Sensitisation and allergic reactions to alpha-1,3-galactose in Podlasie, Poland, an area endemic for tick-borne infections

Purpose Ticks transmit several pathogens and seem implicated in the production of specific IgE antibodies to alpha-1,3-galactose (alpha-gal sIgE). They cause delayed and immediate allergy to mammalian meat and medication including antivenoms, vaccines and monoclonal antibodies. Methods We assessed the prevalence of alpha-gal sIgE in forest workers and healthy controls in the Podlasie voivodeship, north-eastern Poland; the relationship between alpha-gal sIgE and allergy to alpha-gal-containing products; the correlation between alpha-gal sIgE and anti-Borrelia burgdorferi and anti-tick-borne encephalitis virus (TBEV) antibodies; the relationship between alpha-gal sIgE and markers of infection with lesser-known pathogens transmitted by ticks such as Anaplasma phagocytophilum. Results Production of alpha-gal sIgE was closely related to tick bites. The odds ratio for detectable alpha-gal sIgE was 9.31 times higher among people with a history of tick bites (OR 9.3; p < .05). There was no correlation with the history of TBE, Lyme disease or human granulocytic anaplasmosis. However, serum alpha-gal sIgE correlated with anti-TBEV IgM antibodies in CSF. There was a strong correlation between alpha-gal sIgE and total IgE and sIgE to pork and beef. Conclusions Our data support the link between I.ricinus ticks and the production of alpha-gal sIgE and confirm that the pathogens carried by ticks we examined for do not seem implicated in this immune response.