Previously, we demonstrated in heart transplant patients that FOXP3, a gene required for the development and function of regulatory T cells, was highly expressed in the graft during an acute cellular rejection. In this study, we analyzed whether the FOXP3 gene expression in the peripheral blood also reflects anti-donor immune responses, and therefore may provide clues for non-invasive detection of non-responsiveness or acute rejection. We examined the FOXP3 expression patterns of peripheral blood mononuclear cells (PBMC; n = 69) of 19 heart transplant patients during quiescence and rejection in comparison with those of endomyocardial biopsies (EMB; n = 75) of 24 heart transplant patients. While the FOXP3 mRNA levels were abundantly expressed in rejecting EMB (ISHLT rejection grade > 1R) compared with EMB without histological evidence of myocardial damage (ISHLT rejection grade 0R-1R; p = 0.003), no association with rejection or non-responsiveness was found for the FOXP3 mRNA levels in the peripheral blood. Thus, in contrast to intragraft FOXP3 gene expression, the peripheral FOXP3 mRNA levels lack correlation with anti-donor immune responses in the graft, and, consequently, FOXP3 does not appear to be a potential candidate gene for non-invasive diagnosis of non-responsiveness or rejection.

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Keywords Endomyocardial biopsies, FOXP3 gene expression, Heart transplantation, Peripheral blood
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Dijke, I.E., Caliskan, K., Korevaar, S.S., Maat, A.W.P.M., Zondervan, P.E., Balk, A.H.M.M., … Baan, C.C.. (2008). FOXP3 mRNA expression analysis in the peripheral blood and allograft of heart transplant patients. Transplant Immunology, 18(3), 250–254. doi:10.1016/j.trim.2007.08.001