The Meat of the Matter: Understanding and Managing Alpha-Gal Syndrome

Figures & data

Table 1 Tick Species Associated with Alpha-Gal Sensitization

Scientific Name	Common Name(s)^a	Geographic Range^a
Amblyomma americanum	Lone Star Tick	North America (Southeastern US, Canada, Mexico)
Amblyomma cajennense	Cayenne Tick	North and Central America
Amblyomma hebraeum^b	South African Bont Tick	South Africa
Amblyomma sculptum	N/A	South America (Brazil)
Amblyomma testudinarium	N/A	South Asia (India, Sri Lanka) and East Asia (including Japan)
Amblyomma variegatum^b	Tropical Bont Tick	Southeast Asia, Africa
Haemaphysalis longicornis	Asian Longhorned Tick, Bush Tick	Japan
Ixodes australiensis	N/A	Australia
Ixodes holocyclus	Paralysis Tick	Australia, Southern Asia
Ixodes nipponensis^b	Cattle Tick	Asia (including Korea, Japan)
Ixodes ricinus	Sheep Tick, Wood Tick, Deer Tick, Castor Bean Tick	North America, Europe and Northern Asia, Africa
Ixodes scapularis	Blacklegged Tick	Middle America, North America
Rhipicephalus spp (including R. microplus; R. evertsi)^b	Asian Blue Tick, Australian Cattle Tick, Southern Cattle Tick, Cuban Tick, Madagascar Blue Tick, Puerto Rican Tick	Southern Asia, South America, North America, Caribbean, Australia, Africa

Notes: ^aCommon name and Geographic Range reported in Integrated Taxonomic Information System (ITIS, https://www.itis.gov/)¹³⁸ and/or reviewed in Carson AS, Gardner A, Iweala OI.^{19 b}Suspected link, but not definitive association of tick with the development of alpha-gal syndrome.

Table 2 Common Symptoms and Symptom Distribution in Study Participants with AGS (n = 15)^a

Organ System	Presentation	Percentage (Number Out of 15)
Cutaneous	Urticaria (hives), pruritus, angioedema	93% (14)
Gastrointestinal	Emesis, diarrhea, gastroesophageal reflux, abdominal pain, abdominal bloating,	73% (11)
Respiratory	Respiratory distress, dyspnea, coughing, chest tightness, wheeze, hypoxia	33% (5)
Oropharyngeal	Throat itching, throat constriction, neck tightness, mouth/throat swelling	26% (4)
Cardiovascular	Syncope, pre-syncope	13% (2)

Notes: ^aAdapted from Iweala OI, Choudhary SK, Addison CT, Commins SP. T and B Lymphocyte Transcriptional States Differentiate between Sensitized and Unsensitized Individuals in Alpha-Gal Syndrome. Int J Mol Sci. 2021;22(6).²⁷

Figure 1 Foods, medications, and supplements to avoid in patients with alpha-gal syndrome. Items in the red circle should be avoided by all patients. Items in the orange and yellow circles should be avoided if patients remain symptomatic after avoidance of red circle items.

Integrated taxonomic information system [database on the Internet]. Available from: https://www.itis.gov/. Accessed September 6, 2022.

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Carson AS, Gardner A, Iweala OI. Where’s the beef? Understanding allergic responses to red meat in alpha-gal syndrome. J Immunol. 2022;208(2):267–277.

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Iweala OI, Choudhary SK, Addison CT, Commins SP. T and B lymphocyte transcriptional states differentiate between sensitized and unsensitized individuals in alpha-gal syndrome. Int J Mol Sci. 2021;22(6):3185.

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