{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:58:58Z","timestamp":1784303938615,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R37\u2010AI\u201020565"],"award-info":[{"award-number":["R37\u2010AI\u201020565"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21\u2010AI166861"],"award-info":[{"award-number":["R21\u2010AI166861"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Ustekinumab, a monoclonal antibody (mAb) used to treat inflammatory bowel disease, has been associated with immediate hypersensitivity reactions during first intravenous infusion. While rare, the mechanism for these reactions is unclear. IgE to the oligosaccharide galactose\u2010\u03b1\u20101,3\u2010galactose (\u03b1\u2010gal) is a cause of allergy to mammalian meat and other mammalian products that express \u03b1\u2010gal. Given that ustekinumab (Stelara) is produced in murine SP2\/0 cells, a cell line known to introduce \u03b1\u2010gal during post\u2010translational modification, we hypothesized that \u03b1\u2010gal could explain some of these reactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>We describe six patients with Crohn's disease who experienced acute reactions during ustekinumab infusion and were found to have IgE specific to \u03b1\u2010gal. Serum or cells from a separate group of \u03b1\u2010gal IgE\u2010sensitized patients with red meat allergy were used for in\u00a0vitro experiments to investigate ustekinumab allergenicity. ImmunoCAP binding assays confirmed that IgE from four red meat allergic patients, but not controls, bound to ustekinumab on the solid phase. This binding was inhibited by the \u03b1\u2010gal\u2010containing glycoprotein beef thyroglobulin. Basophil activation tests (BAT), carried out to assess functional activity, revealed dose\u2010dependent activation with ustekinumab from four \u03b1\u2010gal\u2010sensitized individuals, but not controls. Two other mAbs produced in SP2\/0 cells (cetuximab and infliximab) as well as a representative mAb produced in Chinese Hamster Ovary (CHO) cells (vedolizumab) were evaluated as comparators, with the mAbs from SP2\/0 but not CHO cells eliciting BAT activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre\u2010existing IgE to \u03b1\u2010gal may account for some first\u2010dose infusion reactions to ustekinumab. Screening for \u03b1\u2010gal sensitization in patients with alpha\u2010gal syndrome should be considered prior to ustekinumab infusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.70374","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:03:45Z","timestamp":1772967825000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>IgE<\/scp>\n                    to Galactose\u2010\u03b1\u20101,3\u2010Galactose (\u03b1\u2010Gal) and Relevance to Ustekinumab First\u2010Dose Infusion Reactions and Allergenicity"],"prefix":"10.1002","volume":"10","author":[{"given":"Preethi G.","family":"Venkat","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill F.","family":"Nehrbas","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela Schoppee","family":"Bortz","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Platts\u2010Mills","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian W.","family":"Behm","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban J.","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5975-1760","authenticated-orcid":false,"given":"Jeffrey M.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Janssen Pharmaceuticals \u201cStelara (Ustekinumab) [Package Insert] \u201d2020 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