The University of Missouri is on the front lines of helping patients with alpha-gal syndrome - a potentially life-threatening red-meat allergy caused by lone star tick bites. With no official treatment and cases on the rise, Mizzou's research and outreach efforts are vital to improving the lives of those who have been affected.
Alpha-gal syndrome gets its name from the alpha-gal carbohydrate, which is found in most mammals but not humans. When a lone star tick bites a human, it injects saliva containing the alpha-gal sugar into a person's skin, causing the body's immune system to recognize it as a "foreign invader" and create antibodies to attack it. With the immune system now on high alert, the consumption of red meat triggers those antibodies to respond in the form of an allergic reaction.
Compared to a peanut allergy, which causes an instant allergic reaction, alpha-gal syndrome symptoms are delayed, often appearing four to six hours after consuming burgers, steaks or other mammalian-derived products such as dairy. Symptoms include hives, stomach pain and severe throat swelling that can be life-threatening.
Benjamin Casterline, an immunologist and dermatologist in the School of Medicine, recently received a grant from the Institute for Clinical and Translational Sciences to try to get a better understanding of the syndrome. He's now collecting blood samples and symptom data from alpha-gal syndrome patients in Missouri, using artificial intelligence to determine any patterns or trends across patient demographics.
There is still a lot we don't know about alpha-gal syndrome, and there is currently no FDA-approved treatment, so the typical guidance we give patients is to avoid eating red meat and dairy. But if we can learn more about patients' blood, genes, gut bacteria and other factors, perhaps we can pinpoint which patients seem to be most at-risk for showing severe symptoms."
Benjamin Casterline, immunologist and dermatologist, School of Medicine, University of Missouri
Casterline sees patients at MU Health Care clinics in Columbia, Jefferson City and Versailles, including patients with alpha-gal syndrome.
"Dr. Casterline is well-positioned to study this topic given his clinical expertise with seeing patients firsthand," said Randi Foraker, chair of the School of Medicine's Department of Biomedical Informatics, Biostatistics and Medical Epidemiology. "By combining AI tools with medical records, clinical notes and observations, he can see patients with alpha-gal syndrome more wholistically, identify symptoms faster and get patients the relief they need sooner."
According to the Centers for Disease Control, at least 450,000 people in the U.S. have alpha-gal syndrome, but it's tough to know how many Missourians have it because it's not tracked at the state level. Experts believe many cases have gone undiagnosed because of a lack of awareness; however, doctors are starting to test for it more as patients are showing meat-related symptoms.
"What makes this allergy tricky is that unlike most allergies, which usually get noticed at young ages or even in infancy, alpha-gal syndrome only develops after being bitten by the lone star tick," Bettina Mittendorfer, senior associate dean for research in the School of Medicine, said. "You can imagine someone who has eaten beef their whole life who now suddenly shows symptoms that can be very severe after eating beef, and they may not be aware that a previous tick bite is now causing the red-meat allergy."
Anecdotally, Casterline and other mid-Missouri clinicians have noticed an increase in cases in recent years, particularly in Boone County.
"While the lone star tick used to be found mainly in the southeastern region of the United States, they are now found in every Missouri county, which explains why Missouri seems to be an epicenter for alpha-gal syndrome right now," Casterline said. "This motivates me to help Missourians impacted. As a land-grant university, Mizzou encourages collaboration between clinicians and researchers, making this the perfect place to address this issue."
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