Which allergy is associated with the fab segment of cetuximab and the Lone Star tick?

The association between the fab segment of cetuximab and the Lone Star tick primarily points to a red meat allergy. The Lone Star tick has been linked to the development of alpha-gal syndrome, which is an allergic reaction triggered by the ingestion of red meat and some other animal products. This syndrome is characterized by the production of IgE antibodies against galactose-alpha-1,3-galactose (often referred to as alpha-gal), a sugar found in the tissues of most mammals except for humans, great apes, and old-world monkeys.

Cetuximab is a chimeric monoclonal antibody that targets the epidermal growth factor receptor (EGFR) and contains both human and murine components. The fab (fragment antigen-binding) portion is derived from a murine source, and for individuals with separate sensitivities, the presence of murine proteins can elicit an immune response. In patients who develop an allergy to red meat due to the Lone Star tick, there is a risk of cross-reactivity especially when exposed to products like cetuximab that contain similar epitopes.

Other allergies mentioned, such as milk, shellfish, and tree nuts, do not have this specific association with the Lone Star tick