Clinical diagnosis and management of wheat and buckwheat allergy: application and prospects of allergen component diagnostics

Abstract

Wheat and buckwheat allergies are common food allergies that significantly impact patients' quality of life and health. Wheat allergy encompasses various forms, including wheat food allergy, exercise-induced allergic reactions (WDEIA), baker's occupational asthma/allergy, and contact urticaria. IgE-mediated allergic reactions involve sensitization to stable wheat allergens such as ω-5 gliadin and gluten. Although buckwheat allergy is less common, it is gaining attention in certain regions. Allergen component diagnostic technologies, by detecting specific allergen components [e.g., ω-5 gliadin, gliadins (α, β, γ), and Tri a 14], offer precise allergen source identification, aiding in the optimization of diagnosis and management processes. Oral challenge tests are considered the gold standard for diagnosing wheat allergy, and combining skin prick tests with specific IgE measurements can enhance diagnostic accuracy. While avoidance of allergens remains the primary management strategy, research into immunotherapy is ongoing. Future research should focus on a deeper understanding of the structural and immunological characteristics of wheat and buckwheat allergens to develop more accurate diagnostic tools and treatment methods, thereby improving allergy management and patient quality of life. This article provides a detailed interpretation of the Molecular Allergology User's Guide 2.0 (MAUG 2.0) published by the European Academy of Allergy and Clinical Immunology (EAACI) and recent research advances on wheat and buckwheat allergies, highlighting the crucial role of allergen component diagnostics in optimizing food allergy diagnosis and treatment processes, supporting clinicians in accurately identifying common allergens and their cross-reactivity, and formulating more personalized treatment plans for patients.