IgE-mediated sensitization to galactose-alfa-1.3-galactose (alfa-Gal) in urticaria and anaphylaxis in Spain: geographical variations and risk factors

ABSTRACT

BACKGROUND: The objectives of this study were to investigate the prevalence of sIgE to galactose-alfa-1,3-galactose (alfa-gal) in individuals with acute urticaria or anaphylaxis from different geographical areas of Spain and to evaluate the relevance of demographics and lifestyle as risk factors for this immune response. METHODS: Participants were recruited from allergy departments at 14 Spanish hospitals. Patients aged 18 years or older presenting with urticaria or anaphylaxis were enrolled into one of 2 arms cases and controls. An interviewer-administered questionnaire collecting demographic data, lifestyle habits, and the presence of cofactors was obtained from each participant. sIgE to alfa-gal and total IgE were determined using ImmunoCAP. sIgE levels ≥0.35 kU/L were considered a positive result. RESULTS: The study population comprised 160 cases and 126 controls. The median age was 44 years. The overall prevalence of a positive result of sIgE to alfa-gal was 15.7%; this was higher in cases (26.3%) than in controls (2.4%). The sIgE anti-alfa-gal positivity rate ranged from 37.68% (rural) to 15.38% (semiurban), and 7.85% (urban). The rates of positivity were 46.32%, (Northern), 0.72% (Center), and 0% (Mediterranean). A positive result for sIgE to alfa-gal was associated with a history of tick bites, participation in outdoor activities, pet ownership, and ingestion of mammalian meats or innards before the onset of symptoms. Only alcohol consumption could be implicated as a cofactor. CONCLUSION: Sensitization to alfa-gal in patients with urticaria or anaphylaxis differs considerably between the 3 geographical areas studied and is related to tick bites