IgE reactivity to α-Gal in relation to Lyme borreliosis.

Ivar Tjernberg,Marianne van Hage,Carl Hamsten,Danijela Apostolovic,J. Stephen Dumler

doi:10.1371/journal.pone.0185723

Ivar Tjernberg, Marianne van Hage + Show 3 more

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https://doi.org/10.1371/journal.pone.0185723

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Abstract

BackgroundAn association between tick bites, the development of immunoglobulin E (IgE) antibodies to galactose-α-1, 3-galactose (α-Gal) and red meat allergy has recently been reported. Here we wanted to elucidate the relation between tick exposure, IgE antibodies to α-Gal and Lyme borreliosis (LB).MethodsIn the highly LB endemic area of Kalmar County, Sweden, serum samples and health inquiries from 518 blood donors were included. All sera were investigated for multiple IgG anti-Borrelia antibodies using a multiplex assay (recomBead, Mikrogen). In addition, three serially collected sera over a six month period from 148 patients with clinically defined erythema migrans (EM) were included. IgE antibodies against α-Gal were determined using ImmunoCAP (Thermo Fisher Scientific).ResultsIn blood donors reporting previous LB (n = 124) IgE to α-Gal was found in 16%, while in donors denying previous LB but with multiple anti-Borrelia antibodies (n = 94; interpreted as asymptomatic LB) 10% were IgE α-Gal-positive. Finally, in donors without Borrelia antibodies denying previous LB (n = 300) 14% showed IgE to α-Gal. No significant difference in proportions among the groups were found. In EM patients, IgE to α-Gal was found in 32/148 (22%) at diagnosis, 31/148 (21%) after two-three months and 23/148 (16%) after six months. A significant reduction of proportion and level of IgE to α-Gal was found between the second and third sample (p<0.01). A positive IgE anti α-Gal was more common among men compared with women both in blood donors and in EM patients (p≤0.01).ConclusionsIgE to α-Gal reactivity was common in a tick endemic area but showed no significant relation to previous LB. IgE anti-α-Gal reactivity in EM patients peaked within three months of diagnosis of EM, after which it waned indicating that recent tick exposure is of importance in α-Gal sensitization. Furthermore, IgE anti α-Gal was more common in men compared with women.

Highlights

In the last few years, an association between immunoglobulin E (IgE) antibodies directed towards the mammalian carbohydrate galactose-α-1, 3-galactose (α-Gal) and red meat allergy has been described [1,2,3,4]
In blood donors reporting previous Lyme borreliosis (LB) (n = 124) IgE to α-Gal was found in 16%, while in donors denying previous LB but with multiple anti-Borrelia antibodies (n = 94; interpreted as asymptomatic LB) 10% were IgE α-Gal-positive
IgE to α-Gal reactivity was common in a tick endemic area but showed no significant relation to previous LB

Summary

Introduction

In the last few years, an association between immunoglobulin E (IgE) antibodies directed towards the mammalian carbohydrate galactose-α-1, 3-galactose (α-Gal) and red meat allergy has been described [1,2,3,4]. Α-Gal has shown to be present in saliva of the ticks Haemaphysalis longicornis and Ambylomma sculptum [9, 10] This and recent data about the prevalence of sensitization to α-Gal [11, 12], strengthens the association between tick bites of various species and the development of IgE antibodies to αGal and in turn red meat allergy [8, 13]. An association between tick bites, the development of immunoglobulin E (IgE) antibodies to galactose-α-1, 3-galactose (α-Gal) and red meat allergy has recently been reported. We wanted to elucidate the relation between tick exposure, IgE antibodies to α-Gal and Lyme borreliosis (LB)

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Discussion

Conclusion