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Background: Food allergy (FA) is a growing health concern with limited therapeutic options. While Korean RedGinseng Extract (KRGE) exhibits immunomodulatory and microbiota-modulating properties, its specific effectsand mechanisms in FA are not fully understood.

Methods: We evaluated the anti-allergic efficacy of KRGE in IL4raF709 mice, a model genetically predisposed toIgE-mediated anaphylaxis. Mice were sensitized with ovalbumin(OVA) and staphylococcal enterotoxin B (SEB)and challenged with OVA. KRGE was administered orally prior to and during sensitization. Clinical symptoms,serum IgE levels, IL-33 levels, and intestinal histology were assessed. Mesenteric lymph nodes and Peyer’spatches immune cell populations were analyzed by flow cytometry. Fecal microbiota composition was profiledusing 16S rRNA sequencing and quantitative PCR; correlations between phenotype and microbiota wereinvestigated.

Results: Results showed KRGE significantly suppressed anaphylactic symptoms, including hypothermia andmortality, and reduced OVA-specific IgE and IL-33 levels. KRGE restored intestinal epithelial integrity andnormalized Peyer’s patch hypertrophy. Immunologically, it decreased IL-13-producing T follicular helper cellsand rebalanced dendritic cell subsets, increasing tolerogenic CD103+ cDC1 and reducing pro-allergic CD11b+cDC2. Microbiome analysis revealed that OVA/SEB increased pro-inflammatory Lachnospiraceae and Ruminococcaceaewhile depleting beneficial Lactobacillaceae and Bifidobacteriaceae. KRGE reversed these changes,notably enriching Akkermansia muciniphila and Lactobacillus gasseri. Correlation analysis revealed that Akkermansia,Lactobacillus, and Christensenellaceae were negatively correlated with allergic markers and positivelycorrelated with epithelial integrity. In contrast, Oscillospiraceae (Eubacterium_g8, Acetobacter, and Pseudoflavonifractor)was associated with allergy exacerbation.

Conclusion: KRGE mitigates FA in IL4raF709 mice by restoring gut microbiota balance and immune homeostasis,suggesting its potential as a microbiota-targeted intervention for FA.

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