Tick-human interactions: from allergic klendusity to the α-Gal syndrome

Biochem J. 2021 May 14;478(9):1783-1794. doi: 10.1042/BCJ20200915.

Abstract

Ticks and the pathogens they transmit, including bacteria, viruses, protozoa, and helminths, constitute a growing burden for human and animal health worldwide. The ability of some animal species to acquire resistance to blood-feeding by ticks after a single or repeated infestation is known as acquired tick resistance (ATR). This resistance has been associated to tick-specific IgE response, the generation of skin-resident memory CD4+ T cells, basophil recruitment, histamine release, and epidermal hyperplasia. ATR has also been associated with protection to tick-borne tularemia through allergic klendusity, a disease-escaping ability produced by the development of hypersensitivity to an allergen. In addition to pathogen transmission, tick infestation in humans is associated with the α-Gal syndrome (AGS), a type of allergy characterized by an IgE response against the carbohydrate Galα1-3Gal (α-Gal). This glycan is present in tick salivary proteins and on the surface of tick-borne pathogens such as Borrelia burgdorferi and Anaplasma phagocytophilum, the causative agents of Lyme disease and granulocytic anaplasmosis. Most α-Gal-sensitized individuals develop IgE specific against this glycan, but only a small fraction develop the AGS. This review summarizes our current understanding of ATR and its impact on the continuum α-Gal sensitization, allergy, and the AGS. We propose that the α-Gal-specific IgE response in humans is an evolutionary adaptation associated with ATR and allergic klendusity with the trade-off of developing AGS.

Keywords: allergy; alpha gal syndrome; host-pathogen interactions; immunity; klendusity; tick resistance.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Allergens / administration & dosage
  • Anaplasma phagocytophilum / immunology
  • Anaplasma phagocytophilum / pathogenicity
  • Anaplasmosis / etiology
  • Anaplasmosis / immunology*
  • Anaplasmosis / pathology
  • Anaplasmosis / prevention & control
  • Animals
  • Basophils / immunology
  • Basophils / pathology
  • Borrelia burgdorferi / immunology
  • Borrelia burgdorferi / pathogenicity
  • CD4-Positive T-Lymphocytes / immunology
  • CD4-Positive T-Lymphocytes / pathology
  • Disease Resistance*
  • Epidermis / immunology
  • Epidermis / parasitology
  • Food Hypersensitivity / etiology
  • Food Hypersensitivity / immunology*
  • Food Hypersensitivity / pathology
  • Food Hypersensitivity / prevention & control
  • Host-Parasite Interactions / immunology
  • Humans
  • Hyperplasia / etiology
  • Hyperplasia / immunology*
  • Hyperplasia / pathology
  • Immunoglobulin E / biosynthesis
  • Immunologic Memory
  • Lyme Disease / etiology
  • Lyme Disease / immunology*
  • Lyme Disease / pathology
  • Lyme Disease / prevention & control
  • Ticks / chemistry
  • Ticks / immunology*
  • Ticks / pathogenicity
  • Tularemia / etiology
  • Tularemia / immunology*
  • Tularemia / pathology
  • Tularemia / prevention & control

Substances

  • Allergens
  • Immunoglobulin E

Supplementary concepts

  • red meat allergy