Alpha-gal Syndrome (AGS)

Alpha-gal syndrome (AGS) (also called alpha-gal allergy, red meat allergy, or tick bite meat allergy) is the result of tick bite from the Lone Star Tick (Amblyomma americanum). [1] There are indications that other types of ticks may carry and use Alpha-gal during the meal process. There is also some evidence that may suggest that chiggers may be implicated as well. [2] Alpha-gal is in a tick’s saliva. It is estimated that greater than 50% or greater of the Lone Star tick carries the antigen that causes AGS. AGS can lead to a serious potentially life threatening allergic reaction to the molecule (Galactose-α-1, 3-galatose) (aka Alpha-gal), which is a carbohydrate epitope that is transmitted to the blood of a host during a blood meal by a tick. Unlike other tick borne diseases, AGS is not related to an infection from bacteria, similar to Lyme disease, but is consider to be a gene expression that results in a simple food allergy. Please read through the rest of this to understand what gene expression is.

The human diets consist of meat, particular red meat which contains Galactose-α-1, 3-galatose. The tick injects Galactose-α-1, 3-galatose into the bloodstream during the blood meal. It is the Galactose-α-1, 3-galatose in the blood stream that stimulates a hypersensitive immune response.

The injection of Alpha-gal by a tick may facilitate the host into an allergic reaction and stimulates a release of Immunoglobulin ε (IgE or Ig Epsilon) in response to the injection from the tick or the intake of mammalian or red meat. Simply, IgE is a response from our immune system in response to a food allergy. Alpha-gal is not found in the meat of fish, reptiles, or poultry. Alpha-gal can be found in mammalian meat such as pork, beef, rabbit, lamb, venison, rabbit and products made from mammals including cow’s milk and milk by products. Elevated IgE titers are indicative of AGS disease process. The titers are subdivided into 4 levels. There is no correlation between the levels of IgE and how those levels relate to the patient’s severity of reactions and symptoms.

Symptoms generally occur after the ingestion of red meat, dairy products and or the use of by products. The allergic reaction can vary from patient to patient. Reactions can range from severe to mid and even life threatening. There is generally a delayed reaction time of the onset of symptoms starting within 3-5 hours after the ingestion of red meat. An anaphylaxis reaction is a life threatening reaction that involves multiple organ systems and necessitates urgent medical attention. And yet, not every exposure to red meat may suffer a reaction. [7]

The oligosaccharide α-Gal is expressed in different mammalian tissues. Besides mammalian muscle, α-Gal can be also found in organs such as kidney, liver, spleen, or heart of mammals (8). Quite some effort went into the identification of α-Gal carrying proteins in beef and pork and it was shown that α-Gal was bound to several proteins in raw and in cooked beef (9).

Interestingly, in case of muscle tissue, patients appear to have more severe reactions after eating fattier meats, whereas they tolerate leaner cuts (10), which suggests that glycolipids carrying α-Gal might be involved in the induction of allergic reactions. Therefore, α-Gal allergic patients are also advised to avoid meat broth and bouillon or food containing mammalian fat, which is for instance used for the preparation of certain sauces, pastries, mashed potatoes, but also vegetable dishes and desserts. Owing to the presence of glycolipids in pork small intestine, certain chicken sausages, where minced chicken meat is stuffed in pig tripe, should also be avoided, because they might also trigger symptoms in patients suffering from the α-Gal syndrome (10). However, innards, like kidney, small intestine, liver, spleen, salivary glands and heart, are generally richer in cholesterol, and high levels of α-Gal expressing glycolipids have been detected in different pig organs (11, 8), which clearly suggests that α-Gal glycolipids might be responsible for the high allergenicity of innards.

Interestingly, the binding of α-Gal to glycolipids instead of glycoproteins might also provide an explanation for the delayed occurrence of symptoms after meat consumption, since the digestion and absorption of lipids takes longer than the digestion of proteins.

According to the Mayo Clinic, the symptoms include but not limited to hives and itchy rashes, nausea or vomiting, heartburn and or indigestion, diarrhea, coughing or shortness of breath, decreased blood pressure, swelling of the lips, throat, tongue and or eye lids, dizziness or fainting, and severe stomach pain.

The signs and symptoms of Rocky Mountain Spotted Fever (RMSF) are similar to that of AGS. The etiology is different, RMSF is caused by a bacteria known as Rickettsia rickettsi and is transmitted via a tick bite. RMSF does not facilitate a red meat allergy.

There are some studies that suggest that hypertension may be the only symptom related AGS food allergy, this is significant because some medications utilized to manage hypertension contain magnesium stearate which can facilitate a reaction by the immune system. Other medications such as Acetaminophen, Naproxen, Lisinopril, Clonidine, and Hydrocodone have been noted as containing MS and should be avoided because of potentially linked to AGS.

Symptoms of AGS may lessen over time or even totally disappear. Generally, some patients may be able to return to consuming red meat and animal by products after 1 to 2 years of the initial onset. The average duration of this hypersensitivity reaction is unknown, although it is likely chronic given the average time from symptom onset to diagnosis is 7 years. [4-6]

Label reading will become imperative in your daily living, it could possibly save your life. Example; Magnesium Stearate (MS) is used as a coating around active ingredients in capsules and tablets. Manufactures of medications use MS because of its lubricating properties, preventing ingredients from sticking to manufacturing equipment. The key is that it is derived from a Bovine source, a source that can make a patient with AGS have a reaction.

For the AGS patient, it is like playing Russian Roulette with products that may contain animal by products from beef: Cosmetics, detergents, lubricants, candles and even fireworks. Read your labels carefully, the word stearic is derived from the Greek word “stear” which means tallow rendered from beef or mutton. Surprisingly the following may contain beef by products and affect AGS patients. Drywall of all things, then the paint on the drywall may have by stearic acid used in the manufacturing process. White sugar is not white to begin with and is filtered with bone char or beef bone ash. Gelatins are a derivative from bone meal and should be avoided. One should consult with their physician before injecting some vaccines as they may stimulate an allergic reaction. The website alphagalinformation.org/mammalian-byproducts/ can be a great start on product you will need to avoid.

There are some studies that suggest that symptoms of heart failure and elevated rapid degeneration of bioprosthetic (pig or beef valve replacements) aortic vales can be related to AGS. [3]

Personal care or skin care products such as lanolin, gelatin/collagen can be derived from animal by products. Manufactures have switched to an animal derived source for the fat because of the cost and the amount of supply. Consider using a soap made from 100% vegetation base such as coconut and shea butter. If you tub soak and find a ring around the tub, the soap you are using is derived from an animal fat. That tub ring is Magnesium Stearate. Read your labels carefully, some of the most popular soaps are made from lard and can promote an immune defense. Vegan can be a good in this case!

Check your toothpaste, mouthwash, liquid hand soaps, shampoo, nail treatments, facial cleansers, lanolin, deodorants, products with glycerin and bath salts. Amazon offers shopping starter list for AGS patients.

Meat alternatives: Butterball makes an alternative ham that is made from turkey and contains no red meat. There are websites that specialize in alternative meats, such as duck bacon, goose pheasant and quail. There can be ordered, so there is meat out there that AGS patients can consume, sometimes you have to search for it.

As stated above, AGS is detected by blood test testing for the presence of IGE in the blood. The medical profession should be able to detect and manage a patient’s symptoms; however the key being that the patient refrains for the ingestion of red meat and by products derived from mammals. Many cuts of meat may contain Alpha-gal such as organ meats, such as liver, lung, heart, kidney, intestines, sweet breads, scrapple and Rock Mountain oysters. AGS patients must also consider products such as lard, tallow and suet, meat broth bouillon stock and gravy. Cross contamination is possible such as chicken grilled on a grill that has had beef cooked on it. A small majority of AGS patients may tolerate the ingestion of cow’s milk and by products derived.

The prevention of tick bites is the number one preventative measure we humans can take. Understand that the Lone Star tick is very prominent in the south and the southeastern portions of the United States and is spreading rapidly to the Midwest. These ticks live in grassy, bushy and wooded areas. Do everything you can to prevent tick bites and encounters.

Make sure your pets are treated with anti-tick medications as ticks can simply fall off your pets onto you. Insect repellants containing DEET, pircaridin, IR3535, oil of lemon Eucalyptus (OLE), para-mentane-diol may help deterring ticks. Please follow age restrictions for children from the CDC.

Certain aromatherapy essential oils, not only smell great, but they are also known to be natural tick repellents. Ticks hate the smell of lemon, orange, cinnamon, lavender, peppermint, and rose geranium, so ticks avoid latching on to anything that smells of those items. The Farmer’s Almanac can offer up numerous ways to deter ticks with natural homemade repellents without toxic chemicals.

Check or have someone do a tick check after being outside. A quick check of the under arms, in and out of the ears, the belly button, back of the knees, in and out and around the hair line, in the groin and around the waist. Tick bites are greater from the months of March through August.

As mentioned above, the immune response is considered a gene expression of the immune system. This is the process where a gene gets turned on or off in a cell. Gene expression is a tightly regulated process that allows a cell to reciprocate to its environment. However, there are times that our immune systems over reacts and reacts when the reaction is not necessary. This is termed as dysregulation or an uncontrolled immune responses.

Hyperbaric oxygen therapy (HBOT) has been utilized in the medical profession for several decades. While HBOT is not a panacea, there are an increasing number of medical indications for treatment with HBOT.

How important is Oxygen in the human body? Oxygen is used in 5700+ cellular processes and activates 8101 different genes in the human body. These genes are responsible for the down regulation of inflammation and up regulation of growth and repair. Dysregulation of the immune and inflammation systems of the human body have been implicated as being responsive to HBOT. This is the theory behind the treatment of AGS utilizing HBOT.

Reference:

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