Mammalian meat allergy and beyond: overview of alpha-gal syndrome

Purpose of review Alpha-gal syndrome (AGS) is a unique allergy to the carbohydrate galactose-alpha-1,3-galactose, which is found in mammalian products, excluding humans and Old World primates. As its prevalence increases, we are learning that AGS has broader geographical range and wider medical impact than initially recognized. Recent findings Time to diagnosis has improved in recent years, but AGS still presents challenges for diagnosis and management, AGS may be found in a larger geographic distribution than originally supposed, and new potential arthropod triggers have been identified. Recent research demonstrates some of the immunologic changes that occur after arthropod bites that can lead to the production of alpha-gal IgE, but we still do not understand why certain individuals become allergic while others are only sensitized. Presentation can vary widely, and reactions may be inconsistent. The list of foods and medical products recognized to have potential for causing reactions continues to expand, which has implications for management of other conditions in patients with AGS. Summary With the growing prevalence of AGS, it is increasingly important for clinicians to recognize the syndrome and understand its management.