WEBVTT - Ep 153 Alpha-Gal Syndrome: A tick bite gone bad 0:00:00.280 --> 0:00:04.800 Hi. My name is Winnie and I'm an ecologist. In 0:00:04.840 --> 0:00:07.600 the summer of twenty eighteen, my husband and I moved 0:00:07.720 --> 0:00:11.400 to northeast Missouri for his job. In early August, we 0:00:11.480 --> 0:00:14.880 decided to go for a hike at a nearby conservation area. 0:00:15.360 --> 0:00:18.040 We had about a mile left in the hike when 0:00:18.040 --> 0:00:21.360 we heard rustling in the brush beneath some big oak trees. 0:00:22.440 --> 0:00:24.599 It turned out to be a red tailed hawk with 0:00:24.640 --> 0:00:27.240 a broken wing. In order to bring the bird to 0:00:27.280 --> 0:00:31.720 the nearest wildlife veterinarian located in Columbia, Missouri, we needed 0:00:31.720 --> 0:00:35.720 to get the bird to our car, so my husband 0:00:35.760 --> 0:00:39.360 gave me his overshirt while he distracted the hawk. I 0:00:39.520 --> 0:00:42.320 tossed the shirt over the bird's head to calmb it down, 0:00:42.520 --> 0:00:45.440 and we safely carried the bird back to our car. 0:00:46.240 --> 0:00:50.320 It was like a ninety minute drive to Missoo Veterinary Hospital, 0:00:51.360 --> 0:00:54.000 and before long we noticed that our feet and our 0:00:54.040 --> 0:00:57.880 ankles were really itchy. About halfway to Columbia, we had 0:00:57.880 --> 0:01:01.360 to stop for gas, so that's when I pulled down 0:01:01.400 --> 0:01:04.840 my sock and I saw what looked like thousands of 0:01:04.920 --> 0:01:10.039 tiny grains of sand moving across my ankles. At the time, 0:01:10.280 --> 0:01:13.560 I was convinced that these were chiggers. With very few 0:01:13.600 --> 0:01:17.280 options for how to remove them, we continued on our 0:01:17.360 --> 0:01:20.360 mission to get the hawk to the veterinary hospital. The 0:01:20.440 --> 0:01:24.520 staff stabilized and treated the animal, and we drove back home. 0:01:25.400 --> 0:01:27.759 After that day. In twenty eighteen, my husband and I 0:01:27.920 --> 0:01:32.160 avoided areas that were chigger prone, particularly between April and 0:01:32.200 --> 0:01:37.520 September when they're the worst. We also used repellent sprays, 0:01:37.560 --> 0:01:40.640 and we treated our clothes and shoes with permethrin to 0:01:40.720 --> 0:01:44.840 deter chiggers. It's worth noting that we had also been 0:01:44.920 --> 0:01:48.920 warned about lone star ticks. These are really common in Missouri, 0:01:49.560 --> 0:01:53.520 and they're common even in urban and suburban areas, and 0:01:53.560 --> 0:01:57.000 they're also really aggressive feeders. So we were really careful 0:01:57.320 --> 0:02:00.240 not to get any ticks. And it turns out that 0:02:00.440 --> 0:02:04.840 chigger treatment and tick treatment for clothes and repellents, they're 0:02:04.880 --> 0:02:08.959 the same thing. One evening in October of twenty twenty two, 0:02:09.120 --> 0:02:12.400 we made a meal with hamburger. It was noteworthy because 0:02:12.400 --> 0:02:15.600 we didn't eat much meat and it was a special 0:02:15.600 --> 0:02:19.000 treat for us. Later that night, I woke up violently ill, 0:02:19.440 --> 0:02:21.560 and I was certain that I had gotten food poisoning. 0:02:22.040 --> 0:02:24.760 At some point, while I was dry heating into a bucket, 0:02:24.919 --> 0:02:28.040 I realized that my ankles and my palms were insanely 0:02:28.080 --> 0:02:31.840 itchy and covered in hives. The hives quickly spread to 0:02:31.880 --> 0:02:36.400 my torso, legs, arms, and scalp. I was struggling to breathe, 0:02:36.440 --> 0:02:40.680 and I remember feeling that numb feeling in my entire body, 0:02:41.080 --> 0:02:43.919 you know, the feeling when you get novacine. At the 0:02:44.000 --> 0:02:47.799 dentist it was like that, but everywhere. I wasn't thinking 0:02:47.960 --> 0:02:51.760 entirely clearly, but I do remember taking to benadryl, waiting 0:02:51.840 --> 0:02:56.040 about five minutes panicking, and then taking two more benadryl 0:02:56.600 --> 0:02:58.320 while I waited for the hives to go away. I 0:02:58.360 --> 0:03:02.040 remember trying to figure out how and why food poisoning 0:03:02.080 --> 0:03:06.280 could cause hives. The next day, I arranged to see 0:03:06.280 --> 0:03:08.920 an allergist. He sent off a bunch of blood tests 0:03:09.560 --> 0:03:12.080 and one of them came back positive. It was for 0:03:12.160 --> 0:03:15.480 Alpha gal. As an ecologist, I knew about Alpha Gal. 0:03:15.600 --> 0:03:18.160 I had friends with Alpha Gal, I have coworkers with 0:03:18.200 --> 0:03:21.240 Alpha gal. It's something that we're aware of in the 0:03:21.240 --> 0:03:24.560 ecology world, at least in Missouri. But I do remember 0:03:24.600 --> 0:03:28.000 being really angry. I was angry because my husband and 0:03:28.040 --> 0:03:30.800 I had been so careful not to get any ticks 0:03:30.919 --> 0:03:34.400 or chiggers since that first incident in twenty eighteen. But 0:03:34.440 --> 0:03:39.160 then I remembered. I remembered those chiggers, and in hindsight, 0:03:39.600 --> 0:03:43.120 they had to have been seed ticks or tick larvae. 0:03:43.760 --> 0:03:46.680 We probably had walked into a bed of these seed ticks, 0:03:46.760 --> 0:03:49.880 and we were probably bitten by hundreds of them. Also, 0:03:49.960 --> 0:03:52.280 it wasn't until the doctor told me the results of 0:03:52.320 --> 0:03:55.440 those tests that I realized a lot of the last 0:03:55.480 --> 0:03:58.560 four years really just sort of fell into place. You see, 0:03:58.560 --> 0:04:01.160 Sometimes I had I'd noticed that my ankles in my 0:04:01.280 --> 0:04:05.440 arms would get really itchy for no apparent reason. In hindsight, 0:04:05.520 --> 0:04:09.120 it was usually after I had like jello or soup 0:04:09.200 --> 0:04:13.120 that was made with beef broth. Fast forward to the present. 0:04:13.320 --> 0:04:16.520 In twenty twenty three, we moved to Minnesota. As an ecologist, 0:04:16.520 --> 0:04:18.359 i'd like to keep an eye out for all sorts 0:04:18.400 --> 0:04:22.239 of different organisms, and I note how their ranges are changing. 0:04:22.720 --> 0:04:24.800 Just last month, I found a lone star tick on 0:04:24.880 --> 0:04:27.800 my dog. Neither she nor I have been to Missouri 0:04:27.800 --> 0:04:31.479 for over a year. So those little ticks, those little 0:04:31.520 --> 0:04:34.480 lone star ticks, they are moving their way. 0:04:34.279 --> 0:05:23.360 North, Winnie, thank you so much for sharing your story 0:05:23.400 --> 0:05:27.039 with us. We really appreciate it, and like, my gosh, 0:05:27.279 --> 0:05:30.800 what a strange yeah thing this is. 0:05:31.080 --> 0:05:33.880 I know, thank you so much for being willing to 0:05:33.920 --> 0:05:35.680 go through all of that with us and with all 0:05:35.720 --> 0:05:39.480 of our listeners. We really appreciate it. Yeah. Hi, I'm 0:05:39.520 --> 0:05:42.320 Aaron Welsh and I'm Erin Allman Updike. 0:05:42.240 --> 0:05:44.320 And this is this podcast will kill you. 0:05:44.760 --> 0:05:49.280 And today we're getting real weird, really weird, because we're 0:05:49.320 --> 0:05:53.200 talking about alpha gal syndrome aka red meat. 0:05:53.040 --> 0:05:57.119 Allergy, as given to you by the bite of a tick. 0:05:57.320 --> 0:06:00.760 By the bite of a tick. It's so weird, Aaron. 0:06:00.920 --> 0:06:04.080 Yeah, it is. It is very bizarre. It feels like 0:06:04.160 --> 0:06:08.640 something out of a sci fi novel that's like, you know, 0:06:08.839 --> 0:06:13.520 near future and the world is about to collapse because 0:06:13.560 --> 0:06:17.839 climate change is farming and whatever, and so then a 0:06:18.080 --> 0:06:21.400 rogue scientist introduces this thing into ticks that causes everyone 0:06:21.440 --> 0:06:23.400 to be vegetarian. Yeah, you get the you get the. 0:06:23.360 --> 0:06:25.360 Right, I got it. I liked it a lot. I 0:06:25.360 --> 0:06:27.240 would watch that movie, honestly. 0:06:27.360 --> 0:06:30.120 I would. Yeah, I would absolutely watch that movie and 0:06:30.120 --> 0:06:34.719 probably fall asleep halfway. But that's my that's my jam. 0:06:35.040 --> 0:06:37.240 Yeah, it's I'm really excited for it. It's gonna be 0:06:37.279 --> 0:06:41.479 a really fun episode. Yeah, I have so many it's 0:06:41.480 --> 0:06:42.800 so weird, it's so weird. 0:06:43.440 --> 0:06:46.280 Yeah, and we'll get we'll get into all of that 0:06:46.480 --> 0:06:50.000 weirdness business later on, but first we've got some other 0:06:50.040 --> 0:06:51.120 business to take care of. 0:06:51.400 --> 0:06:55.719 We do. It's quarantiney time as always. So what are 0:06:55.760 --> 0:06:59.680 we drinking this week? We're drinking gal Pal, you know, 0:07:00.160 --> 0:07:06.360 just Pal, gal Pal, you're out the gal Pal. It's 0:07:06.360 --> 0:07:10.560 a delicious beverage. Of course, it is made with none 0:07:10.600 --> 0:07:13.520 other than Beef Eater Gin Yeah sponsored. 0:07:13.520 --> 0:07:16.200 Not sponsored, but you know, we can't. We can't pass 0:07:16.280 --> 0:07:19.120 up that that name, that branding. 0:07:20.880 --> 0:07:23.560 As well as passion fruit and lemon lime soda. It's 0:07:23.560 --> 0:07:25.720 a really refreshing gin bev. 0:07:26.480 --> 0:07:29.880 Yeah, gal pales great. Yeah, and check it out because 0:07:29.920 --> 0:07:34.080 we'll be posting the recipe for gal Pal the Quarantini 0:07:34.160 --> 0:07:37.320 as well as Galpal the Place Barta on our website. 0:07:37.360 --> 0:07:40.200 This podcast will kill you dot Com and all over 0:07:40.320 --> 0:07:43.320 our social media channels. So if you're not following us there, 0:07:43.560 --> 0:07:45.600 you really should be, because we're coming out with some 0:07:45.760 --> 0:07:49.840 pretty stellar content if we do say so ourselves. 0:07:49.600 --> 0:07:51.960 And we do, we do say so ourselves pretty much 0:07:51.960 --> 0:07:58.160 every week we do. If you check out our website, 0:07:58.200 --> 0:08:00.200 you will also find a lot of other really great 0:08:00.360 --> 0:08:03.320 that we tell you about every single week, including transcripts 0:08:03.360 --> 0:08:05.160 from all of our episodes, which I believe you can 0:08:05.200 --> 0:08:09.160 now find as well on Apple podcasts. Speaking of Apple podcasts, 0:08:09.440 --> 0:08:13.200 are you subscribed? Because you should be to make sure 0:08:13.240 --> 0:08:15.200 that you're helping support the show. It really helps us 0:08:15.240 --> 0:08:18.360 to double check that you are subscribed and haven't accidentally 0:08:18.360 --> 0:08:22.400 been unsubscribed, which happened to me in fact from our 0:08:22.400 --> 0:08:30.120 own podcast. And anyways, back for our website, you can 0:08:30.160 --> 0:08:33.680 find transcripts, you can find merch. We have a whole 0:08:33.679 --> 0:08:35.320 bunch of merch. We have new merch, and we have 0:08:35.400 --> 0:08:38.120 a few items left from some of our old merch. 0:08:38.160 --> 0:08:39.640 So if you wanted to get your hands on things 0:08:39.679 --> 0:08:41.560 that you thought we were out of, double check because 0:08:41.559 --> 0:08:42.199 we might just have. 0:08:42.160 --> 0:08:43.720 It there limited stock. 0:08:45.480 --> 0:08:48.640 We've also got links to Bloodmobile, who does the music 0:08:48.640 --> 0:08:50.920 for all of our episodes. We've got a good Reads list, 0:08:51.080 --> 0:08:53.360 we've got a bookshop dot org affility account, we have 0:08:53.480 --> 0:08:55.880 the sources from all of our episodes. Oh my goodness, 0:08:56.200 --> 0:08:58.000 this podcast will kill you dot com check it out. 0:08:58.600 --> 0:09:02.760 I don't think we have any other business do no? Okay, well, 0:09:02.800 --> 0:09:05.200 then let's get started, because I feel like we have 0:09:05.280 --> 0:09:07.960 a lot of ground to cover when it comes to 0:09:08.000 --> 0:09:11.640 this bizarre thing called alphagal syndrome. 0:09:12.040 --> 0:09:13.800 We do, we do, we do. Let's get into it 0:09:13.960 --> 0:09:33.720 right after this break. Alpha gal syndrome is at its 0:09:33.760 --> 0:09:40.079 core a food allergy, and allergies are a hypersensitivity response 0:09:40.360 --> 0:09:46.080 to a very specific thing. Most allergies usually are a 0:09:46.360 --> 0:09:51.160 hyper sensitive response to a protein. So that right there 0:09:51.400 --> 0:09:55.440 is the first of so many places where the story 0:09:55.480 --> 0:09:58.960 of alphagal syndrome is so much weirder than just a 0:09:58.960 --> 0:10:02.760 food allergy, because in this case, it's an allergy to 0:10:02.920 --> 0:10:07.280 a specific sugar. Alpha gal an alpha gal of course, 0:10:07.320 --> 0:10:10.760 has a much more complicated chemical name. It's galactose alpha 0:10:10.800 --> 0:10:11.959 one three galactose. 0:10:12.520 --> 0:10:15.079 It's really hard to search for because I didn't want 0:10:15.120 --> 0:10:17.000 to have to put in the little alpha sign every 0:10:17.000 --> 0:10:17.800 time I searched. 0:10:20.280 --> 0:10:23.280 Actually, I never thought about if you just type alpha, 0:10:23.400 --> 0:10:27.160 does Google also recognize alpha as the word alpha? 0:10:27.320 --> 0:10:28.720 You know? Probably? 0:10:29.120 --> 0:10:31.120 I don't know it does, and I don't know enough 0:10:31.160 --> 0:10:35.600 about seo or whatever. Any Oh, gosh, no, In any case, 0:10:35.920 --> 0:10:39.280 galactose alpha one three galactose alpha GAL. So this is 0:10:39.360 --> 0:10:42.760 a short sugar, it's a aligosach ride. It's just a 0:10:42.760 --> 0:10:45.560 couple of sugar molecules linked together in a specific way. 0:10:46.400 --> 0:10:50.280 And alpha gal syndrome is when people develop an allergy 0:10:50.679 --> 0:10:54.920 to this particular sugar. And like we already mentioned, this 0:10:55.000 --> 0:10:58.360 food allergy is also different than most food allergies because 0:10:58.400 --> 0:11:02.440 it develops after an initial exposure not to a food, 0:11:03.160 --> 0:11:06.439 but to a tick. So I figured to understand the 0:11:06.480 --> 0:11:09.920 story of alpha gal. To understand this weird food allergy, 0:11:10.320 --> 0:11:12.360 we first have to kind of take a step back 0:11:12.400 --> 0:11:17.240 and understand allergies more generally, like how do allergies? Food 0:11:17.280 --> 0:11:21.840 allergies usually work. So, an allergy at its core, like 0:11:21.880 --> 0:11:26.240 I said, is a hypersensitivity reaction, which basically means it's 0:11:26.280 --> 0:11:31.839 your body overdoing it in response to some kind of exposure, 0:11:31.880 --> 0:11:35.080 and that exposure is usually a protein. So in the 0:11:35.120 --> 0:11:39.200 case of food allergies, it's proteins that we eat, and 0:11:39.520 --> 0:11:42.800 adverse reactions to foods can come in a lot of 0:11:42.840 --> 0:11:47.240 different types and flavors. We already covered this season seliac disease, 0:11:47.280 --> 0:11:52.000 which is an adverse food reaction to specific proteins in gluten. 0:11:53.360 --> 0:11:57.000 Some types of adverse reactions are classified as allergies, and 0:11:57.040 --> 0:12:02.280 these are usually what are called ig e mediated allergies 0:12:03.160 --> 0:12:06.680 and IgE mediated allergies are the types of allergies that 0:12:06.720 --> 0:12:09.280 you probably think of. If you think of a food allergy, 0:12:09.440 --> 0:12:14.400 you probably think of most classically peanuts m hm. So 0:12:14.679 --> 0:12:17.960 someone who's allergic to peanuts might develop hives and then 0:12:18.200 --> 0:12:24.160 throat swelling and then anaphylaxis difficulty breathing after exposure to peanuts. 0:12:24.800 --> 0:12:27.800 At its core, what's happening here is that our body 0:12:27.920 --> 0:12:31.720 is mistaking a food protein like a peanut protein, for 0:12:31.840 --> 0:12:35.920 a pathogen and then mounting an immune response to this 0:12:36.080 --> 0:12:40.400 perceived threat. But it's doing that in a weird way 0:12:40.800 --> 0:12:48.119 by making these antibodies called IgE antibodies. So to understand allergies, 0:12:49.000 --> 0:12:51.080 we then also have to understand what the heck is 0:12:51.120 --> 0:12:52.520 an IgE ant a body? 0:12:53.320 --> 0:12:55.840 Can I ask a question real quick? 0:12:56.080 --> 0:12:56.520 Please? 0:12:57.400 --> 0:13:01.720 Why proteins? Ooh, good question. 0:13:02.720 --> 0:13:05.160 I don't have an exact answer to that, except that 0:13:05.240 --> 0:13:10.559 proteins tend to be more iminogenic. Okay, So it's similar 0:13:10.600 --> 0:13:13.960 with like vaccines. A lot of times, if we try 0:13:14.000 --> 0:13:18.120 and develop a vaccine against just carbohydrates or sugars that 0:13:18.400 --> 0:13:21.240 we could also target on the outside of a pathogen 0:13:21.640 --> 0:13:25.679 that doesn't tend to last as long, so we usually 0:13:25.760 --> 0:13:29.800 then link it to a protein like, for example, tetnos toxoid, 0:13:30.320 --> 0:13:33.040 and then we'll link carbohydrates to that protein to generate 0:13:33.080 --> 0:13:36.400 a better immune response. But I don't know why proteins 0:13:36.480 --> 0:13:39.760 tend to be more iminogenic. Yeah, it's a good question. 0:13:40.080 --> 0:13:43.760 It's interesting. Okay, Yeah, and so I feel like maybe 0:13:43.760 --> 0:13:48.120 this is jumping ahead. Okay, you said when you are 0:13:48.160 --> 0:13:53.959 exposed to something that triggers this IgE response. The IgE 0:13:54.040 --> 0:13:56.600 response is because your body is thinking that this is 0:13:56.640 --> 0:14:01.640 a pathogen. But this response is kind of out of 0:14:01.679 --> 0:14:06.559 control and really bad. Yeah, and can be much worse 0:14:06.600 --> 0:14:09.560 for you than a pathogen than a potential pathogen could be. 0:14:09.920 --> 0:14:15.400 Totally Yeah, So I don't know what my question is 0:14:17.760 --> 0:14:20.520 why why would that happen? Like why why would that 0:14:20.560 --> 0:14:22.000 be an evolved response? 0:14:22.400 --> 0:14:26.040 Yeah, it's a great question, like why did allergies evolve? 0:14:26.280 --> 0:14:29.400 Is a bigger question than I can maybe not only 0:14:29.400 --> 0:14:33.440 something that we address in the R two parter, but. 0:14:33.880 --> 0:14:36.040 What what part of your question is getting at, is 0:14:36.080 --> 0:14:39.080 like why IgE? Like why is this response so weird? 0:14:39.120 --> 0:14:41.880 So let's talk about what IgE is and why the 0:14:41.960 --> 0:14:47.120 response with IgE antibodies can be so severe. So antibodies, 0:14:47.160 --> 0:14:48.680 I feel like we've talked a lot about on this 0:14:48.760 --> 0:14:52.160 podcast in various time points, But antibodies are one of 0:14:52.200 --> 0:14:56.200 our immune systems ways of having a very specific response. 0:14:56.760 --> 0:15:00.000 So antibodies are the things that we make, say, for example, 0:15:00.040 --> 0:15:02.600 but when we get a vaccine to then be able 0:15:02.640 --> 0:15:07.560 to specifically target and fight off one particular say virus 0:15:07.680 --> 0:15:12.440 or something, right, our antibodies can very precisely identify one 0:15:12.520 --> 0:15:19.240 particular protein, for example, or carbohydrate sugar on a particular virus. 0:15:19.280 --> 0:15:22.520 And then when we're exposed to that again, our antibodies 0:15:22.720 --> 0:15:26.720 bind to those antigens that they can identify, and they 0:15:26.760 --> 0:15:30.080 act like a flag. They alert our immune system, Hey, 0:15:30.600 --> 0:15:33.560 come over here, I found something that shouldn't be here, right, 0:15:33.600 --> 0:15:37.160 and then we do our immune response thing. Most of 0:15:37.160 --> 0:15:39.520 the time when we talk about antibodies, or at least 0:15:39.520 --> 0:15:42.000 on this podcast when we have, we haven't mentioned the 0:15:42.040 --> 0:15:48.560 different types. But in vaccines and those kinds of antibody responses, 0:15:48.800 --> 0:15:53.720 our body is usually making IgM and IgG antibodies. There's 0:15:53.760 --> 0:15:55.920 other ones that are like in the context of our 0:15:55.960 --> 0:16:00.480 guts and our mucosal membranes called IgA, and then there's 0:16:00.600 --> 0:16:04.840 IgE antibodies, and these are created in the same basic 0:16:04.880 --> 0:16:07.880 way as all of our other antibodies in response to 0:16:08.040 --> 0:16:12.280 one particular protein. They're very very specific, and it's our 0:16:12.320 --> 0:16:15.920 B cells, the same cells that are making these antibodies. 0:16:16.880 --> 0:16:22.240 It's thought that evolutionarily this antibody responds. IgE evolved mostly 0:16:22.280 --> 0:16:26.280 to respond to parasites and protozoan pathogens and maybe even 0:16:26.440 --> 0:16:29.920 venoms like snake venom. And what IgE does is it 0:16:29.960 --> 0:16:33.000 doesn't just serve as a flag the way that something 0:16:33.040 --> 0:16:37.760 like IgG does. IgE is an antibody that hangs out 0:16:37.800 --> 0:16:41.520 attached to some of our other immune cells, like called 0:16:41.640 --> 0:16:44.720 mass cells and our basofyls. That part's less important, but 0:16:44.760 --> 0:16:48.720 basically IgE is attached. It's not free floating. It's attached 0:16:48.800 --> 0:16:52.600 to these other white blood cells, and when they find 0:16:52.680 --> 0:16:56.600 the anigen that they're targeted for, they grab onto it. 0:16:57.120 --> 0:17:00.080 And what that does is it triggers these cells that 0:17:00.120 --> 0:17:03.720 they're attached to to kind of almost burst open and 0:17:03.960 --> 0:17:10.920 spew forth a ton of highly reactive, super inflammatory stuff 0:17:11.960 --> 0:17:14.520 really quick, all of a sudden. It's like a boom 0:17:14.680 --> 0:17:18.159 immune response rather than like a flag. Hey, guys, everyone 0:17:18.200 --> 0:17:20.200 come over and then that response takes some time. 0:17:20.600 --> 0:17:24.440 Right, It's kind of like scorched Earth policy exactly. 0:17:24.680 --> 0:17:28.840 Yes, it's like something's here, Wow, I just just destroy 0:17:28.920 --> 0:17:29.680 it all a. 0:17:29.640 --> 0:17:33.520 Little reactive maybe, like let's take a moment, let's breathe, 0:17:33.640 --> 0:17:35.679 let's just see do we need to do this? Are 0:17:35.720 --> 0:17:38.679 there less extreme responses that we can come up with? 0:17:38.800 --> 0:17:38.840 No? 0:17:38.960 --> 0:17:40.600 Apparently, not ig. 0:17:40.680 --> 0:17:42.560 Is like my toddler last night when I told me 0:17:42.560 --> 0:17:49.600 we needed to come out of the bath, Like yeah. So, 0:17:49.800 --> 0:17:52.840 in a food allergy, like a peanut allergy, our body 0:17:52.960 --> 0:17:57.000 is inappropriately recognizing a peanut protein and then it's mounting 0:17:57.240 --> 0:18:03.840 weirdly this IgE response to it. That process is called sensitization. 0:18:04.520 --> 0:18:06.879 That has to happen first. You have to be exposed 0:18:06.920 --> 0:18:09.600 to something. Your body does kind of a weird thing 0:18:09.920 --> 0:18:12.919 by deciding that it's going to make IgE antibodies against 0:18:12.960 --> 0:18:16.760 that protein, and our immune system doesn't ever forget things, 0:18:17.280 --> 0:18:20.399 so it holds on to those IgE antibodies just waiting 0:18:20.480 --> 0:18:23.080 in the wings. And then the next time that we 0:18:23.119 --> 0:18:26.760 eat a peanut, those antibodies are already there and they're 0:18:26.800 --> 0:18:29.439 like we prod the invader and they do their scorz 0:18:29.480 --> 0:18:32.399 ter thing. They bind to that peanut protein, all of 0:18:32.440 --> 0:18:37.000 those mass cells expel tons of inflammatory material and then 0:18:37.040 --> 0:18:41.240 you have the symptoms of that allergic reaction. And that 0:18:41.440 --> 0:18:45.479 is what we see in alphagau syndrome, except for a 0:18:45.520 --> 0:18:50.520 few pretty important details. M H. So again, alpha gal. 0:18:50.760 --> 0:18:54.040 It's a sugar, a carbohydrate, and already that's a little 0:18:54.040 --> 0:18:59.440 bit weird. We're mounting a massive immune response to an oligosaccharide. 0:18:59.760 --> 0:19:05.879 Why is this particular sugar so immunogenic. Well, it turns 0:19:05.920 --> 0:19:11.760 out that this particular sugar is found pretty universally attached 0:19:11.800 --> 0:19:16.919 to proteins and lipids on cell membranes of it seems 0:19:16.960 --> 0:19:21.160 like most all, many many different types of cells throughout 0:19:21.160 --> 0:19:26.880 the body of pretty much every mammal except for humans 0:19:27.160 --> 0:19:30.760 and apes and old old monkeys. Oh yeah, we'll get 0:19:30.760 --> 0:19:33.160 into it. I know, I cannot wait. I know, Aaron, 0:19:33.200 --> 0:19:35.160 that you're going to get into a lot more detail 0:19:35.480 --> 0:19:39.040 about alpha gal and the antibodies that we make against 0:19:39.040 --> 0:19:42.199 alpha gal from an evolutionary context. But just for some 0:19:42.320 --> 0:19:46.600 context on alphagel. So we do not make this sugar 0:19:46.720 --> 0:19:51.359 in our bodies. We happen to make from infancy and 0:19:51.520 --> 0:19:56.480 to bodies against this particular alphag sugar the same way 0:19:56.960 --> 0:20:00.640 that people who like me are blood group oh make 0:20:00.760 --> 0:20:05.560 antibodies against the A and B sugars that make blood 0:20:05.600 --> 0:20:08.320 groups A, B, and O that are attached to our 0:20:08.359 --> 0:20:12.879 red blood cells. So the antibodies that we make and 0:20:13.040 --> 0:20:18.080 have circulating around us are IgG antibodies. I like to 0:20:18.080 --> 0:20:20.600 think of them as like normal ones, even though they're 0:20:20.640 --> 0:20:23.200 all normal. That's a terrible descriptor, but you know what 0:20:23.240 --> 0:20:25.160 I mean, they're just like free floating. They're not doing 0:20:25.280 --> 0:20:28.439 much right. We can eat all the bacon that we 0:20:28.520 --> 0:20:31.560 want and it doesn't trigger any kind of immune response, 0:20:31.680 --> 0:20:35.720 even though we have these IgG anti bodies floating around. Now, 0:20:36.000 --> 0:20:39.280 we cannot take a pig heart and transplant it into 0:20:39.320 --> 0:20:42.919 a human body. It so happens that this particular sugar 0:20:43.000 --> 0:20:46.680 is one of the major barriers to transplantation of animal 0:20:46.800 --> 0:20:51.400 organs into humans. But we can eat bacon, be exposed 0:20:51.400 --> 0:20:54.560 to it through our guts, and do just fine unless 0:20:55.280 --> 0:20:58.040 we can't enter the tick. 0:20:59.560 --> 0:21:02.480 Oh gosh, yep, it's so weird. 0:21:02.720 --> 0:21:06.640 It it's so weird. So when I talked about how 0:21:06.680 --> 0:21:10.080 food allergies work, the first step that I went through 0:21:10.400 --> 0:21:13.639 was sensitization. Right there, has to be a period of 0:21:13.680 --> 0:21:19.080 sensitization where our body sees these antigens and goes, ooh, 0:21:19.440 --> 0:21:21.840 something's weird here. I'm going to make antibodies against it. 0:21:22.359 --> 0:21:26.679 And in alphagau syndrome, that's sensitization. To alpha gal it 0:21:26.720 --> 0:21:33.880 doesn't happen from food. It happens from a tick bite. Ticks, 0:21:34.040 --> 0:21:38.040 of course, are our little six to eight legged, depending 0:21:38.080 --> 0:21:42.840 on life stages, blood feeding friends. These are obligate blood 0:21:42.840 --> 0:21:46.359 feeders throughout their whole life cycle, and they have to 0:21:46.440 --> 0:21:50.280 stay attached for a pretty long time, like hours to days, 0:21:50.800 --> 0:21:54.000 in order to get a full blood meal. And while 0:21:54.040 --> 0:21:57.600 they do this, just like our friend the leech, they 0:21:57.760 --> 0:22:00.720 spit a whole bunch of their saliva into our bodies 0:22:00.760 --> 0:22:04.720 to help with things like anti coagulation and anesthetizing us 0:22:04.760 --> 0:22:06.760 so that we don't notice them and we're not bothered 0:22:06.760 --> 0:22:08.600 by them. It can hang out for a long time. 0:22:08.800 --> 0:22:13.720 Tick saliva is kind of a magical substance. Saliva is 0:22:13.800 --> 0:22:17.000 right exactly, and I feel like saliva. I know people 0:22:17.040 --> 0:22:18.760 are working on it, but I do feel like there 0:22:18.800 --> 0:22:22.359 are some amazing opportunities in tickspit. 0:22:22.760 --> 0:22:25.080 I agree. I was reading about like the sia loam. 0:22:25.240 --> 0:22:29.919 They call it the saliva microbiome. I love it. 0:22:29.960 --> 0:22:32.080 I love when there's a new word for microbiome for 0:22:32.119 --> 0:22:37.919 a different part of a different area, but different area. 0:22:38.040 --> 0:22:40.840 So what happens in alpha gau syndrome is that during 0:22:40.880 --> 0:22:46.000 blood feeding, some species of tick, somehow, some way introduce 0:22:46.119 --> 0:22:50.320 alpha gal into our bodies, directly into our bloodstream or 0:22:50.359 --> 0:22:54.720 our lymphatics while they're blood feeding, and for some people 0:22:55.480 --> 0:23:00.440 this triggers that sensitization, the development of those ig e 0:23:00.560 --> 0:23:06.280 anna bodies against that specific sugar alphagal. That is how 0:23:06.320 --> 0:23:13.040 sensitization happens. Often, but not always, when people develop alpha gal, 0:23:13.240 --> 0:23:16.440 they report like one specific tick bite that they had 0:23:16.440 --> 0:23:19.760 a more severe local reaction to, So they'll get like 0:23:19.880 --> 0:23:23.199 a large red welt that's super itchy, and this reaction 0:23:23.280 --> 0:23:25.800 will last like a lot longer or be a lot 0:23:25.800 --> 0:23:28.119 more extreme than other tick bites that they might have 0:23:28.200 --> 0:23:31.679 had in the past. And then what happens is that 0:23:31.840 --> 0:23:35.240 on re exposure to alpha gal, like the next time 0:23:35.240 --> 0:23:38.720 that somebody eats bacon, because alpha gal is all over 0:23:38.920 --> 0:23:42.720 any meat products that you're eating. Now their body has 0:23:43.000 --> 0:23:46.760 all of this IgE waiting and it goes whoa wha whoa, 0:23:46.920 --> 0:23:49.520 this is that highly varulent pathogen. I have to respond 0:23:49.520 --> 0:23:53.960 to it, binds to it. Those mast cells de granulate, 0:23:54.040 --> 0:23:59.280 they release all of their super inflammatory stuff, and you 0:23:59.359 --> 0:24:05.280 get this massive immune response aka allergy. That's that's how 0:24:05.280 --> 0:24:06.160 alpha that works. 0:24:06.680 --> 0:24:09.240 Well, Aaron, I have a few questions here. 0:24:10.200 --> 0:24:12.120 Well, Aaron, I thought that you might. 0:24:13.760 --> 0:24:18.040 Okay, we know that this is multiple tick species all 0:24:18.119 --> 0:24:21.640 over the world. The worst is happening yep, and so 0:24:21.680 --> 0:24:25.359 it's clearly not related to certain tick species or like 0:24:25.400 --> 0:24:26.320 tick phylogeny. 0:24:26.880 --> 0:24:29.840 Yeah, it's It was surprising to me how many different 0:24:30.000 --> 0:24:34.879 genera of ticks, like totally unrelated species of ticks across 0:24:34.880 --> 0:24:37.200 the whole globe can end up causing. 0:24:36.920 --> 0:24:42.360 This, right, which suggests like can any tick be a culprit? 0:24:42.400 --> 0:24:46.080 And this can can any tick induce this allergy? So 0:24:46.560 --> 0:24:49.640 where is like what is the trigger from the tick? 0:24:50.119 --> 0:24:54.880 Yeah, that's a great question. It's the trigger is alpha gal. Yeah, 0:24:55.000 --> 0:24:57.600 question is where is this alpha gal coming from? Right? 0:24:57.680 --> 0:24:59.719 Is it coming from a previous blood meal? Does that mean? 0:24:59.800 --> 0:25:02.159 But I also couldn't find I did a little bit 0:25:02.200 --> 0:25:05.199 of digging, and I couldn't find any relationship between life 0:25:05.200 --> 0:25:09.240 stage of the tick that bit someone and because you 0:25:09.280 --> 0:25:11.560 would think, Okay, now I'm just getting nitty gritty. But 0:25:12.600 --> 0:25:15.880 when when ticks are first born, or when ticks first 0:25:15.880 --> 0:25:18.160 hatch from their little eggs, they haven't eaten, they haven't 0:25:18.160 --> 0:25:21.439 taken any blood meals. So those larva, if they bite you, 0:25:21.520 --> 0:25:24.320 and they do bite you like the seed ticks, will 0:25:24.359 --> 0:25:28.800 that still induce alpha gal response? It can exactly, So 0:25:28.920 --> 0:25:30.320 like what the heck is going on? 0:25:30.800 --> 0:25:30.960