Heterogeneity in allergen-specific CD4+ T cell responses and distinct gut microbial composition define pediatric cow milk allergy endotypes

Pediatric cow milk allergy (CMA) is a highly prevalent food allergy which manifests as IgE or Non-IgE mediated type. However, the underlying CD4+ T cell immune responses associated, particularly with non-IgE mediated CMA remain poorly characterized. As gut microbiome plays a pivotal role in the modulation of CD4+ T cell immune responses in allergy, this study aimed to characterize allergen-specific immune responses mediated by conventional (Tcon) and regulatory (Treg) CD4+ T cell subsets and to investigate the influence of the gut microbiota on these immune responses in pediatric CMA.