Molecular diagnostics and lack of clinical allergy in helminth-endemic areas in Indonesia

While interpreting our results, we acknowledge certain limitations. Although we used a cross-sectional study design, a longitudinal study following individual patients over time would be valuable in testing causality. Food-allergic patients had an increased prevalence of atopic dermatitis, allergic rhinitis, and asthma as would be expected, and differences in Treg cells may be important in the atopic march process and not solely food allergy. Therefore, some of our findings could have broader implications for the general predisposition of atopy. In summary, we found that young, atopic food-allergic children have lower percentages of strictly defined Treg cells compared with healthy controls of similar age. Moreover, age-related increases in Treg-cell expression of CCR6 were observed in healthy controls but not food-allergic children, which may be important for Treg-cell migration to peripheral sites of inflammation in the maintenance of tolerance. Our study supports the concept that Treg-cell frequency is associated with the maintenance of tolerance in allergy. Benjamin T. Prince, MD, Msci Ashley L. Devonshire, MD, MPH Kristin A. Erickson Jenna Bergerson, MD Dalia Fuleihan, BA Christine Szychlinski, APN Robert P. Schleimer, PhD Paul J. Bryce, PhD Anne Marie Singh, MD From the Department of Pediatrics, Division of Allergy and Immunology, Ann & Robert H. Lurie Children’s Hospital of Chicago and the Department of Medicine, Division of Allergy and Immunology, Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Ill; and the Department of Pediatrics, Division of Allergy and Immunology, Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio. E-mail: anne-singh@northwestern.edu. Disclosure of potential conflict of interest: B. T. Prince receives grant funding from Northwestern University Allergy-Immunology T32 National Institutes of Health (NIH) training grant. C. Szychlinski receives payment for lectures from the Mylan Speakers Bureau. R. P. Schleimer receives grant support from the NIH; serves as a consultant for Intersect ENT, GlaxoSmithKline, Allakos, Aurasense, Merck, BioMarck, Sanofi, AstraZeneca/Medimmune, Genentech, Ecicure, Inc, and Ostuka, Inc, and holds stock options from Allakos, Aurasense, BioMarck, and Exicure, Inc. P. J. Bryce serves as a consultant for Allakos; is an employee of Northwestern University; receives grant support from the NIH; and received payments for lectures from FOCIS. A. M. Singh receives grant support from the National Institute of Allergy and Infectious Diseases, Glen and Wendy Miller Family Foundation, Melchiorre Family Foundation, Bunning Food Allergy Initiative, and Thrasher Research Fund. The rest of the authors declare that they have no relevant conflicts of interest.