Researchers are conducting basic, epidemiological, and clinical research designed to shed important new insights into this poorly understood but often serious disease.

image2
Scott Commins, MD, PhD and Maya Jerath, MD, PhD

When Dr. Maya Jerath’s patient walked in the door of her clinic, he was mystified and alarmed by his recent symptoms. The previous night he had eaten steak for dinner, and felt fine when he went to bed. A few hours later he found himself in an emergency room, suffering from a severe allergic reaction. Dr. Jerath determined that the patient had developed a recently identified meat allergy known as “alpha-gal,” possibly related to a recent tick bite.

Alpha-gal refers to galactose-alpha-1,3-galactose, a sugar found in mammalian animals such as cows and pigs. Alpha-gal allergy was virtually unheard of among the general population 10 years ago. Now it’s becoming an increasingly common diagnosis, though it’s still not well understood. The Thurston Arthritis Research Center (TARC) is one of only a few facilities in the US actively conducting clinical and basic science research to understand this often baffling, and sometimes life-threatening allergy.

“This is a food allergy that doesn’t act like any other food allergy, and too often it goes undiagnosed,” says Maya Jerath, MD, PhD, associate professor of medicine and director of the University of North Carolina (UNC) Allergy and Immunology Clinic. “People might eat red meat products their entire lives and not have any problems. Then one day they can have a meal with meat such as beef, pork or lamb, and develop allergic complications that in some cases are quite severe. Unlike with other food allergies, the symptoms might not appear for several hours after consuming the meal, and may not happen with every exposure.”

Allergic reactions associated with alpha-gal can include mild symptoms such as the patient breaking out in hives or experiencing stomach distress, or more severe reactions that include difficulty breathing or loss of consciousness.

While the exact cause of alpha-gal allergy is still undetermined, in the US it appears to occur in people who have been bitten by a lone star tick or chigger. In fact, throughout the world the reports of red meat allergy from alpha-gal have been associated with various kinds of tick bites. However, scientists have not yet proven whether or not the insect bite causes the allergy and do not understand how it would do so.

Dr. Jerath is working closely with her colleague, Scott Commins, MD, PhD, an associate professor of medicine at UNC and one of the first researchers to study alpha-gal. Together they are conducting basic, epidemiological, and clinical research designed to shed new light on this disease. Because they are at a leading research site for alpha-gal, together they see on average one to two patients per day with this allergy.

“We are studying patients’ blood for specific genetic or immunologic markers to see why some people develop this allergy while others don’t, and why some people become much sicker than others once they’ve developed this allergic response. We’re looking at demographics and patients’ clinical histories for links to help us tie together clues that will help us better understand, more accurately diagnose, and hopefully someday find a way to treat this allergy,” says Jerath.

Dr. Scott Commins, who along with Dr. Jerath is considered one of the leading alpha-gal experts in the US, also expresses optimism regarding the possibility of one day being able to treat the allergy. He emphasizes, however, that it’s essential to gain better insights into what causes the allergy as well as to find better ways to diagnose it.

“When we achieve a better understanding of the mechanism by which tick bites give rise to an immune system response, we can begin to unravel the mystery of the alpha-gal allergy – a necessary first step toward potentially one day being able to design treatments,” says Commins.

While no one knows if researchers will one day be able to develop a treatment, and if so how long it might take, the work being performed at the Thurston Arthritis Research Center is an important step in the right direction. For those who have alpha-gal allergy now, and those who might contract it in the future, that is good news indeed. To arrange an appointment with Dr. Jerath or Commins, you may contact the UNC Allergy and Immunology Clinic at 984-974-2645.