Risk Factors, Pathogenesis, and Management of Alpha-Gal Syndrome

Hulscher et al. once again try to make something plausible and frame it as evidence. “Whether vaccine-derived alpha-gal also contributes to sensitization remains unproven, but convergent human, immunochemical, and animal evidence provides a compelling basis for urgent direct testing.” They go on to try to frame vaccines as a causal role without any evidence to support the claim.

The authors substitute structural/mechanistic analogy in place of empirical demonstration, yet they use analogies at least six times to try to make a claim of evidence.

  • This immunologic situation is analogous to the naturally occurring ABO blood group antibodies.
  • This phenomenon is well recognized in the Rh alloimmunization model.
  • These memory B cells rapidly differentiate…producing a robust anamnestic (secondary) immune response characterized by a rapid and marked increase in anti-D IgG antibody titers.
  • This is the logic underlying cutaneous sensitization to food proteins with subsequent oral allergy, and it explains the route dependence.
  • Individuals of blood group O carry anti-A and anti-Bantibodies generated largely through exposure to cross-reactive microbial antigens.
  • Sequential class switching…is a described route to high-affinity IgE.

The Japanese gelatin allergy study cited is related to allergy to gelatin and has nothing to do with alpha-gal syndrome. “We therefore consider it probable, though not formally demonstrated, that a substantial fraction of the anti-gelatin IgE induced by gelatin-containing vaccines in Japanese infants was directed at alpha-gal.” The authors commit an association-is-not-causation fallacy by assuming that because gelatin contains trace alpha-gal, the anti-gelatin IgE generated in Japanese children must have been alpha-gal-specific. Without testing those archived sera specifically, their claim remains unvalidated speculation.

The authors acknowledge that “the alpha-gal mass delivered by a feeding tick has never been measured,” yet attempt to draw comparative conclusions between tick saliva and vaccine doses. In toxicology and immunotoxicology, a comparison between a quantified variable (vaccine dose) and an entirely unquantified, variable vector exposure (tick bite delivery) invalidates any claims regarding sensitizing thresholds. Furthermore, tick bites deliver salivary antigens over days accompanied by complex immunomodulatory adjuvants, a microenvironment completely unanalogous to a single subcutaneous vaccine injection.

Another major flaw is comparing murine (mouse) models to human physiology. The immune systems are different and the doses used in murine testing are far beyond what would ever be relatively used in humans. They even state this “First, the murine protocol was designed to achieve consistent sensitization for mechanistic study, not to establish a threshold” but then continue to treat it as evidence around vaccines.

Their primary hypothesis would suggest that there is an age gradient because younger age groups would have received more gelatin-containing vaccines. Under their “vaccine priming” hypothesis, younger age groups (who receive more routine pediatric vaccines) should show higher rates of alpha-gal sensitization. However, real-world CDC seroprevalence data shows that alpha-gal IgE positivity increases monotonically with age (reaching peak levels in older adults). The authors acknowledge that the age distribution “provides no support for the priming hypothesis”, yet fail to recognize that this negative correlation strongly disproves their premise.

In Section 8.4 “Why a real off-target immunization effect would be invisible,” the authors assert that because childhood vaccination is widespread, the hypothesized priming effect cannot be detected by conventional epidemiologic methods. This creates a classic unfalsifiable hypothesis. By claiming that the absence of observational evidence is merely an artifact of universal exposure hiding the signal, the authors remove their theory from empirical testability, violating basic scientific epistemology.

As the norm for them they completely disregard the preponderance of evidence that there is no association between vaccination and food allergy development. Further, they go on to promote “therapies” where there is no controlled trials.

This will never get published in a reputable journal.

https://zenodo.org/records/22003548