IgE to the Mammalian Oligosaccharide Galactose-α-1,3-Galactose Is Associated With Increased Atheroma Volume and Plaques With Unstable Characteristics-Brief Report

Arterioscler Thromb Vasc Biol. 2018 Jul;38(7):1665-1669. doi: 10.1161/ATVBAHA.118.311222. Epub 2018 Jun 14.


Objective: Emerging evidence suggests a link between coronary artery disease and type 2 immunity. We sought to test the hypothesis that IgE sensitization to the mammalian oligosaccharide galactose-α-1,3-galactose (α-Gal)-the target allergen of delayed anaphylaxis to red meat-is associated with coronary artery disease.

Approach and results: Total IgE and specific IgE to α-Gal were assayed on sera from 118 subjects who presented for cardiac catheterization and underwent intravascular ultrasound. IgE to α-Gal was detected in 26%, and atheroma burden was higher in sensitized subjects (P=0.02). Because α-Gal sensitization relates to an environmental exposure that could be a risk factor for early-onset coronary artery disease (ie, tick bites), we age stratified the cohort. In subjects ≤65 years of age, the strength of the association with atheroma burden was stronger (P<0.001), and plaques in the sensitized group had less stable features based on intravascular ultrasound. To address the specificity of the association with IgE to α-Gal, IgE to inhalants and peanut were assayed and were not associated with coronary artery disease. Total IgE and α-Gal-specific IgE were strongly associated with each other, but the strength of the relationship with atheroma burden was stronger for α-Gal-specific IgE. This association was significant when adjusted for sex, diabetes mellitus, hypertension, statin use, and total IgE (regression coefficient, 12.2; SE, 5.2; P=0.02).

Conclusions: Increased atheroma burden and plaques with more unstable features were associated with IgE to α-Gal-an effect most pronounced in subjects ≤65 years of age. IgE sensitization to α-Gal may represent a novel, and potentially modifiable, risk factor for coronary atherosclerosis.

Keywords: atherosclerosis; galactosyl-(1-3)galactose; immunoglobulin E; red meat; risk factors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Allergens / immunology*
  • Biomarkers / blood
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / immunology*
  • Coronary Artery Disease / pathology
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / immunology*
  • Coronary Vessels / pathology
  • Disaccharides / immunology*
  • Female
  • Food Hypersensitivity / blood
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / immunology*
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin E / immunology*
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic*
  • Risk Factors
  • Ultrasonography, Interventional


  • Allergens
  • Biomarkers
  • Disaccharides
  • galactosyl-(1-3)galactose
  • Immunoglobulin E