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Jappe, U.; Minge, S.; Kreft, B.; Ludwig, A.; Przybilla, B.; Walker, A.; Varga, R.; Seidel, P.; Biedermann, T.; Anemüller, W.; Kromminga, A.; Rueff, F.; Merk, H.; Wagner, N.; Treudler, R.; Worm, M.; Waldmann, I.; Saloga, J.; Becker, W. M.; Goldmann, T.; Platts-Mills, T. A.; Homann, A. (2018): Meat allergy associated with galactosyl--(1,3)-galactose (-Gal)Closing diagnostic gaps by anti--Gal IgE immune profiling. In: Allergy, Vol. 73, No. 1: pp. 93-105
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Abstract

Background: Glycoproteins and glycolipids of some mammalian species contain the disaccharide galactosyl--(1,3)-galactose (-Gal). It is known that -Gal is immunogenic in humans and causes glycan-specific IgG and also IgE responses with clinical relevance. -Gal is part of the IgE-reactive monoclonal therapeutic antibody cetuximab (CTX) and is associated with delayed anaphylaxis to red meat. In this study, different -Gal-containing analytes are examined in singleplex and multiplex assays to resolve individual sensitization patterns with IgE against -Gal. Methods: Three serum groups, -Gal-associated meat allergy (MA) patients, idiopathic anaphylaxis (IA) patients with suspected MA, and non-meat-allergic healthy control individuals (HC), were analyzed via singleplex allergy diagnostics and a newly established immunoblot diagnostic system. The new dot blot detection system resolved individual IgE sensitization profiles for -Gal-containing analytes CTX, bovine thyroglobulin (Bos d TG), and human serum albumin (HSA)-conjugated -Gal. Results: Singleplex allergy diagnostics using the -Gal analytes CTX and Bos d TG confirms the history of MA patients in 91% and 88% of the cases, respectively. A novel dot blot-based assay system for the detection of IgE against -Gal reveals individual IgE sensitization profiles for -Gal-containing analytes. An -Gal-associated IgE cross-reactivity profile (IgE against CTX, Bos d TG, and HSA--Gal) was identified, which is associated with MA. Conclusions: Detection of individual sensitization patterns with different -Gal-containing analytes provides the basis for an individual allergy diagnosis for -Gal-sensitized patients. Higher amounts of -Gal in pork and beef innards compared to muscle meat as indicated by a higher staining intensity are a plausible explanation for the difference in allergic symptom severity.