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α-Gal specific-IgE prevalence and levels in Ecuador and Kenya: Relation to diet, parasites, and IgG4

Wilson, J; Keshavarz, B; James, H; Retterer, M; Schuyler, A; Knoedler, A; Workman, L; Ng'ang'a, L; Chico, ME; Rönmark, E; et al. Wilson, J; Keshavarz, B; James, H; Retterer, M; Schuyler, A; Knoedler, A; Workman, L; Ng'ang'a, L; Chico, ME; Rönmark, E; Heymann, P; Perzanowski, M; Platts-Mills, T; Cooper, P (2021) α-Gal specific-IgE prevalence and levels in Ecuador and Kenya: Relation to diet, parasites, and IgG4. J Allergy Clin Immunol, 147 (4). 1393-1401.e7. ISSN 1097-6825 https://doi.org/10.1016/j.jaci.2020.12.650
SGUL Authors: Cooper, Philip John

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Abstract

Background IgE to α-Gal is a cause of mammalian meat allergy and has been linked to tick bites in North America, Australia, and Eurasia. Reports from the developing world indicate that α-Gal sensitization is prevalent but has been little investigated. Objective We sought evidence for the cause(s) of α-Gal sensitization and lack of reported meat allergy among children in less developed settings in Ecuador and Kenya. Methods IgE to α-Gal and total IgE were assessed in children from Ecuador (n = 599) and Kenya (n = 254) and compared with children with (n = 42) and without known (n = 63) mammalian meat allergy from the southeastern United States. Information on diet, potential risk factors, and helminth infections was available for children from Ecuador. IgG4 to α-Gal and antibodies to regionally representative parasites were assessed in a subset of children. Results In Ecuador (32%) and Kenya (54%), α-Gal specific IgE was prevalent, but levels were lower than in children with meat allergy from the United States. Sensitization was associated with rural living, antibody markers of Ascaris exposure, and total IgE, but not active infections with Ascaris or Trichuris species. In Ecuador, 87.5% reported consuming beef at least once per week, including 83.9% of those who had α-Gal specific IgE. Levels of α-Gal specific IgG4 were not high in Ecuador, but were greater than in children from the United States. Conclusions These results suggest that in areas of the developing world with endemic parasitism, α-Gal sensitization is (1) common, (2) associated with Ascaris exposure, and (3) distinguished by a low percentage of specific/total IgE compared with individuals with meat allergy in the United States.

Item Type: Article
Additional Information: © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Ascaris, IgE, mammalian meat allergy, parasite, sensitization, α-Gal, Ascaris, IgE, mammalian meat allergy, parasite, sensitization, α-Gal, Allergy, 1107 Immunology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: J Allergy Clin Immunol
ISSN: 1097-6825
Language: eng
Dates:
DateEvent
April 2021Published
1 February 2021Published Online
22 December 2020Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Projects:
Project IDFunderFunder ID
R37 AI-20565National Institutes of Healthhttp://dx.doi.org/10.13039/100000002
088862/Z/09/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
PubMed ID: 33539899
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112921
Publisher's version: https://doi.org/10.1016/j.jaci.2020.12.650

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