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The syndrome, mediated by IgE antibodies against the oligosaccharide galactose\u2010alpha\u20101,3\u2010galactose (alpha\u2010gal), can also involve reactions to visceral organs, dairy, gelatin and other products, including medications sourced from non\u2010primate mammals. Thus, fittingly, this allergic disorder is now called the alpha\u2010gal syndrome (AGS). The syndrome is strikingly regional, reflecting the important role of tick bites in sensitization, and is more common in demographic groups at risk of tick exposure. Reactions in AGS are delayed, often by 2\u20136\u2009h after ingestion of mammalian meat. In addition to classic allergic symptomatology such as urticaria and anaphylaxis, AGS is increasingly recognized as a cause of isolated gastrointestinal morbidity and alpha\u2010gal sensitization has also been linked with cardiovascular disease. The unusual link with tick bites may be explained by the fact that allergic cells and mediators are mobilized to the site of tick bites and play a role in resistance against ticks and tick\u2010borne infections. IgE directed to alpha\u2010gal is likely an incidental consequence of what is otherwise an adaptive immune strategy for host defense against endo\u2010 and ectoparasites, including ticks.<\/jats:p>","DOI":"10.1111\/all.16003","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T04:09:32Z","timestamp":1704773372000},"page":"1440-1454","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":75,"title":["Tick bites,\n                    <scp>IgE<\/scp>\n                    to galactose\u2010alpha\u20101,3\u2010galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha\u2010gal syndrome"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5975-1760","authenticated-orcid":false,"given":"Jeffrey M.","family":"Wilson","sequence":"first","affiliation":[{"name":"Division of Allergy and Immunology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loren","family":"Erickson","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology, and Cancer Biology and Beirne Carter Center for Immunology Research University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2439-7981","authenticated-orcid":false,"given":"Michael","family":"Levin","sequence":"additional","affiliation":[{"name":"University of Cape Town  Rondebosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel M.","family":"Ailsworth","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1198-2428","authenticated-orcid":false,"given":"Scott P.","family":"Commins","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1263-329X","authenticated-orcid":false,"given":"Thomas A. 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