Tuesday, October 4, 2022

Alpha Gal And Lyme Disease

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Chronic Lyme Disease Can Seriously Affect A Persons Quality Of Life

Alpha-gal Syndrome Presents to the Tick Borne Diseases Working Group 02/12/2018

Regarding This tiny bug is at the root of a big controversy over Lyme disease : I am a registered nurse who has suffered the effects of post-tick-bite Lyme disease. Despite being treated, progressive signs of Lyme disease persist. Something that most doctors and the general population do not know about tick bites is that a tick carries other infectious diseases simultaneously. A single bite can cause a myriad of infections that may not be responsive to the traditional tick-bite antibiotics.

Thomas Platts-Mills, a noted tick-bite researcher at the University of Virginia, and his colleagues are working to determine why certain individuals who have been bitten by ticks and treated for Lyme disease develop an allergic reaction to beef and pork that can cause an anaphylactic reaction necessitating emergency treatment. Researchers are finding that many viruses can affect ones DNA post-infection.

Manassas

Have the author and her daughter been tested for alpha-gal allergy?

I had tick-bite-related symptoms similar to what the author described in the article. Then I learned about how tick bites can induce alpha-gal allergy.

I was a vaccine senior scientist . Alpha gal could easily have been missed by doctors.

Frank A. Robey,Bethesda

My daughter had lost 20 pounds and suffered from nausea, joint pain, dizziness and flulike symptoms.

My daughter finally saw a Lyme specialist, who said there is only one lab in the United States that can detect Lyme in the early stages.

Tick Bite Host Response And Development Of Ags

Figure 2 Proposed model of -gal sensitization from tick bites. Skin is comprised of three layers: epidermis, dermis, and hypodermis. Antigen-presenting cells , including Langerhans cells and dermal Dendritic cells residing in epidermis and dermis, respectively, respond to tick-secreted antigens, such as glycoproteins, glycolipids, and tick cement-containing -gal moieties. After antigen exposure, APCs process antigen, migrate to skin-draining lymph nodes, and participate in allergen sensitization. During this process, naïve T cells are primed through presentation of tick -gal antigens by LCs and dermal DCs within skin-draining lymph nodes. Activated CD4+ T cells subsequently traffic to the skin through blood and lymphatic vessels. Cognate T cell help, provided by T follicular helper cells, to -gal-specific B cells leads to germinal center responses, positive clonal selection of B cells via recognition of native antigens retained by follicular dendritic cells , and the development of memory B cells and plasma cells. After clonal selection, B cells migrate to the tick bite site on the skin to manifest allergic responses by presenting antigens to T cells, secreting proinflammatory cytokines, and secreting -gal-specific antibodies that ultimately triggers activation of mast cells and basophils and allergic response.

Likelihood Of Tick Bite To Cause Red Meat Allergy Could Be Higher Than Previously Thought

Date:
University of North Carolina Health Care
Summary:
The original hypothesis was that humans developed the red meat allergy after being exposed to the alpha-gal protein through a tick that had fed previously on a small mammal. But new data suggests ticks can induce this immune response without requiring the mammal blood meal, which likely means the risk of each bite potentially leading to the allergy is higher than doctors had anticipated.

Until now it has been believed that in order for a tick to trigger an allergic immune response to alpha-gal in humans, the tick would need to have recently fed on the alpha-gal-rich blood of a mammal. New research from the UNC School of Medicine presented at the American Academy of Allergy, Asthma and Immunology annual conference in San Francisco shows that may not be so.

Alpha-gal is a sugar found in most mammal blood, except humans. When humans develop an allergic immune response to it, this response can lead to a red meat allergy called alpha-gal syndrome .

As researchers expected, saliva from the Lone Star and Deer ticks that recently fed on blood caused a reaction. However, saliva from those same types of tick that had not recently fed on blood also caused a reaction. Saliva from a Lone Star tick that had not recently fed caused reactivity 40 times higher compared to the control. Neither type of saliva from the Gulf Coast nor the American Dog ticks caused a reaction.

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Know The Symptoms Of Lyme Disease

According to pest experts, this years tick season is anticipated to be one of the worst in decades. This is partially due to a mild winter across the United States, but also because of a decrease in the population of a certain species of mouse. Increased tick populations mean increased instances of tick-borne diseases. Here are some symptoms to be on the lookout for.

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Alpha Gal and the Lone Star Tick

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Tick Saliva And The Alpha

  • Center for Molecular and Cellular Biology, School of Biological, Environmental, and Earth Sciences, University of Southern Mississippi, Hattiesburg, MS, United States

Ticks and tick-borne diseases are significant public health concerns. Bioactive molecules in tick saliva facilitate prolonged blood-feeding and transmission of tick-borne pathogens to the vertebrate host. Alpha-gal syndrome , a newly reported food allergy, is believed to be induced by saliva proteins decorated with a sugar molecule, the oligosaccharide galactose–1,3-galactose . This syndrome is characterized by an IgE antibody-directed hypersensitivity against -gal. The -gal antigen was discovered in the salivary glands and saliva of various tick species including, the Lone Star tick . The underlying immune mechanisms linking tick bites with -gal-specific IgE production are poorly understood and are crucial to identify and establish novel treatments for this disease. This article reviews the current understanding of AGS and its involvement with tick species.

Protect Yourself From Ticks

As with any tick bite, its important not to panic if you discover one, Lieberman says. The vast majority in this country and elsewhere who get bitten by ticks dont develop alpha-gal allergy, he says.

Still, you can take reasonable precautions to protect yourself from ticks and the diseasesor allergiesthey can cause. Heres what to do:

Wear an effective bug spray if youre going to be in an area where ticks are common. Lone star and other types of ticks prefer wooded areas, brush, and long grass. Consumer Reports insect repellent testing has found that products containing 25 to 30 percent deet provide the most reliable protection.

Dress carefully. Wear long pants and long sleeves, and tuck your pants into your socks. Wearing clothing commercially treated with the pesticide permethrin, or treating your clothes and gear with permethrin yourself, is also a good option for additional protection.

Check yourself for ticks at the end of every day youve been out in their territory. Taking a shower soon after you come in is a good opportunity to wash away any ticks that may be crawling on your skin without having yet bitten you, and to carefully look for any that have attached. If you find them on you, remove them properly.

Be careful with the clothes you were wearing in tick habitats, Stromdahl recommends. Run them through a cycle in a hot dryer to kill any ticks that may be clinging on, and leave your shoes outside in the sun.

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Symptoms Of Lyme Disease

According to the CDC, Lyme disease is the most commonly reported vector-borne illness in the United States. It is caused by a bacterial infection transmitted through the bites of blacklegged ticks. The symptoms can be divided into two phases:

Early Symptoms :

  • Fever
  • Muscle and joint aches
  • Swollen lymph nodes
  • Erythema migrans rash- This rash occurs in roughly 70 to 80 percent of patients and presents at the site of the tick bite between three and thirty days after the original bite. It expands gradually and can cover an area up to one foot in diameter. It may feel warm to the touch, but is rarely itchy or painful. In some cases, it may take on a bulls-eye appearance.

Late Symptoms :

  • Severe headache
  • Additional EM rashes on additional body parts
  • Arthritis with severe joint pain and swelling, most commonly in the knees
  • Pain in tendons, muscles and joints
  • Facial palsya loss of muscle tone or droopiness in one side of the face
  • Dizziness and shortness of breath
  • Inflammation of the brain and/or spinal cord
  • Nerve pain
  • Shooting pains, numbness or tingling in the hands or feet
  • Short-term memory loss or confusion

In most cases, Lyme disease can be treated successfully with antibiotics. If left untreated, Lyme disease can cause serious damage to the heart, lungs, nervous system and joints.

Delayed Allergic Reaction To Red Meat

ER Removal of a Lone Star Tick, STARI and Alpha-Gal Syndromes

Why does a person with alpha-gal allergy experience a reaction several hours after eating red meat, instead of like a peanut allergy which can happen immediately?

Theres two main answers to thatthe first of which is that alpha-gal is a sugar. So much of what we know about allergies in general center on proteins. Part of this, is that we believe that the response to the sugar is in some ways a weaker response than we might see for proteins. Secondly, the most severe reactions tend to happen with fattier forms of meat. The digestion of fat is very different from the way that sugars or proteins are absorbed. The digestion of fat is a process that takes three to hours to deliver fat to the bloodstream.

Typically, allergic reactions to mammalian meat occurs 2-6 hoursafter ingesting the meats, and can be severe. Whats interesting, is that these allergic reactions to mammalian meat dont typically occur until 1 to 3 months after being bitten by an infected tick!

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How Has Lyme Disease Expanded Since Its First Discovery

Lyme disease, was first discovered in the United States in Lyme, Connecticut, in the mid-1970s and is now the most common US vector-borne disease. The estimated cumulative number of Americans struggling with chronic symptoms relating to Lyme disease may be as high as 1.9 million in 2020.

The number of new cases in the US exceeds 476,000 a year.

Lyme disease is spreading geographically and is hyper-endemic in the northeast and mid-Atlantic, upper Great Lakes region, and west coast. The ticks that transmit Lyme disease have been found in half of all US counties. Lyme disease is a worldwide health epidemic and a growing problem in regions such as Canada, Europe, and Asia.

Lyme disease is spreading geographically, as illustrated by the CDC maps below.

Reported Cases of Lyme Disease- United States, 2018

Note that Massachusetts, an endemic state, is no longer reporting Lyme Disease cases

Reported Cases of Lyme Disease- United States, 2001

Ticks that Transmit Lyme Disease are spreading geographically and are found in half of US Counties.

Map A shows tick distributions 1907-1996. Map B shows 1907-2015.

The Lone Star Tick Is The Bully Of The Tick World Its Population Is Booming

It was on Tom Muirs daily commute from Virginia to his federal-government job in DC that he knew something was very wrong.

On those drives, he started to notice that my eyes would swell, my lips would swell. I had facial flushing, and my heart rate would go through the roof.

For two years, Muirwho often works outdoors on his farm in Fauquier Countywas having increasingly bad allergic reactions to something, but he couldnt figure out what. He went to allergy clinics but tested negative for common food allergies. It wasnt until a wasp sting landed him in the emergency room that he started putting the pieces together.

He told the doctors that his reactions seemed to occur any day after he ate red meat, which was often. I used to eat bacon for breakfast, a steak for lunch, and a hamburger for dinner, he says.

It turned out Muir had alpha-gal syndrome, named for a sugar molecule, alpha-gal, or galactose-alpha-1, 3-galactose. Its sometimes called the meat allergy because those with AGS can no longer eat red meat without getting sick.

AGS is most often transmitted to humans by the lone star tick, a creepy, crawly thing thats sometimes no bigger than a poppy seed. Around the area, theyre the largest variety of tick you will encounter by far, says Holly Gaff of Old Dominion University in Norfolk, who has been studying ticks, their behaviors, and the diseases they carry.

Says Gaff: Theyre the bully of the tick world.

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Infectious Diseases Society Of America

The Infectious Diseases Society of America is writing to provide input to the Tick-Borne Disease Working Group ahead of its Feb. 28, 2022, meeting to review the work of the Working Groups subcommittees and develop recommendations for its 2022 report to Congress. IDSA represents more than 12,000 infectious disease physicians, scientists, public health practitioners and other health care professionals specializing in infectious diseases. IDSA members focus on the investigation, diagnosis, epidemiology, prevention and treatment of infectious diseases. Our members care for patients of all ages with serious infections, including tick-borne diseases. We would be happy to serve as a resource for the Working Group. IDSA appreciates the work of the Working Group and its subcommittees and continues to strongly urge the Working Group to ground all its recommendations in the best available scientific evidence. Below, we have flagged critical areas for funding and support we feel the Working Group is best equipped to address.

Surveillance and Tick Ecology Studies and Funding

Vaccine, Diagnostic and Therapeutic Development

Patient Access and Equity

Evidence-Based Care

How To Protect Yourself From Ticks

Pin by Laura Lambert on Alpha Gal

Cover up. Measures to guard against the lone star tick are the same as for Lyme-bearing ticks: Wear a hat, a long-sleeved shirt, and long pants with the legs tucked into your socks. Keep in mind that its easier to spot ticks on light-colored clothes.

Use repellents. Permethrin is extremely effective at disabling ticks, not just repelling them. However, its toxic to humans and best applied only to clothing. Another alternative, DEET, is a mild tick repellent that can be applied to the skin. Other repellents claim to be safer for the environment, including ones offered by TickWarriors.com, which is owned by Jennifer Platt, the public-health researcher who cofounded Tick-Borne Conditions United, an advocacy group.

Tick-proof your yard. Remove leaf litter, mow the lawn frequently, and clear tall grasses around homes and at the edge of lawns. Use cedar mulch or chips to create a barrier for restricting tick migration.

Check for ticks. After coming in from outside, inspect every part of your body, including behind the knees, in elbows and armpits, and behind ears. Ticks love warm, dark places, and they can be as small as a poppy seed.

Inspect clothing, too. The best way to kill ticks is to tumble-dry clothes for ten to 15 minutes, or wash them in hot water. Cold or lukewarm water wont kill ticks.

This article appears in the July 2021 issue of Washingtonian.

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Can I Get Ags From A Tick Bite

  • Growing evidence suggests that AGS may be triggered by the bite of a lone star or blacklegged tick in the United States. Other tick species have been connected with the development of AGS in other countries.
  • More research is needed to understand the role ticks play in starting this reaction, and why certain people develop AGS.

Prevention And Tick Removal

Tick bites can be prevented by treating clothing and gear with products containing 0.5% permethrin and by avoiding areas inhabited by ticks.

Debate exists around the best method of tick removal although recent consensus is to freeze them with an ether-containing spray .

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What Recent Research Reveals

Initially, scientists connected the dots between lone star ticks and meat allergies because of overlap between the geographic areas where the tick and the allergy were most common, according to an analysis published earlier this year in Annals of Allergy, Asthma & Immunology. Other studies showed that people who had the allergy tended to have a history of being bitten by ticks, or worked in jobs where they were likely to be exposed to ticks.

And in two recent cases reported in The Journal of Allergy and Clinical Immunology: In Practice, people who had an allergic reaction to red meat developed hives around the area where they had been previously bitten by a tick.

The 2018 study looked at just one allergy clinic in Tennessee, and found that in cases where they were able to pinpoint the cause, the alpha-gal allergy was behind about a third of anaphylaxis cases seen there between 2006 and 2016. Thats more than were caused by food allergies to peanuts, shellfish, or others, the researchers found.

Study author Jay Lieberman, M.D., associate professor at the University of Tennessee Health Science Center and vice chair of the American College of Allergy, Asthma and Immunology Food Allergy Committee, is quick to point out that these results do not mean that a third of severe allergic reactions nationwide are due to the effects of lone star tick bites, or that alpha gal is the number one cause of anaphylaxis in the country.

How Common Is Alpha

Alpha Gal Tick Borne Allergy to Meat

In the U.S., the syndrome has mostly been found where Lone Star ticks predominate, which is in the southeastern part of the country, as well as the east coast and south central regions. However, these ticks also are common as far north as Maine and as far west as central Texas. Deer that carry Lone Star ticks also appear to be moving further north and west due to climate change, potentially increasing the syndromes spread.

For now, its difficult to say how common alpha-gal syndrome is. It is a new syndrome and, as such, healthcare providers are not required to track it as a disease or syndrome. It may also be underdiagnosed. Recent estimates suggest more than 5,000 people may have it in the U.S.

Besides red meat, people with alpha-gal syndrome may react to the drug cetuximab, as well as vaccines or other drugs made with gelatin .

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