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Basophil Activation Test for Allergy Diagnosis
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Buckwheat allergy.

Feng Chen1, Yangshuhan Xu2, Kelong Ma1

  • 1College of Integrated Chinese and Western Medicine/College of Life Science, Anhui University of Chinese Medicine, Hefei, Anhui, China.

Asian Pacific Journal of Allergy and Immunology
|February 16, 2026
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Summary

Buckwheat allergy is a growing concern, especially with its use in gluten-free foods. Accurate diagnosis is crucial, as standard tests may miss key allergens, necessitating advanced methods like component-resolved diagnostics.

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Area of Science:

  • Food science
  • Allergology
  • Immunology

Background:

  • Buckwheat is a gluten-free pseudocereal common in East Asia and Russia, but less so in Southeast Asia.
  • Its increasing global use in gluten-free products raises concerns about buckwheat allergy, with symptoms ranging from mild to life-threatening anaphylaxis.
  • Both dietary intake and occupational inhalation are potential exposure routes.

Purpose of the Study:

  • To highlight the diagnostic challenges in buckwheat allergy.
  • To emphasize the limitations of conventional diagnostic methods.
  • To advocate for improved diagnostic strategies, including component-resolved diagnostics.

Main Methods:

  • Review of current understanding of buckwheat allergy.
  • Discussion of conventional diagnostic approaches and their limitations.
  • Introduction of component-resolved diagnostics (CRD) and specific allergens like Fag e 2 and oleosins.

Main Results:

  • Conventional diagnostics using aqueous extracts may miss lipid-soluble allergens (e.g., oleosins), leading to false negatives.
  • Component-resolved diagnostics targeting Fag e 2, a 2S albumin, significantly improves diagnostic specificity, being recognized by IgE in up to 90% of symptomatic patients.
  • Cross-reactivity with latex, peanut, and wheat is possible but requires individual assessment.

Conclusions:

  • Accurate diagnosis of buckwheat allergy is critical due to its presence in unlabeled gluten-free foods.
  • Standardized detection protocols, including non-aqueous extraction, and precision diagnostic tools are needed.
  • Strict avoidance is the primary management strategy, as no immunotherapy is currently approved.