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Anaphylaxis to pork kidney is related to I g E antibodies specific for galactose‐alpha‐1,3‐galactose
Author(s) -
Morisset M.,
Richard C.,
Astier C.,
Jacquenet S.,
Croizier A.,
Beaudouin E.,
Cordebar V.,
MorelCodreanu F.,
Petit N.,
MoneretVautrin D. A.,
Kanny G.
Publication year - 2012
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2012.02799.x
Subject(s) - anaphylaxis , kidney , medicine , antibody , renal function , immunology , chemistry , allergy
Background Carbohydrate‐specific I g E antibodies present on nonprimate mammalian proteins were incriminated recently in delayed meat anaphylaxis. The aim of this study was to explore whether anaphylaxis to mammalian kidney is also associated with galactose‐α‐1,3‐galactose (α G al)‐specific I g E . Methods Fourteen patients with anaphylaxis to pork or beef kidney underwent prick tests to meat and kidney. Some patients also underwent skin tests to Erbitux ® (cetuximab). I g E antibodies to α G al, swine urine proteins, beef and pork meat, serum albumin proteins, cat, and r Fel d 1 were measured by I mmuno CAP ® . The αGal levels were estimated in meats and kidney by ELISA inhibition assay. Cross‐reactivity between α G al and pork kidney was studied with the I mmuno CAP ® inhibition assay. Results Among the 14 patients, 12 presented with anaphylactic shock. Reactions occurred within 2 h from exposure in 67% of patients. Associated risk factors were observed in 10 cases, and alcohol was the main cofactor. Three patients underwent an oral challenge to pork kidney, and anaphylaxis occurred after ingestion of small quantities (1–2 g). Prick tests to kidney were positive in 54% of patients. All tested patients showed positive skin tests to E rbitux ® . All patients tested positive for I g E to α G al, with levels ranging from 0.4 to 294 kU/l. I g E binding to α G al was inhibited by raw pork kidney extract (mean, 77%; range, 55–87%), which showed a high amount of α G al determinants. Conclusions Pork or beef kidney anaphylaxis is related to α G al I g E . Its peculiar severity could be due to an elevated content of α G al epitopes in kidney.