Genetic variants of FOXP3 influence graft survival in kidney transplant patients

FOXP3(+) regulatory T cells (T-reg) play a role in controlling alloreactivity. It has been shown that short (GT)(n) dinucleotide repeats (<=(GT)(15); S) in the promoter region of the FOXP3 gene enhance the promoter activity when compared to long (GT)(n) repeats (>=(GT)(16); L). The present study retrospectively investigated the influence of this (GT)(n) FOXP3 gene polymorphism on renal allograft survival. A total of 599 consecutive first-time kidney transplant patients (median follow-up time 7.7 years) were subdivided according to their FOXP3 genotype into the S-genotype group (SG) and the L-genotype group (LG). The SG was superior to the LG in both general graft survival censored for death (logrank test, p = 0.013) and graft survival following acute rejection (p = 0.021). Multivariate analysis defined the (GT)(n) FOXP3 dinucleotide repeat polymorphism as an independent factor and confirmed an advantage for the SG in renal allograft survival (HR = 0.67, 95% CI 0.48-0.94, p = 0.02). This gene association study identified a beneficial effect of FOXP3 genetic variants on graft survival in kidney transplant patients. (c) 2013 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.