# IgE antibodies to the mammalian oligosaccharide galactose-alpha-1, 3-galactose (alpha-gal): immunology, epidemiology and relevance to allergic and inflammatory disease

> **NIH NIH R37** · UNIVERSITY OF VIRGINIA · 2024 · $622,802

## Abstract

Our ongoing and proposed studies are focused on understanding the causes and consequences of the
IgE response to the oligosaccharide galactose alpha-1,3-galactose (α-gal) which is a major blood group
substance of non-primate mammals. These studies are focused on three areas. (i) Understanding the
epidemiology and clinical management of the delayed allergic reactions that occur after eating
mammalian products which are referred to as the α-gal syndrome (AGS). While the syndrome clearly
relates to the distribution of the lone star ticks, Amblyomma americanum, there is increasing evidence that
fire ants can interfere with this tick in the south and also that the range of this tick is moving northwards in
the USA. We plan to use assays to identify the α-gal epitope in food and medicinal products, e.g. CroFab
and heparin. There are many such items that have some connection to mammalian source materials and
could be contaminated. (ii) Full investigation of the serology and cellular responses related to AGS
including comparison with other forms of food allergy. These studies will continue investigating the cellular
basis of the immune response and cellular responses related to AGS using recent development of the
technique of spectral flow analysis. In addition, we propose to extend these studies to a comparison with
other forms of food allergy in particular with Eosinophilic Esophagitis, which like AGS has only become
common over the last 30 years but is immunologically and clinically completely different. (iii) Detailed
studies on two situations, where patients with IgE to α-gal develop either abdominal symptoms or
coronary artery disease without any symptoms that are typically regarded as allergic. Evidence about
these two conditions has developed recently. The relationship to cardiac risk was first reported in 2018
and similar data has recently been reported to a cardiology meeting in Sydney, Australia. Furthermore
investigation of B cells in the circulation of patients undergoing coronary angiography in Virginia has
provided evidence supporting the relevance of B cells to the cardiac risk of α-gal. The abdominal cases
also make up a major percentage of the cases of irritable bowel syndrome (IBS) in areas of the USA
where bites from the lone star tick are common e.g. Central Virginia. Our plan is to carry out challenges in
these cases with pork meat using α-gal knock-out pork as a blinded placebo to further investigate the
evidence for the association and to further understand the delayed clinical reactions to red meat.

## Key facts

- **NIH application ID:** 10802292
- **Project number:** 5R37AI020565-40
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** THOMAS A. PLATTS-MILLS
- **Activity code:** R37 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $622,802
- **Award type:** 5
- **Project period:** 1984-07-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10802292

## Citation

> US National Institutes of Health, RePORTER application 10802292, IgE antibodies to the mammalian oligosaccharide galactose-alpha-1, 3-galactose (alpha-gal): immunology, epidemiology and relevance to allergic and inflammatory disease (5R37AI020565-40). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10802292. Licensed CC0.

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