French Guiana and AGS: a path to uncovering hidden clues.

Introduction: This article is a narrative review exploring how research in French Guiana could unlock the mysteries surrounding Alpha-Gal Syndrome (AGS), a recently identified IgE-mediated allergy with delayed reactions to exposure to non-Catarrhine mammalian-derived products. Although fewer than 10 cases have been reported across Latin America, two case series involving 11 and 18 patients with AGS have been documented in French Guiana.

Areas Covered: This article discusses risk factors such as ethnicity, prior pathogen-induced immunization to α-Gal, vectors responsible for AGS, their environment and ecosystems, observed phenotypes, and therapeutic implications for sensitized individuals. Literature research was based on PubMed between 12/2023 and 08/2024, using: α-Gal/Alpha-1,3-Galactose/galactose-α 1,3-galactose/Red meat allergy/Mammalian meat allergy/Alpha gal syndrome/Antivipmyn. Grey literature from French Guiana were obtained from Prof. Loïc Epelboin.

Expert Opinion: Advancing AGS research in French Guiana could yield valuable epidemiological insights, as existing data predominantly stem from European, North American, Australian, and Japanese contexts - regions with comparatively lower diversity in tick species, their mammalian hosts, associated pathogens, and parasitic infestations. Additionally, French Guiana presents unique therapeutic scenarios, such as Viperidae envenomation and transfusions under inventory constraints, that merit further investigation.