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The article provides an update on the diagnosis and treatment of alpha-Gal syndrome, a red meat allergy caused by specific antibodies. The syndrome is severe and associated with delayed anaphylaxis, and it is not directly linked to tick-borne infections. Diagnosis involves a combination of history, sensitization tests, and oral challenges. Management includes avoiding alpha-Gal exposure, but serious reactions can still occur. Oral immunotherapy shows promise but requires further study. The document itself is a list of authors, affiliations, and references related to alpha-gal syndrome and meat allergy. [Extracted from the article]

Background: Vaccination of the population is required to combat the COVID‐19 pandemic. Allergy testing could reduce anxiety towards COVID‐19 vaccination and thereby may increase vaccination rate, however, its effectiveness remains unclear. Methods: One hundred and thirty prospective real‐life patients in need of but not daring to get vaccinated asked for allergy workup for COVID‐19 vaccine hypersensitivity in 2021/2022. Characterization of patients, identification of anxieties, decrease of patient's anxiety levels, overall vaccination rate and adverse reactions after vaccination were assessed. Results: Tested patients were characterized by being female (91.5%) and having a high rate of previous allergies (e.g. to food 55.4%, drugs 54.6%, or previous vaccinations 50%) and dermatological disease (29.2%) but not always had medical contraindications for COVID‐19 vaccination. Sixty one patients (49.6%) were highly concerned (4‐6, Likert scale 0‐6) about vaccination and 47 (37.6%) expressed resolving thoughts about vaccinaion anaphylaxis (3‐6, Likert scale 0‐6). However only 35 patients (28.5%) were scared of getting COVID‐19 within 2 months (4–6, Likert scale 0–6) and only 11 (9%) patients had high expectations of getting COVID‐19 (4–6, Likert scale 0–6). Allergy testing significantly (p < 0.01 to p < 0.05 respectively) reduced the median anxiety of allergic symptoms following vaccination: dyspnoea (4.2–3.1), to faint (3.7–2.7), long‐term consequences (3.6–2.2), pruritus (3.4–2.6), skin rash (3.3–2.6) and death (3.2–2.6). After allergy testing, most patients (108/122, 88.5%) let themselves be vaccinated within 60 days. Revaccinated patients with previous symptoms experienced a reduction of symptoms (p < 0.05) upon revaccination. Conclusions: Patients not daring to get vaccinated have more anxiety towards vaccination than to acquire COVID‐19. For those, allergy testing excludes vaccine allergy, and is a tool to increase vaccination willingness and thereby helps to combat vaccination hesitancy. [ABSTRACT FROM AUTHOR]

Dr. Seneschal has been an investigator, speaker, or consultant for Novartis, Abbvie, Sanofi, LeoPharma and Eli Lilly. Dr. De Raeve is a consultant, member of scientific advisory boards and/ or received personal fees and non-financial support from LEO Pharma, Pierre Fabre, Sanofi-Genzyme and Bioderma. Dr. Vestergaard has been investigator, speaker, or consultant for Novartis, Abbvie, Sanofi, LeoPharma and Eli Lilly. [Extracted from the article]

Background Hymenoptera stings can cause severe anaphylaxis in untreated venom-allergic patients. A correct diagnosis regarding the relevant species for immunotherapy is often hampered by clinically irrelevant cross-reactivity. In vespid venom allergy, cross-reactivity between venoms of different species can be a diagnostic challenge. To address immunological IgE cross-reactivity on molecular level, seven recombinant antigens 5 of the most important Vespoidea groups were assessed by different diagnostic setups. Methods The antigens 5 of yellow jackets, hornets, European and American paper wasps, fire ants, white-faced hornets, and Polybia wasps were recombinantly produced in insect cells, immunologically and structurally characterized, and their sIgE reactivity assessed by Immuno CAP, ELISA, cross-inhibition, and basophil activation test ( BAT) in patients with yellow jacket or Polistes venom allergy of two European geographical areas. Results All recombinant allergens were correctly folded and structural models and patient reactivity profiles suggested the presence of conserved and unique B-cell epitopes. All antigens 5 showed extensive cross-reactivity in sIgE analyses, inhibition assays, and BAT. This cross-reactivity was more pronounced in Immuno CAP measurements with venom extracts than in sIgE analyses with recombinant antigens 5. Dose-response curves with the allergens in BAT allowed a differentiated individual dissection of relevant sensitization. Conclusions Due to extensive cross-reactivity in various diagnostic settings, antigens 5 are inappropriate markers for differential sIgE diagnostics in vespid venom allergy. However, the newly available antigens 5 from further vespid species and the combination of recombinant allergen-based sIgE measurements with BAT represents a practicable way to diagnose clinically relevant sensitization in vespid venom allergy. [ABSTRACT FROM AUTHOR]

Background Anaphylaxis caused by hymenoptera venom allergy is associated with elevation of baseline serum tryptase ( sBT) and/or mastocytosis in about 5% of patients. Up to now, no information has become available on single venom allergen sIgE reactivity and the usefulness of component-resolved approaches to diagnose this high-risk patient group. To address the component-resolved sIgE sensitization pattern and diagnostic sensitivity in hymenoptera venom-allergic patients with elevated sBT levels and/or mastocytosis, a panel of yellow jacket and honeybee venom allergens was applied on a widely used IgE immunoassay platform. Methods Fifty-three patients with mastocytosis and/or elevated sBT tryptase level and systemic reactions to hymenoptera venoms were analyzed for their IgE reactivity to recombinant yellow jacket and honeybee venom allergens by Immulite3 g. Results sIgE reactivity to Ves v 1, Ves v 5, Api m 1 to Api m 4 and Api m 10 was found at a similar frequency in hymenoptera venom-allergic patients with and without elevated sBT levels and/or mastocytosis. However, the use of the recombinant allergens and a diagnostic cutoff of 0.1 kUA/L allowed the diagnosis of patients with otherwise undetectable IgE to venom extract. The diagnostic sensitivity of yellow jacket venom allergy using the combination of Ves v 1 and Ves v 5 was 100%. Conclusions In high-risk patients with elevated sBT levels and/or mastocytosis, the use of molecular components and decreasing the threshold sIgE level to 0.1 kUA/L may be needed to avoid otherwise undetectable IgE to hymenoptera venom extracts in about 8% of such patients. [ABSTRACT FROM AUTHOR]