Ascaris lumbricoides and ticks associated with sensitization to galactose α1,3-galactose and elicitation of the alpha-gal syndrome

Tatenda Murangi, Prema Prakash, Bernardo Pereira Moreira, Wisdom Basera, Maresa Botha, Stephen Cunningham, Heidi Facey-Thomas, Ali Halajian, Lokesh Joshi, Jordache Ramjith, Franco H Falcone, William Horsnell, Michael E Levin

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: IgE to galactose alpha-1,3 galactose (alpha-gal) causes alpha-gal syndrome (delayed anaphylaxis after ingestion of mammalian meat). Development of sensitization has been attributed to tick bites; however, the possible role of other parasites has not been well studied.

OBJECTIVE: Our aims were to assess the presence, relative abundances, and site of localization of alpha-gal-containing proteins in common ectoparasites and endoparasites endemic in an area of high prevalence of alpha-gal syndrome, as well as to investigate the ability of ascaris antigens to elicit a reaction in a humanized rat basophil in vitro sensitization model.

METHODS: Levels of total IgE, Ascaris-specific IgE, and alpha-gal IgE were measured in sera from patients with challenge-proven alpha-gal syndrome and from controls without allergy. The presence, concentration, and localization of alpha-gal in parasites were assessed by ELISA, Western blotting, and immunohistochemistry. The ability of Ascaris lumbricoides antigen to elicit IgE-dependent reactivity was demonstrated by using the RS-ATL8 basophil reporter system.

RESULTS: Alpha-gal IgE level correlated with A lumbricoides-specific IgE level. Alpha-gal protein at 70 to 130 kDa was detected in A lumbricoides at concentrations higher than those found in Rhipicephalus evertsi and Amblyomma hebraeum ticks. Immunohistochemistry was used to localize alpha-gal in tick salivary acini and the helminth gut. Non-alpha-gal-containing A lumbricoides antigens activated RS-ATL8 basophils primed with serum from subjects with alpha-gal syndrome.

CONCLUSION: We demonstrated the presence, relative abundances, and site of localization of alpha-gal-containing proteins in parasites. The activation of RS-ATL8 IgE reporter cells primed with serum from subjects with alpha-gal syndrome on exposure to non-alpha-gal-containing A lumbricoides proteins indicates a possible role of exposure to A lumbricoides in alpha-gal sensitization and clinical reactivity.

Original languageEnglish
JournalJournal of Allergy and Clinical Immunology
Early online date29 Jul 2021
DOIs
Publication statusE-pub ahead of print - 29 Jul 2021

Bibliographical note

Funding Information:
Supported by the Birmingham-Nottingham Strategic Collaboration Fund (to W.G.C.H. and F.H.F.); the LOEWE Centre DRUID within the Hessian Excellence Initiative (P.P., B.P.M., and F.H.F.), and a National Research Foundation Innovation M&D Scholarship (to T.M.).

Publisher Copyright:
© 2021 American Academy of Allergy, Asthma & Immunology

Keywords

  • Alpha-gal
  • Amblyomma hebraeum
  • Ascaris lumbricoides
  • Rhipicephalus evertsi
  • anaphylaxis
  • food allergy
  • galactose-alpha-1,3-galactose
  • helminths
  • meat allergy
  • red meat allergy
  • ticks

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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