日本における無症候性Galactose-α-1,3-galactose感作のコホート研究

概要

Sensitization to galactose-α-1,3-galactose (α-Gal) leads to the development of α-Gal
syndrome, which includes red meat allergy and cetuximab-induced anaphylaxis. Cetuximab
contains glycosylation sites, including the α-Gal site in the Fab region. The late-onset urticaria
and anaphylaxis that occurred 3–6 h after red meat consumption are mediated by IgE specific to
the α-Gal carbohydrate structure, similar to that in cetuximab allergy. Several studies showed
that tick bites are involved in the development of red-meat allergy via sensitization to α-Gal,
because the salivary gland or the gastrointestinal tract of tick contains α-Gal-bearing proteins.
Since tick bites represent the main cause of α-Gal sensitization, it was speculated that
sensitization to α-Gal occurs throughout Japan. However, few cohort studies have investigated
α-Gal sensitization in Japan. Since we have identified certain cases of cetuximab allergy even
without a previous history of red meat allergy, 18 it is of clinical interest to determine the
prevalence of sensitization to α-Gal for predicting the risk of allergic reactions before cetuximab
administration. Therefore, we aimed to elucidate the subclinical sensitization rate to α-Gal in
Japan. ...