Genetic variants of FOXP3 influence graft survival in kidney transplant patients.

Abstract 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.