Abstract
Alpha-gal syndrome is characterized by an IgE-mediated immune response against galactose-α-1,3-galactose. In the United States, the principal vector is the Lone Star tick, whose range has expanded nationwide. 110,000 cases have been reported since 2010, with the CDC estimating 450,000 as many cases go unrecognized. Vomiting, difficulty breathing, and hypotension can occur immediately or hours after exposure. Ongoing exposure to alpha galactose with AGS increases mast cell inflammatory response, raising coronary artery disease risk. Perioperative ingredients like gelatin, monoclonal antibodies, and stearic acid have triggered anaphylactic shock in AGS patients. These complications hinder diagnosis. The inclusion criteria required original research in English peer-reviewed journal between January 1, 2010, and March 22, 2025. Eligible studies included quantitative, qualitative, and mixed-methods designs examining AGS acquisition. Relevant tick studies were included. Systematic reviews, scoping reviews, meta-analyses; case reports, series; studies involving pregnant individuals or children, lacking full-text, duplicate publications, or overlapping datasets were excluded. Authors screened publications using Rayyan. Discrepancies were resolved through discussion. Clinicians do not immediately think about testing for IgE antibody levels after a tick bite. Repeated exposure after a bite to alpha-gal through red meat exposure and pharmaceutical agents leads to more severe reactions over time. There is a need for more education regarding allergic complications in heparin and perioperative ingredients as AGS is overlooked from perioperative ingredient allergy screening. Understanding the AGS mechanisms from tick-induced immune modulation to delayed lipid-mediated allergen presentation is crucial for the development of diagnostic tools, therapies, and prevention. This review plays a role by synthesizing evidence on the immunological and molecular processes involved in AGS, highlighting key areas of agreement and gaps that warrant further investigation.
Faculty Sponsors
Dr. Marc Kesselman
Project Type
Event
Location
Alvin Sherman Library
Start Date
4-1-2026 12:43 PM
End Date
4-2-2026 12:00 PM
Ticked Off: A Systematic Review of Alpha-gal Syndrome Mechanisms
Alvin Sherman Library
Alpha-gal syndrome is characterized by an IgE-mediated immune response against galactose-α-1,3-galactose. In the United States, the principal vector is the Lone Star tick, whose range has expanded nationwide. 110,000 cases have been reported since 2010, with the CDC estimating 450,000 as many cases go unrecognized. Vomiting, difficulty breathing, and hypotension can occur immediately or hours after exposure. Ongoing exposure to alpha galactose with AGS increases mast cell inflammatory response, raising coronary artery disease risk. Perioperative ingredients like gelatin, monoclonal antibodies, and stearic acid have triggered anaphylactic shock in AGS patients. These complications hinder diagnosis. The inclusion criteria required original research in English peer-reviewed journal between January 1, 2010, and March 22, 2025. Eligible studies included quantitative, qualitative, and mixed-methods designs examining AGS acquisition. Relevant tick studies were included. Systematic reviews, scoping reviews, meta-analyses; case reports, series; studies involving pregnant individuals or children, lacking full-text, duplicate publications, or overlapping datasets were excluded. Authors screened publications using Rayyan. Discrepancies were resolved through discussion. Clinicians do not immediately think about testing for IgE antibody levels after a tick bite. Repeated exposure after a bite to alpha-gal through red meat exposure and pharmaceutical agents leads to more severe reactions over time. There is a need for more education regarding allergic complications in heparin and perioperative ingredients as AGS is overlooked from perioperative ingredient allergy screening. Understanding the AGS mechanisms from tick-induced immune modulation to delayed lipid-mediated allergen presentation is crucial for the development of diagnostic tools, therapies, and prevention. This review plays a role by synthesizing evidence on the immunological and molecular processes involved in AGS, highlighting key areas of agreement and gaps that warrant further investigation.
