Q:

10/13/2013
I recently developed delayed onset Urticaria to beef and pork; had + RAST to pork, beef, lamb and an Alpha Gal of 24.6. Lone star tick bites in late June in Fire Island, NY. My question is how often in Alpha Gal elevated in the general population; i.e., those not sensitive to mammalian meats? In the U. VA study from 2009 this was not mentioned. Were the patients who were allergic to Cetuxamib sensitive to meats? If Dr. Commins is interested in helping me with the answers I would be grateful; we have a huge Lone Star Tick population in Fire Island.

A:

Thank you for your inquiry.

Since you mentioned Dr. Scott Commins, who is a national authority in this area, I am referring your question to him. When we receive his response, we will forward it to you.

Thank you again for your inquiry.

Sincerely,
Phil Lieberman, M.D.

We have received a response from Dr. Commins. Thank you again for your inquiry.

Sincerely,
Phil Lieberman, M.D.

Response from Dr. Scott Commins:
We, too, are interested in the prevalence of IgE to alpha-gal in the general population. Given the large differences in the local cases that we and others have found, the prevalence likely varies quite significantly based on practice location. We have investigated the prevalence in sera from a Central Virginia cohort (~7-10%), Boston cohort (<1%), and northern Sweden (<1%). Based on our current data and hypothesis, the prevalence would clearly differ based upon whether ticks are present in the geographical locale in question.

When we returned to the population that was treated with cetuximab and had IgE to alpha-gal in order to ask the same question posed above, we found that those patients had unfortunately passed away. Cetuximab was being used as salvage chemotherapy in that group and those patients had advanced disease at the time of their study enrollment. The assay for IgE to alpha-gal came after that sera was collected and not in time to inquire about meat allergy in those patients.

Scott Commins, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology