{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:06:15Z","timestamp":1793120775895,"version":"4.5.0"},"reference-count":121,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Alpha-gal syndrome (AGS) is an emerging allergic disease caused by an immunoglobulin E (IgE) response to galactose-\u03b1-1,3-galactose (alpha-gal), a sugar found in mammalian meat. The initial IgE sensitization follows a bite from the Amblyomma americanum (lone star) tick in the United States, although other tick species can also cause the disease. AGS presents with delayed symptoms, primarily gastrointestinal or allergic reactions like urticaria or anaphylaxis, hours after mammalian meat consumption. The nonspecificity of the symptoms can delay the diagnosis of AGS for years. Diagnosis relies on clinical evaluation and detection of alpha-gal\u2013specific IgE in blood. As the lone star tick's range is expanding beyond the southern United States, AGS is gaining recognition in other regions. However, many healthcare providers remain unaware of the condition, leading to misdiagnosis. Infectious diseases physicians who frequently evaluate patients with tick exposure must be familiar with AGS, including tick identification, bite prevention, and knowledge of the alpha-gal\u2013containing vaccines.<\/jats:p>","DOI":"10.1093\/ofid\/ofaf430","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T11:21:03Z","timestamp":1752837663000},"source":"Crossref","is-referenced-by-count":11,"title":["A Review of Alpha-Gal Syndrome for the Infectious Diseases Practitioner"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2649-4139","authenticated-orcid":false,"given":"Akira A","family":"Shishido","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Virginia Commonwealth University , Richmond, Virginia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary P","family":"Wormser","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, New York Medical College , Valhalla, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"2025073109264672400_ofaf430-B1","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1016\/j.jaci.2011.02.019","article-title":"The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-\u03b1-1,3-galactose","volume":"127","author":"Commins","year":"2011","journal-title":"J Allergy Clin Immunol"},{"key":"2025073109264672400_ofaf430-B2","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.1111\/all.14802","article-title":"Carbohydrate epitopes currently recognized as targets for IgE antibodies","volume":"76","author":"Platts-Mills","year":"2021","journal-title":"Allergy"},{"key":"2025073109264672400_ofaf430-B3","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1111\/all.16003","article-title":"Tick bites, IgE to galactose-alpha-1,3-galactose and urticarial or anaphylactic reactions to mammalian meat: the alpha-gal syndrome","volume":"79","author":"Wilson","year":"2024","journal-title":"Allergy"},{"key":"2025073109264672400_ofaf430-B4","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1084\/jem.42.6.863","article-title":"Serological studies on the blood of the primates: iii. Distribution of serological factors related to human isoagglutinogens in the blood of lower monkeys","volume":"42","author":"Landsteiner","year":"1925","journal-title":"J Exp Med"},{"key":"2025073109264672400_ofaf430-B5","doi-asserted-by":"crossref","first-page":"1335911","DOI":"10.3389\/fimmu.2024.1335911","article-title":"The \u03b1-gal epitope\u2014the cause of a global allergic disease","volume":"15","author":"Perusko","year":"2024","journal-title":"Front Immunol"},{"key":"2025073109264672400_ofaf430-B6","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1084\/jem.160.5.1519","article-title":"A unique natural human IgG antibody with anti-alpha-galactosyl specificity","volume":"160","author":"Galili","year":"1984","journal-title":"J Exp Med"},{"key":"2025073109264672400_ofaf430-B7","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/j.jaci.2020.01.047","article-title":"On the cause and consequences of IgE to galactose-\u03b1-1,3-galactose: a report from the 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