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46 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 8 environment is less capable of dealing with allergic stimuli due to antibiotic use, low exposures to environmental triggers, and other factors. Another possibility is that the same numbers of people are being exposed to this trigger, but an increasing portion of them are proceeding to develop allergies— again, for reasons that are not clear. Finally, we could be seeing a reflection of changes to the ticks' microbiomes as well as our own. And of course, it could be a combination of any or all of these possibilities. How is this different from other allergies? Alpha-gal syndrome is unique in several ways. First, it seems to come on with a specific and extreme onset in people who never had allergies to meat before—this is different from the pattern seen in most allergies, which usually begin in childhood and persist into adulthood. Also, this food-based allergy is triggered by a sugar molecule; almost every other food allergy is related to proteins. The allergy-causing antibodies are peculiar in alpha-gal syndrome too. Alpha-gal can trigger the production of several types of antibodies, and not all of them lead to big reactions. For some reason, it appears that the immune system switches what kind of antibodies it uses in alpha-gal syndrome, and this leads to the most severe immune system response. Lastly, alpha- gal syndrome is different because for most people it seems to subside within a few years—this is not a typical allergy pattern. Is there a connection with other disorders? One of the most fascinating lines of inquiry about alpha-gal syndrome is that it may be a factor in the inflammatory processes that support the deposition of atherosclerotic plaques. In the United States, the Southeast Why is there a response to alpha- gal from ticks, but not from a lifetime of meat eating? Many people are exposed to alpha-gal from eating meat for decades without any immune system reactivity. Then, something happens to make the susceptible person's immune system response to alpha-gal much more extreme. Scientists theorize that other chemicals in tick saliva may heighten the immune system reaction and trigger the body to react to alpha-gal from all sources. Does everybody who gets bitten by a lone star tick get alpha-gal syndrome? No. Even if the same tick bites two people, it is not a guarantee that both people will develop an allergy to alpha-gal. Why? That may be a matter of individual immune system functionality. It has been observed that people with type A or O blood and a history of multiple tick bites are more likely to have this kind of reaction than others. Why is this happening now? What has changed? This is a very complex question with many possible answers. It may be that there are simply more ticks and tick bites than in previous years, so the percentage of the population with alpha-gal syndrome is growing. Or it may be due to changes in human gut microbiomes—our internal Life cycle of the lone star tick.