446 Association of Mammalian Oligosaccharide Galactose-α-1,3-galactose (α-Gal) With Atherosclerotic Coronary Artery Disease

Abstract

An association between type 2 immunity and coronary artery atherosclerosis has recently been described. Ixodes holocyclus (Australian paralysis tick) bites can result in IgE sensitization to the mammalian oligosaccharide galactose-α-1,3-galactose (α-Gal) which in turn is associated with mammalian meat anaphylaxis. A previous angiography-based study identified that IgE sensitization to α-Gal is associated with coronary artery disease plaque burden. We sought to confirm the hypothesis that IgE α-Gal sensitization is associated with coronary artery plaque burden in a subset of the BioHEART-CT cohort. Specific IgE α-Gal antibodies were measured in serum from 220 participants in the BioHEART-CT cohort using a commercially available assay (ImmunoCAP 250). Participants with previous stents or coronary artery bypass grafts were excluded. Demographics, cardiovascular risk factors and current medication information was collected at time of enrolment. CTCAs were scored using the 17 segment Gensini Score. IgE α-Gal association with plaque burden was assessed using simple linear and multivariate linear regression models. IgE α-Gal sensitization was significantly associated with disease burden, Beta coefficient, 1.14; SE, 0.3; p<0.001. The association remained significant when adjusted for age, sex, and standard cardiovascular risk factors, Beta coefficient, 1.03; SE, 0.3; p=0.001. In individuals sensitized to IgE α-Gal, compared to those that were not sensitized, the relative risk of having coronary artery disease was 1.4 (95% CI 1.1-1.7, p=0.002). IgE α-Gal sensitization was associated with coronary artery disease burden in the BioHEART-CT cohort. Further research is needed to investigate potential mechanistic pathways.