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