Tatiana ROȘCA1, Manole COJOCARU2,3
Abstract. Alpha-gal syndrome is an IgE-mediated allergic reaction to a carbohydrate called galactose-alpha-1,3-galactose. Unlike most food allergies, which are reactions to proteins, this syndrome is due to the introduction into the body of a sugar molecule called alpha-gal. The condition is caused by tick bites, in Europe of the species Ixodes ricinus and in North America more commonly of the species Amblyomma americanum or “Lone Star tick”. This introduces into the body a sugar molecule called alpha-gal (galactose-alpha-1,3-galactose), which causes the immune system to produce specific antibodies. Alpha-gal syndrome is a new and special model in allergology for at least 2 reasons: unlike other food allergies: it is not triggered by a protein, but by a carbohydrate and occurs hours after ingestion. Mechanism of “cross-reactivity”: Alpha-gal is found in most mammals, but is absent in humans and primates. Alpha-gal syndrome is an emerging food allergy characterized by delayed IgE-mediated reactions to the ingestion of mammalian-derived products. Sensitization is induced by tick bites and involves antibodies directed against galactose-α-1,3-galactose. The authors conducted a systematic review of the PubMed literature (2008–2025) to synthesize current data on the pathophysiology, clinical manifestations and management of AGS. Twenty eight relevant studies were included. Alpha-gal syndrome presents an atypical clinical profile, with onset of symptoms at 3-6 hours after ingestion, and is frequently underdiagnosed. Recent data suggest possible links to cardiovascular inflammation and the role of the gut microbiome. Alpha-gal syndrome can be conceptualized as an allergy dependent on lipid antigen kinetics, which redefines the classical paradigms in allergology.
Keywords: alpha-gal syndrome, red meat allergy, tick bites, IgE, delayed anaphylaxis, galactose.
DOI 10.56082/annalsarscimed.2026.1.5
1 CARDIOELA SRL, Bucharest, Romania; e-mail: manole.cojocaru@yahoo.com
2 Academy of Romanian Scientists, Bucharest, Romania
3 “Titu Maiorescu” University, Faculty of Medicine, Bucharest, Romania
PUBLISHED in Annals of the Academy of Romanian Scientists Series of Medicine, Volume 7, Issue 1