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(Note: Martha Stewart has never admitted wrongdoing.)
Alpha-Gal Allergy – with Dr. Scott Commins
UNC School of Medicine
Dr. Scott ComminsDr. Scott Commins describes alpha-gal allergy, which scientists believe is triggered by a tick bite and can cause a reaction to red meat. Dr. Commins talks about the symptoms of a reaction, how one can be tested for the allergy, and changes in diet recommended for patients who have alpha-gal. Dr. Scott Commins is an Associate Professor of Medicine in the Division of Rheumatology, Allergy, and Immunology and UNC Thurston Arthritis Research Center.
“Initially, we ask people to strictly avoid red meat—beef, pork, lamb, this would include venison, bison, buffalo—anything essentially that has hooves and walks on four legs, we ask them to avoid.”
– Dr. Scott Commins
...
Falk: Tell us a little about the history of how alpha-gal allergy was discovered, and what was your role in that discovery process?
Commins: I think it’s a fascinating history, and it actually starts in the oncology, or cancer world. In fact, there is some indication that when Martha Stewart went to prison, it involved alpha-gal. Her role in this essentially is that a company creating a cancer drug produced it in a mouse cell line. These mouse cells, as we discussed earlier, that would be one of the species that makes alpha-gal. These mouse cells decorated this cancer drug with their alpha-gal sugar. So, when this therapeutic was given to people who were allergic to alpha-gal, they reacted, and they reacted in a very serious way—life-threatening, anaphylactic-type reactions. The company began to find that this was happening throughout the southeast, but not in California or New York. In fact, UNC was one of the early sites that identified that their patients who were receiving this medication were reacting on the order of one in five or one in four on first infusion of this medication.
Falk: One in five, or one in four patients.
Commins: Correct. Nearly a quarter of them were reacting the first time getting this medication. Reacting meaning getting hives, itching, loss of blood pressure, true kind of anaphylaxis. The company began to know that this was happening in a certain geographic region but not in others. The story goes that perhaps they weren’t as forthcoming with some of this data, but eventually they did have to tell the FDA. Allegedly, Martha’s stock broker found out that the company was moving towards telling the FDA and her stock was sold at the appropriate time. That’s the cancer side of alpha-gal. Essentially the way the story goes is these patients were reacting because they had developed an allergic response to alpha-gal.
That was work done in Dr. Platts-Mills’s lab in the University of Virginia, where I was training as an allergy and immunology fellow. When I joined the lab, they had just published this work, but what we were seeing in the clinic, was patients who were telling us, “Hey doc, I think I’m allergic to beef (or pork, or lamb) but it doesn’t happen every time, and it happens in a delayed way.” This sort of flew in the face of conventional food allergy at that point. But because we had this knowledge of the distribution of alpha-gal being in these lower mammals, and we had a test because Dr. Platts-Mills had just published this work with the cancer therapeutic, we thought, “Maybe we should run their serum sample for this alpha-gal allergy.” Sure enough, that opened the Pandora’s box. In 2009, we then published 24 cases who had reported they had delayed allergic responses to beef, pork or lamb.
Falk: Prior to that, somebody who thought they were having an allergic response to a slice of beef, would have thought they were…nutty.
Commins: Absolutely....
Some science papers on the topic
Fatal anaphylaxis due to alpha-gal syndrome after initial cetuximab administration: The first forensic case report
The alpha gal story: Lessons learned from connecting the dots
Alpha-Gal Allergy – with Dr. Scott Commins
UNC School of Medicine
Dr. Scott ComminsDr. Scott Commins describes alpha-gal allergy, which scientists believe is triggered by a tick bite and can cause a reaction to red meat. Dr. Commins talks about the symptoms of a reaction, how one can be tested for the allergy, and changes in diet recommended for patients who have alpha-gal. Dr. Scott Commins is an Associate Professor of Medicine in the Division of Rheumatology, Allergy, and Immunology and UNC Thurston Arthritis Research Center.
“Initially, we ask people to strictly avoid red meat—beef, pork, lamb, this would include venison, bison, buffalo—anything essentially that has hooves and walks on four legs, we ask them to avoid.”
– Dr. Scott Commins
...
Falk: Tell us a little about the history of how alpha-gal allergy was discovered, and what was your role in that discovery process?
Commins: I think it’s a fascinating history, and it actually starts in the oncology, or cancer world. In fact, there is some indication that when Martha Stewart went to prison, it involved alpha-gal. Her role in this essentially is that a company creating a cancer drug produced it in a mouse cell line. These mouse cells, as we discussed earlier, that would be one of the species that makes alpha-gal. These mouse cells decorated this cancer drug with their alpha-gal sugar. So, when this therapeutic was given to people who were allergic to alpha-gal, they reacted, and they reacted in a very serious way—life-threatening, anaphylactic-type reactions. The company began to find that this was happening throughout the southeast, but not in California or New York. In fact, UNC was one of the early sites that identified that their patients who were receiving this medication were reacting on the order of one in five or one in four on first infusion of this medication.
Falk: One in five, or one in four patients.
Commins: Correct. Nearly a quarter of them were reacting the first time getting this medication. Reacting meaning getting hives, itching, loss of blood pressure, true kind of anaphylaxis. The company began to know that this was happening in a certain geographic region but not in others. The story goes that perhaps they weren’t as forthcoming with some of this data, but eventually they did have to tell the FDA. Allegedly, Martha’s stock broker found out that the company was moving towards telling the FDA and her stock was sold at the appropriate time. That’s the cancer side of alpha-gal. Essentially the way the story goes is these patients were reacting because they had developed an allergic response to alpha-gal.
That was work done in Dr. Platts-Mills’s lab in the University of Virginia, where I was training as an allergy and immunology fellow. When I joined the lab, they had just published this work, but what we were seeing in the clinic, was patients who were telling us, “Hey doc, I think I’m allergic to beef (or pork, or lamb) but it doesn’t happen every time, and it happens in a delayed way.” This sort of flew in the face of conventional food allergy at that point. But because we had this knowledge of the distribution of alpha-gal being in these lower mammals, and we had a test because Dr. Platts-Mills had just published this work with the cancer therapeutic, we thought, “Maybe we should run their serum sample for this alpha-gal allergy.” Sure enough, that opened the Pandora’s box. In 2009, we then published 24 cases who had reported they had delayed allergic responses to beef, pork or lamb.
Falk: Prior to that, somebody who thought they were having an allergic response to a slice of beef, would have thought they were…nutty.
Commins: Absolutely....
Some science papers on the topic
Fatal anaphylaxis due to alpha-gal syndrome after initial cetuximab administration: The first forensic case report
The alpha gal story: Lessons learned from connecting the dots