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Blood, 5 November 2009, Vol. 114, No. 19, pp. 4138-4141. Prepublished online as a Blood First Edition Paper on September 8, 2009; DOI 10.1182/blood-2009-04-214593.
IMMUNOBIOLOGY Wild-type FOXP3 is selectively active in CD4+CD25hi regulatory T cells of healthy female carriers of different FOXP3 mutations1 San Raffaele Telethon Institute for Gene Therapy (HSR-TIGET), Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy; 2 University of Rome Tor Vergata, Rome, Italy; 3 Human Genetics Laboratory, Galliera Hospital, Genoa, Italy; 4 Department of Surgery, University of British Columbia, Vancouver, BC; 5 Epiontis GmbH, Berlin, Germany; 6 Pediatric Gastroenterology, Gaslini Hospital, Genoa, Italy; 7 Pediatric Immunology Laboratory, Istitutio di Ricovero e Cura a Carattere Scientifico (IRCCS) Burlo Garofalo, Trieste, Italy; 8 Cystic Fybrosis Center, Verona, Italy; and 9 Vita Salute San Raffaele University, Milan, Italy Forkhead box P3 (FOXP3) is constitutively expressed by CD4+CD25hi regulatory T cells (nTregs). Mutations of FOXP3 cause a severe autoimmune syndrome known as immune dysregulation polyendocrinopathy enteropathy X-linked, in which nTregs are absent or dysfunctional. Whether FOXP3 is essential for both differentiation and function of human nTreg cells remains to be demonstrated. Because FOXP3 is an X-linked gene subject to X-chromosome inactivation (XCI), we studied 9 healthy female carriers of FOXP3 mutations to investigate the role of wild-type (WT) versus mutated FOXP3 in different cell subsets. Analysis of active WT versus mutated (mut)–FOXP3 allele distribution revealed a random pattern of XCI in peripheral blood lymphocytes and in naive and memory CD4+T cells, whereas nTregs expressed only the active WT-FOXP3. These data demonstrate that expression of WT-FOXP3 is indispensable for the presence of a normal nTreg compartment and suggest that FOXP3 is not necessary for effector T-cell differentiation in humans.
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