α半乳糖综合征的发病机制及治疗

doi:10.35541/cjd.20230669

中华皮肤科杂志 ›› 2026, e20230669.doi: 10.35541/cjd.20230669

α半乳糖综合征的发病机制及治疗

王春婷¹ 叶劲涛² 方苏萍² 杨海元¹

¹南京医科大学异种移植重点实验室，南京 210066；²杭州爱唯生命科技有限公司，杭州 311599

收稿日期:2023-11-15 修回日期:2025-10-13 发布日期:2026-06-22
通讯作者: 杨海元 E-mail:hyyang@njmu.edu.cn
基金资助:
国家自然科学基金（81970164）

Pathogenesis and treatment of alpha-gal syndrome

Wang Chunting^1, Ye Jintao², Fang Suping², Yang Haiyuan¹

¹Key Laboratory of Xenotransplantation, Nanjing Medical University, Nanjing 210066, China; ²Hangzhou Aiwei Life Technology Co., Ltd., Hangzhou 311599, China

Received:2023-11-15 Revised:2025-10-13 Published:2026-06-22
Contact: Yang Haiyuan E-mail:hyyang@njmu.edu.cn
Supported by:
National Natural Science Foundation of China（81970164）

摘要/Abstract

摘要： 【摘要】 α半乳糖综合征（AGS）是一种由蜱虫叮咬引起的延迟性过敏反应。在被蜱虫叮咬后，人体会对半乳糖-α-1,3-半乳糖（α-gal）的糖分子产生免疫球蛋白E（IgE）抗体。α-gal广泛存在于非灵长类哺乳动物的肉和其他组织中，因此，体内存在抗α-gal IgE抗体者在食用红肉或接触含有α-gal的药物和生物材料后，可能会出现AGS，包括荨麻疹、血管性水肿等症状，严重时甚至可引发过敏性休克。AGS日益成为一个严重的公共健康问题，涉及食品安全、药品应用及器官移植等方面。本文旨在讨论该综合征的发病机制及治疗方法。

关键词: 蜱, 免疫球蛋白E, α半乳糖, α半乳糖综合征, 红肉过敏

Abstract: 【Abstract】 Alpha-gal syndrome （AGS） is an increasingly recognized, delayed, immunoglobulin E （IgE）-mediated allergic disorder triggered by tick bites. Following exposure to tick saliva, susceptible individuals develop IgE antibodies directed against the oligosaccharide epitope galactose-α-1,3-galactose （α-gal）. The α-gal epitope is widely expressed in the tissues and meat of non-primate mammals. Consequently, sensitized individuals may experience delayed hypersensitivity reactions several hours after consuming red meat or upon exposure to pharmaceuticals, biologics, or medical products containing α-gal. Clinically, AGS typically manifests as urticaria and angioedema, and in severe cases may progress to anaphylactic shock. AGS has emerged as a growing public health concern, posing significant challenges to food safety, pharmaceutical development, and organ xenotransplantation. This review summarizes the current understanding of the immunopathogenesis of AGS, and discusses currently available and emerging therapeutic strategies.

Key words: Ticks, Immunoglobulin E, Galactose-alpha-1,3-galactose, Alpha?gal syndrome, Red meat allergy

王春婷叶劲涛方苏萍杨海元. α半乳糖综合征的发病机制及治疗[J]. 中华皮肤科杂志, 2026,e20230669. doi:10.35541/cjd.20230669

Wang Chunting, Ye Jintao, Fang Suping, Yang Haiyuan. Pathogenesis and treatment of alpha-gal syndrome[J]. Chinese Journal of Dermatology,2026,e20230669. doi:10.35541/cjd.20230669

参考文献 23

［1］	Lesmana E, Rao S, Keehn A, et al. Clinical presentation and outcomes of alpha⁃gal syndrome［J］. Clin Gastroenterol Hepatol, 2025,23（1）:69⁃78. DOI: 10.1016/j.cgh.2024.06.044.
［2］	Keet C, McGowan EC, Jacobs D, et al. IgE to common food allergens is associated with cardiovascular mortality in the National Health and Examination Survey and the Multi⁃Ethnic Study of Atherosclerosis［J］. J Allergy Clin Immunol, 2024,153（2）:471⁃478. DOI: 10.1016/j.jaci.2023.09.038.
［3］	Kersh GJ, Salzer J, Jones ES, et al. Tick bite as a risk factor for alpha⁃gal⁃specific immunoglobulin E antibodies and development of alpha⁃gal syndrome［J］. Ann Allergy Asthma Immunol, 2023,130（4）:472⁃478. DOI: 10.1016/j.anai.2022.11.021.
［4］	Van Nunen SA, O'Connor KS, Clarke LR, et al. An association between tick bite reactions and red meat allergy in humans［J］. Med J Aust, 2009,190（9）:510⁃511. DOI: 10.5694/j.1326⁃5377. 2009.tb02533.x.
［5］	Apostolovic D, Mihailovic J, Commins SP, et al. Allergenomics of the tick Ixodes ricinus reveals important α⁃gal⁃carrying IgE⁃binding proteins in red meat allergy［J］. Allergy, 2020,75（1）:217⁃220. DOI: 10.1111/all.13978.
［6］	Liu K, Wofford RN, Newcomb DC, et al. Active surveillance of alpha⁃gal （galactose⁃alpha⁃1,3⁃galactose） syndrome in Middle Tennessee［J］. Ann Allergy Asthma Immunol, 2023,131（1）:123⁃125. DOI: 10.1016/j.anai.2023.04.005.
［7］	Thompson JM, Carpenter A, Kersh GJ, et al. Geographic distribution of suspected alpha⁃gal syndrome cases ⁃ United States, January 2017⁃December 2022［J］. MMWR Morb Mortal Wkly Rep, 2023,72（30）:815⁃820. DOI: 10.15585/mmwr.mm72 30a2.
［8］	McGill SK, Levin ME, Shaheen NJ, et al. Gastrointestinal⁃isolated distress is common in alpha⁃gal allergic patients on mammalian meat challenge［J］. J Clin Gastroenterol, 2024,58（1）:80⁃84. DOI: 10.1097/MCG.0000000000001827.
［9］	Glynn D, Halma J, Welch H, et al. Nonanaphylactic variant of alpha⁃gal syndrome as an etiology for chronic gastrointestinal symptoms in children［J］. J Pediatr, 2023,259:113486. DOI: 10.1016/j.jpeds.2023.113486.
［10］	Román⁃Carrasco P, Lieder B, Somoza V, et al. Only α⁃gal bound to lipids, but not to proteins, is transported across enterocytes as an IgE⁃reactive molecule that can induce effector cell activation［J］. Allergy, 2019,74（10）:1956⁃1968. DOI: 10.1111/all.13873.
［11］	Commins SP, Karim S. Development of a novel murine model of alpha⁃gal meat allergy［J］. J Allergy Clin Immunol, 2017, 139（2）:101674. DOI: 10.1016/j.jaci.2016.12.628.
［12］	Choudhary SK, Karim S, Iweala OI, et al. Tick salivary gland extract induces alpha⁃gal syndrome in alpha⁃gal deficient mice［J］. Immun Inflamm Dis, 2021,9（3）:984⁃990. DOI: 10.1002/iid3.457.
［13］	Hajer A, Chaima B, Youmna M, et al. Tick salivary compounds for targeted immunomodulatory therapy［J］. Front Immunol, 2020,9（11）:583845. DOI: 10.3389/fimmu.2020.583845.
［14］	Denisov SS, Dijkgraaf I. Immunomodulatory proteins in tick saliva from a structural perspective［J］. Front Cell Infect Microbiol, 2021,11:769574. DOI: 10.3389/fcimb.2021.769574.
［15］	Schmidle P, Mehlich J, Brockow K, et al. Gelatin⁃containing vaccines for varicella, zoster, measles, mumps, and rubella induce basophil activation in patients with alpha⁃gal syndrome［J］. Int Arch Allergy Immunol, 2021,182（8）:716⁃722. DOI: 10. 1159/000514263.
［16］	Platts⁃Mills T, Commins SP, Biedermann T, et al. On the cause and consequences of IgE to galactose⁃α⁃1,3⁃galactose: a report from the national institute of allergy and infectious diseases workshop on understanding IgE⁃mediated mammalian meat allergy［J］. J Allergy Clin Immunol, 2020,145（4）:1061⁃1071. DOI: 10.1016/j.jaci.2020.01.047.
［17］	van Nunen SA. Tick⁃induced allergies: mammalian meat allergy and tick anaphylaxis［J］. Med J Aust, 2018,208（7）:316⁃321. DOI: 10.5694/mja17.00591.
［18］	Kuravi KV, Sorrells LT, Nellis JR, et al. Allergic response to medical products in patients with alpha⁃gal syndrome［J］. J Thorac Cardiovasc Surg, 2022,164（6）:e411⁃e424. DOI: 10.1016/j.jtcvs.2021.03.100.
［19］	McGill SK, Commins SP, Peery AF, et al. Alpha⁃gal sensitization in a US screening population is not associated with a decreased meat intake or gastrointestinal symptoms［J］. Am J Gastroenterol, 2023,118（7）:1276⁃1281. DOI: 10.14309/ajg.0000 000000002219.
［20］	Boyce RM, Schulz A, Mansour O, et al. Alpha⁃gal syndrome in the infectious diseases clinic: a series of 5 cases in central North Carolina［J］. Open Forum Infect Dis, 2022,9（12）:ofac663. DOI: 10.1093/ofid/ofac663.
［21］	Serrier J, Davy JB, Dupont B, et al. Validation of an anti⁃α⁃gal IgE fluoroenzyme⁃immunoassay for the screening of patients at risk of severe anaphylaxis to cetuximab［J］. BMC Cancer, 2023,23（1）:32. DOI: 10.1186/s12885⁃023⁃10501⁃5.
［22］	Mullins RJ, James H, Platts⁃Mills TA, et al. Relationship between red meat allergy and sensitization to gelatin and galactose⁃α⁃1,3⁃galactose［J］. J Allergy Clin Immunol, 2012,129（5）:1334⁃1342. DOI: 10.1016/j.jaci.2012.02.038.
［23］	Morticelli L, Rossdam C, Cajic S, et al. Genetic knockout of porcine GGTA1 or CMAH/GGTA1 is associated with the emergence of neo⁃glycans［J］. Xenotransplantation, 2023,30（4）:e12804. DOI: 10.1111/xen.12804.

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α半乳糖综合征的发病机制及治疗

Pathogenesis and treatment of alpha-gal syndrome

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