Ticktective Podcast Transcript
Ticktective™ host Dana Parish interviews Scott P. Commins, MD, PhD, about the growing prevalence of alpha-gal syndrome, a food allergy condition caused by a tick bite, where people develop an allergic reaction to a sugar found in red meat and other mammalian products. Symptoms can include hives, gastrointestinal distress, and potentially life-threatening anaphylaxis, often occurring 3–6 hours after consuming specific foods. This syndrome is increasing, especially in the Southeastern United States, due to the spread of the Lone Star tick. Dr. Commins discusses the current state of research in the US and how investigators are working to develop immunotherapy approaches to help desensitize patients and potentially resolve the allergy over time.
Dana Parish: Welcome to the Ticktective Podcast, a program of the Bay Area Lyme Foundation, where our mission is to make Lyme disease easy to diagnose and simple to cure. I’m your host, Dana Parish, and I’m the co-author of the book Chronic, and I sit on the advisory board of Bay Area Lyme Foundation. This program offers insightful interviews with scientists, clinicians, patients, and other interesting people. We’re a nonprofit based in Silicon Valley, and thanks to a generous grant that covers a hundred percent of our overhead. All of your donations go directly to our research and prevention programs. For more information about Lyme disease, please visit us at bayarealyme.org.
Today, I welcome Dr. Scott Commins. He is a highly esteemed expert in the field of allergy and immunology at the University of North Carolina (UNC) and a pioneer when it comes to alpha-gal syndrome. You’ve heard about alpha-gal when a tick bite can cause a meat allergy, but there is so much more to know. So enjoy this interview. I hope you learn a lot and please share it with your doctors because there is such a lack of education about this very important syndrome, and doctors becoming aware of it will only help us patients.


Our Ticktective host, Dana Parish, interviews Dr. Neil Nathan, renowned physician and best-selling author. Dr. Nathan specializes in treating chronic illnesses, particularly those related to environmental toxins, vector-borne infections, and complex systemic disorders. With decades of experience in clinical practice, he focuses on understanding the impact of toxins on health and is dedicated to helping patients recover from illnesses that conventional medicine often struggles to address. His bestselling book, 


“I want to leave you with hope. I think we’re going to be unstoppable because I think that these are solvable problems. These are answerable questions. I think that there are already a lot of existing tools in immunology that just need to be brought into the fight, and we can change this.”
Any respectable pathogen that can establish a persistent infection needs to figure out your immune system to the point that it can evade it. The fact that it has persisted means that it was able to evade your immune clearance. And so, I got to that from a very interesting direction working on immune regulation, trying to understand these brakes on the immune response and how they impact the response to infection. The immune system has the power to kill you and obviously, nobody has any incentive for that to happen. So, there are a lot of mechanisms in place to put brakes on the immune system and reign it in. One of the huge developments in cancer over the last two decades has been reevaluating the question: can we take those brakes off? So in my postdoc, I was studying a particular checkpoint where this was turning into an exciting immuno-oncology target, and I said, ‘I want to look at how this checkpoint is used in infection.’ I realized that this checkpoint was being used to help you survive an acute infection, but created a vulnerability for pathogens to evade immune clearance and establish chronic infection much like it allows cancer cells to evade immune clearance. In an amazing collaboration with Irv Weissman, Balyn Zaro, and Jenifer Coburn we realized that the bacteria that cause Lyme disease manipulate this brake and that’s how I became fascinated with Lyme. But I also became concerned about turning off this brake in cancer patients because I was concerned about what would happen if you used this on cancer patients during an active infection. Indeed, the 


Charlotte Mao:

Sunjya Schweig, MD, founder of the