• Dorrit Krustrup, Martin Iversen, Torben Martinussen, Hans Henrik L Schultz, and Claus B Andersen.
• Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Denmark.
• Clin Transplant. 2015 Mar 1; 29 (3): 179-84.

BackgroundAn important limitation to the success of lung transplantation is the development of bronchiolitis obliterans syndrome (BOS). It has been hypothesized that regulatory T lymphocytes (Tregs) are related to the risk of BOS. We aim to evaluate whether the number of forkhead box P3 (FoxP3+) cells/mm(2) in lung allograft biopsies is a predictor of long-term outcome.Materials And MethodsA total of 58 consecutive lung transplant patients were included in the study. For 233 routine surveillance biopsy samples, the numbers of FoxP3+ cells/mm(2) were assessed by immunohistochemical staining with antibodies against FoxP3. BOS scores were calculated for the first five yr after transplantation.ResultsWe determined that acute rejection was related to the time elapsed from transplantation to BOS with hazard ratios of 3.18 (p = 0.02) and 3.73 (p = 0.04) when comparing the levels of acute rejection grade 1 and grade 2/3, respectively, to no rejection. According to a Cox regression analysis, the number of FoxP3+ cells/mm(2) was not predictive of time to BOS.Discussion And ConclusionsOur data indicate that the number of FoxP3+ cells in the lung allograft did not correlate with BOS-free survival time. Previous studies have been contradictory and included different time points. Our findings emphasize the importance of including a time factor.© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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