol. 2013;13(4):354–9.CrossRef
8.
go back to reference Bhate C, Schwartz RA. Lyme disease: part I. Advances and perspectives. J Am Acad Dermatol. 2011;64(4):619–36 (quiz 37–8).CrossRef Bhate C, Schwartz RA. Lyme disease: part I. Advances and perspectives. J Am Acad Dermatol. 2011;64(4):619–36 (quiz 37–8).CrossRef
9.
go back to reference Patel C, Iweala OI. ‘Doc, will I ever eat steak again?’ Diagnosis and management of alpha-gal syndrome. Curr Opin Pediatr. 2020;32(6):816–24.CrossRef Patel C, Iweala OI. ‘Doc, will I ever eat steak again?’ Diagnosis and management of alpha-gal syndrome. Curr Opin Pediatr. 2020;32(6):816–24.CrossRef
10.
go back to reference Fischer J, Yazdi AS, Biedermann T. Clinical spectrum of α-Gal syndrome: from immediate-type to delayed immediate-type reactions to mammalian innards and meat. Allergo J Int. 2016;25:55–62.CrossRef Fischer J, Yazdi AS, Biedermann T. Clinical spectrum of α-Gal syndrome: from immediate-type to delayed immediate-type reactions to mammalian innards and meat. Allergo J Int. 2016;25:55–62.CrossRef
11.
go back to reference Wilson JM, Keshavarz B, Retterer M, Workman LJ, Schuyler AJ, McGowan EC, et al. A dynamic relationship between two regional causes of IgE-mediated anaphylaxis: α-Gal syndrome and imported fire ant. J Allergy Clin Immunol. 2021;147(2):643-652.e7.CrossRef Wilson JM, Keshavarz B, Retterer M, Workman LJ, Schuyler AJ, McGowan EC, et al. A dynamic relationship between two regional causes of IgE-mediated anaphylaxis: α-Gal syndrome and imported fire ant. J Allergy Clin Immunol. 2021;147(2):643-652.e7.CrossRef
12.
go back to reference Chinuki Y, Ishiwata K, Yamaji K, Takahashi H, Morita E. Haemaphysalis longicornis tick bites are a possible cause of red meat allergy in Japan. Allergy. 2016;71(3):421–5.CrossRef Chinuki Y, Ishiwata K, Yamaji K, Takahashi H, Morita E. Haemaphysalis longicornis tick bites are a possible cause of red meat allergy in Japan. Allergy. 2016;71(3):421–5.CrossRef
13.
go back to reference Hamsten C, Tran TAT, Starkhammar M, Brauner A, Commins SP, Platts-Mills TAE, et al. Red meat allergy in Sweden: association with tick sensitization and B-negative blood groups. J Allergy Clin Immunol. 2013;132(6):1431–4.CrossRef Hamsten C, Tran TAT, Starkhammar M, Brauner A, Commins SP, Platts-Mills TAE, et al. Red meat allergy in Sweden: association with tick sensitization and B-negative blood groups. J Allergy Clin Immunol. 2013;132(6):1431–4.CrossRef
14.
go back to reference Apostolovic D, Tran TAT, Starkhammar M, Sánchez-Vidaurre S, Hamsten C, Van Hage M. The red meat allergy syndrome in Sweden. Allergo J Int. 2016;25(2):49–54.CrossRef Apostolovic D, Tran TAT, Starkhammar M, Sánchez-Vidaurre S, Hamsten C, Van Hage M. The red meat allergy syndrome in Sweden. Allergo J Int. 2016;25(2):49–54.CrossRef
15.
go back to reference Schimmel J, Fawaz B, Renzi M, Heymann WR, Van Nunen S, Manders S. Mammalian meat allergy—beyond urticaria? Int J Dermatol. 2020;59(8):e312–4.CrossRef Schimmel J, Fawaz B, Renzi M, Heymann WR, Van Nunen S, Manders S. Mammalian meat allergy—beyond urticaria? Int J Dermatol. 2020;59(8):e312–4.CrossRef
16.
go back to reference Donaldson B, Le MN. The clinical presentation of alpha-gal allergy among pediatric patients with food allergy in southwest Missouri. Ann Allergy Asthma Immunol. 2019;123(5):524–5.CrossRef Donaldson B, Le MN. The clinical presentation of alpha-gal allergy among pediatric patients with food allergy in southwest Missouri. Ann Allergy Asthma Immunol. 2019;123(5):524–5.CrossRef
17.
go back to reference Wen S, Unuma K, Chinuki Y, Hikino H, Uemura K. Fatal anaphylaxis due to alpha-gal syndrome after initial cetuximab administration: the first forensic case report. Leg Med (Tokyo). 2021;51:101–18.CrossRef Wen S, Unuma K, Chinuki Y, Hikino H, Uemura K. Fatal anaphylaxis due to alpha-gal syndrome after initial cetuximab administration: the first forensic case report. Leg Med (Tokyo). 2021;51:101–18.CrossRef
18.
go back to reference Commins SP, James HR, Stevens W, Pochan SL, Land MH, King C, et al. Delayed clinical and ex vivo response to mammalian meat in patients with IgE to galactose-alpha-1,3-galactose. J Allergy Clin Immunol. 2014;134(1):108–15.CrossRef Commins SP, James HR, Stevens W, Pochan SL, Land MH, King C, et al. Delayed clinical and ex vivo response to mammalian meat in patients with IgE to galactose-alpha-1,3-galactose. J Allergy Clin Immunol. 2014;134(1):108–15.CrossRef
19.
go back to reference Wilson JM, Platts-Mills TAE. Red meat allergy in children and adults. Curr Opin Allergy Clin Immunol. 2019;19(3):229–35.CrossRef Wilson JM, Platts-Mills TAE. Red meat allergy in children and adults. Curr Opin Allergy Clin Immunol. 2019;19(3):229–35.CrossRef
20.
go back to reference Fischer J, Hebsaker J, Caponetto P, Platts-Mills TA, Biedermann T. Galactose-alpha-1,3-galactose sensitization is a prerequisite for pork-kidney allergy and cofactor-related mammalian meat anaphylaxis. J Allergy Clin Immunol. 2014;134(3):755-9.e1.CrossRef Fischer J, Hebsaker J, Caponetto P, Platts-Mills TA, Biedermann T. Galactose-alpha-1,3-galactose sensitization is a prerequisite for pork-kidney allergy and cofactor-related mammalian meat anaphylaxis. J Allergy Clin Immunol. 2014;134(3):755-9.e1.CrossRef
21.
go back to reference Cabezas-Cruz A, Hodžić A, Román-Carrasco P, Mateos-Hernández L, Duscher GG, Sinha DK, et al. Environmental and molecular drivers of the α-gal syndrome. Front Immunol. 2019;10:1210.CrossRef Cabezas-Cruz A, Hodžić A, Román-Carrasco P, Mateos-Hernández L, Duscher GG, Sinha DK, et al. Environmental and molecular drivers of the α-gal syndrome. Front Immunol. 2019;10:1210.CrossRef
22.
go back to reference Rutkowski K, Wagner A, Rutkowski R, Sowa P, Pancewicz S, Moniuszko-Malinowska A. Alpha-gal syndrome: an emerging cause of food and drug allergy. Clin Exp Allergy J Br Soc Allergy Clin Immunol. 2020;50(8):894–903.CrossRef Rutkowski K, Wagner A, Rutkowski R, Sowa P, Pancewicz S, Moniuszko-Malinowska A. Alpha-gal syndrome: an emerging cause of food and drug allergy. Clin Exp Allergy J Br Soc Allergy Clin Immunol. 2020;50(8):894–903.CrossRef
23.
go back to reference Hilger C, Fischer J, Swiontek K, Hentges F, Lehners C, Eberlein B, et al. Two galactose-α-1,3-galactose carrying peptidases from pork kidney mediate anaphylactogenic responses in delayed meat allergy. Allergy. 2016;71(5):711–9.CrossRef Hilger C, Fischer J, Swiontek K, Hentges F, Lehners C, Eberlein B, et al. Two galactose-α-1,3-galactose carrying peptidases from pork kidney mediate anaphylactogenic responses in delayed meat allergy. Allergy. 2016;71(5):711–9.CrossRef
24.
go back to reference Kwak M, Somerville C, Van Nunen S. A novel Australian tick Ixodes (Endopalpiger) australiensis inducing mammalian meat allergy after tick bite. Asia Pac Allergy. 2018;8(3): e31.CrossRef Kwak M, Somerville C, Van Nunen S. A novel Australian tick Ixodes (Endopalpiger) australiensis inducing mammalian meat allergy after tick bite. Asia Pac Allergy. 2018;8(3): e31.CrossRef
25.
go back to reference Commins SP. Diagnosis and management of alpha-gal syndrome: lessons from 2,500 patients. Expert Rev Clin Immunol. 2020;16(7):667–77.CrossRef Commins SP. Diagnosis and management of alpha-gal syndrome: lessons from 2,500 patients. Expert Rev Clin Immunol. 2020;16(7):667–77.CrossRef
26.
go back to reference Steinke JW, Platts-Mills TA, Commins SP. The alpha-gal story: lessons learned from connecting the dots. J Allergy Clin Immunol. 2015;135(3):589–96.CrossRef Steinke JW, Platts-Mills TA, Commins SP. The alpha-gal story: lessons learned from connecting the dots. J Allergy Clin Immunol. 2015;135(3):589–96.CrossRef
27.
go back to reference Westermann-Clark E, Pepper AN, Lockey RF. Economic considerations in the treatment of systemic allergic reactions. J Asthma Allergy. 2018;11:153–8.CrossRef Westermann-Clark E, Pepper AN, Lockey RF. Economic considerations in the treatment of systemic allergic reactions. J Asthma Allergy. 2018;11:153–8.CrossRef
28.
go back to reference Taylor BWP, Ratchford A, Van Nunen S, Burns B. Tick killing in situ before removal to prevent allergic and anaphylactic reactions in humans: a cross-sectional study. Asia Pac Allergy. 2019;9(2): e15.CrossRef Taylor BWP, Ratchford A, Van Nunen S, Burns B. Tick killing in situ before removal to prevent allergic and anaphylactic reactions in humans: a cross-sectional study. Asia Pac Allergy. 2019;9(2): e15.CrossRef
29.
go back to reference Kaneko Y, Kitano S, Umayahara T, Kageyama R, Hashizume H. Tick anaphylaxis in Japan. J Cutan Immunol Allergy. 2019;2(2):53–4.CrossRef Kaneko Y, Kitano S, Umayahara T, Kageyama R, Hashizume H. Tick anaphylaxis in Japan. J Cutan Immunol Allergy. 2019;2(2):53–4.CrossRef
30.
go back to reference Dunkman WJ, Rycek W, Manning MW. What does a red meat allergy have to do with anesthesia? Perioperative management of alpha-gal syndrome. Anesth Analg. 2019;129(5):1242–8.CrossRef Dunkman WJ, Rycek W, Manning MW. What does a red meat allergy have to do with anesthesia? Perioperative management of alpha-gal syndrome. Anesth Analg. 2019;129(5):1242–8.CrossRef
31.
go back to reference Wilson JM, McNamara CA, Platts-Mills TAE. IgE, α-gal and atherosclerosis. Aging. 2019;11(7):1900–2.CrossRef Wilson JM, McNamara CA, Platts-Mills TAE. IgE, α-gal and atherosclerosis. Aging. 2019;11(7):1900–2.CrossRef
32.
go back to reference Wilson JM, Nguyen AT, Schuyler AJ, Commins SP, Taylor AM, Platts-Mills TAE, et al. IgE to the mammalian oligosaccharide galactose-α-1,3-galactose is associated with increased atheroma volume and plaques with unstable characteristics-brief report. Arterioscler Thromb Vasc Biol. 2018;38(7):1665–9.CrossRef Wilson JM, Nguyen AT, Schuyler AJ, Commins SP, Taylor AM, Platts-Mills TAE, et al. IgE to the mammalian oligosaccharide galactose-α-1,3-galactose is associated with increased atheroma volume and plaques with unstable characteristics-brief report. Arterioscler Thromb Vasc Biol. 2018;38(7):1665–9.CrossRef
33.
go back to reference Vernon ST, Kott KA, Hansen T, Finemore M, Baumgart KW, Bhindi R, et al. Immunoglobulin E sensitization to mammalian oligosaccharide galactose-a-1,3 (α-Gal) is associated with noncalcified plaque, obstructive coronary artery disease, and ST-segment-elevated myocardial infarction. Arterioscler Thromb Vasc Biol. 2022;42:352–61.CrossRef Vernon ST, Kott KA, Hansen T, Finemore M, Baumgart KW, Bhindi R, et al. Immunoglobulin E sensitization to mammalian oligosaccharide galactose-a-1,3 (α-Gal) is associated with noncalcified plaque, obstructive coronary artery disease, and ST-segment-elevated myocardial infarction. Arterioscler Thromb Vasc Biol. 2022;42:352–61.CrossRef
34.
go back to reference Rubin R. Red meat allergy associated with coronary artery plaque. JAMA. 2018;320(4):331–3.PubMed Rubin R. Red meat allergy associated with coronary artery plaque. JAMA. 2018;320(4):331–3.PubMed
35.
go back to reference Slayden TA, Shakir MKM, Hoang TD. A bull in a pill shop: alpha-gal allergy complicating treatment options for postprocedural hypothyroidism. AACE Clin Case Rep. 2020;6(3):e101–4.CrossRef Slayden TA, Shakir MKM, Hoang TD. A bull in a pill shop: alpha-gal allergy complicating treatment options for postprocedural hypothyroidism. AACE Clin Case Rep. 2020;6(3):e101–4.CrossRef
36.
go back to reference Seddon I, Venincasa M, Farber N, Sridhar J. Alpha-gal syndrome in ophthalmology and medicine. Int Ophthalmol Clin. 2020;60(4):61–75.CrossRef Seddon I, Venincasa M, Farber N, Sridhar J. Alpha-gal syndrome in ophthalmology and medicine. Int Ophthalmol Clin. 2020;60(4):61–75.CrossRef
37.
go back to reference Hawkins RB, Frischtak HL, Kron IL, Ghanta RK. Premature bioprosthetic aortic valve degeneration associated with allergy to galactose-alpha-1,3-galactose. J Card Surg. 2016;31(7):446–8.CrossRef Hawkins RB, Frischtak HL, Kron IL, Ghanta RK. Premature bioprosthetic aortic valve degeneration associated with allergy to galactose-alpha-1,3-galactose. J Card Surg. 2016;31(7):446–8.CrossRef
38.
go back to reference Muglia C, Kar I, Gong M, Hermes-DeSantis ER, Monteleone C. Anaphylaxis to medications containing meat byproducts in an alpha-gal sensitized individual. J Allergy Clin Immunol Pract. 2015;3(5):796–7.CrossRef Muglia C, Kar I, Gong M, Hermes-DeSantis ER, Monteleone C. Anaphylaxis to medications containing meat byproducts in an alpha-gal sensitized individual. J Allergy Clin Immunol Pract. 2015;3(5):796–7.CrossRef
39.
go back to reference Yuile A, Fanuli C, Van Nunen S, Diakos C, Clarke S, Steiner C, et al. Increased rates of cetuximab reactions in tick prevalent regions and a proposed protocol for risk mitigation. Asia Pac J Clin Oncol. 2021;17(6):448–53.CrossRef Yuile A, Fanuli C, Van Nunen S, Diakos C, Clarke S, Steiner C, et al. Increased rates of cetuximab reactions in tick prevalent regions and a proposed protocol for risk mitigation. Asia Pac J Clin Oncol. 2021;17(6):448–53.CrossRef
40.
go back to reference Raghavan RK, Koestel Z, Ierardi R, Peterson AT, Cobos ME. Climatic suitability of the eastern paralysis tick, Ixodes holocyclus, and its likely geographic distribution in the year 2050. Sci Rep. 2021;11(1):15330.CrossRef Raghavan RK, Koestel Z, Ierardi R, Peterson AT, Cobos ME. Climatic suitability of the eastern paralysis tick, Ixodes holocyclus, and its likely geographic distribution in the year 2050. Sci Rep. 2021;11(1):15330.CrossRef
Metadata
Title
Meat Allergy: A Ticking Time Bomb
Authors
Rohan Shah
Robert A. Schwartz
Publication date
16-05-2022
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 4/2022
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.1007/s40257-022-00696-x

Other articles of this Issue 4/2022

American Journal of Clinical Dermatology 4/2022 Go to the issue