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Individuals with AGS develop delayed hypersensitivity reactions, with symptoms occurring &amp;gt;2 h after consuming mammalian (\u201cred\u201d) meat and other mammal-derived food products. The mechanisms of pathogenesis driving this paradigm-breaking food allergy are not fully understood. We review the role of tick bites in the development of alpha-gal\u2013specific IgE and highlight innate and adaptive immune cells possibly involved in alpha-gal sensitization. We discuss the impact of alpha-gal glycosylation on digestion and metabolism of alpha-gal glycolipids and glycoproteins, and the implications for basophil and mast cell activation and mediator release that generate allergic symptoms in AGS.<\/jats:p>","DOI":"10.4049\/jimmunol.2100712","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T21:20:21Z","timestamp":1641936021000},"page":"267-277","source":"Crossref","is-referenced-by-count":39,"title":["Where\u2019s the Beef? Understanding Allergic Responses to Red Meat in Alpha-Gal Syndrome"],"prefix":"10.1093","volume":"208","author":[{"given":"Audrey S","family":"Carson","sequence":"first","affiliation":[{"name":"Department of Medicine, Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, University of North Carolina School of Medicine , Chapel Hill, NC; and , Chapel Hill, NC"},{"name":"Department of Pediatrics, University of North Carolina Food Allergy Initiative, Division of Allergy and Immunology, University of North Carolina School of Medicine , Chapel Hill, NC; and , Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliyah","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, University of North Carolina School of Medicine , Chapel Hill, NC; and , Chapel Hill, NC"},{"name":"Department of Pediatrics, University of North Carolina Food Allergy Initiative, Division of Allergy and Immunology, University of North Carolina School of Medicine , Chapel Hill, NC; and , Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7470-7904","authenticated-orcid":false,"given":"Onyinye I","family":"Iweala","sequence":"additional","affiliation":[{"name":"Department of Medicine, Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, University of North Carolina School of Medicine , Chapel Hill, NC; and , Chapel Hill, NC"},{"name":"Department of Pediatrics, University of North Carolina Food Allergy Initiative, Division of Allergy and Immunology, University of North Carolina School of Medicine , Chapel Hill, NC; and , Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,15]]},"reference":[{"key":"2025021008504328000_r1","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1073\/pnas.84.5.1369","article-title":"Evolutionary relationship between the natural anti-Gal antibody and the Gal alpha 1----3Gal epitope in primates","volume":"84","author":"Galili","year":"1987","journal-title":"Proc. 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