Basophils in allergy: immunological mechanisms, diagnostic innovations, and clinical implications in the context of meat allergy

Introduction: Allergic diseases remain a widespread clinical problem, affecting diverse populations and placing increasing demands on healthcare resources. Objective: This review set out to assess the modern research about the immunological functions of basophils in the context of allergic disorders and to evaluate their diagnostic and therapeutic relevance. Methods: A thorough literature review, which adhered to PRISMA 2020 guidelines, was performed utilising the PubMed, Scopus, and Web of Science databases. Research published from 2019 to 2024 was chosen according to certain keywords pertaining to basophil activation, α-gal syndrome, and the diagnostic uses of the basophil activation test (BAT). Results and Conclusion: The evidence compiled here demonstrates the pivotal contribution of basophils to both IgE-dependent and IgE-independent allergic processes. These cells release potent mediators such as histamine and interleukin-4 (IL-4), influencing T-helper 2 (Th2) cell differentiation and amplifying inflammatory cascades. Recent research highlights the usefulness of the BAT in detecting IgE-mediated hypersensitivities to foods, medications, and insect venoms, owing to its notable sensitivity and specificity. Studies further suggest that monitoring basophil responsiveness during allergen-specific immunotherapy or biological interventions may guide therapeutic decisions, as declining basophil reactivity correlates with improved allergen tolerance. Notably, emerging research on meat allergies, particularly α-gal syndrome, reveals that basophils are critical mediators in IgE-mediated reactions to mammalian meat allergens. BAT is proving instrumental in diagnosing meat allergies, helping to distinguish sensitized individuals from those with clinical manifestations. Despite promising developments, several obstacles hinder the wider integration of BAT into clinical protocols, including variations in basophil responsiveness, lack of standardized testing procedures, and insufficient large-scale population studies. These gaps underscore the importance of ongoing research aimed at refining diagnostic accuracy, developing targeted therapeutics, and clarifying the multifaceted interplay between basophils and other immune components.