Immune dysregulation, polyendocrinopathy, enteropathy, X-linked: Forkhead box protein 3 mutations and lack of regulatory T cells  Troy R. Torgerson, MD,

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Immune dysregulation, polyendocrinopathy, enteropathy, X-linked: Forkhead box protein 3 mutations and lack of regulatory T cells  Troy R. Torgerson, MD, PhD, Hans D. Ochs, MD  Journal of Allergy and Clinical Immunology  Volume 120, Issue 4, Pages 744-750 (October 2007) DOI: 10.1016/j.jaci.2007.08.044 Copyright © 2007 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Bowel and pancreas pathology in IPEX. Hematoxylin and eosin stains of small bowel (A) and pancreas (B) from a patient with IPEX syndrome. Note the complete villous atrophy of the bowel mucosa (arrow) as well as marked lymphocytic infiltrate in the intestinal wall. Note the lack of pancreatic islets, diffuse fibrosis, and marked lymphocytic infiltrates in the pancreas (shown at higher magnification in the inset). Journal of Allergy and Clinical Immunology 2007 120, 744-750DOI: (10.1016/j.jaci.2007.08.044) Copyright © 2007 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 CD4+CD25+FOXP3+ cells in IPEX. Flow cytometry demonstrating the population of CD25+FOXP3+ Tregs, which make up 5% to 7% of the CD4+ cell population in normal individuals (left). A decreased percentage of FOXP3+ Treg is sometimes observed in patients with a milder IPEX phenotype and point mutations of FOXP3 (center). Most patients with IPEX have a markedly decreased percentage of FOXP3+ Treg (right). The heading indicates the specific mutation present in the patient. Journal of Allergy and Clinical Immunology 2007 120, 744-750DOI: (10.1016/j.jaci.2007.08.044) Copyright © 2007 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Domain structure of the FOXP3 protein showing the location of mutations identified in patients with IPEX. The size and location of the 4 characterized functional domains of the FOXP3 protein are shown. The ruler represents the amino acid number (1-431), and each hash mark represents 10 amino acids. The approximate locations of mutations identified in patients with IPEX are shown (O = missense point mutations, ▾= deletion/frameshift mutations, □ = splicing mutations)7,8,10,13,14,78-81 (T. Torgerson and H. Ochs, unpublished data, September 2007). ZnF, Zink finger; FKH, forkhead. Journal of Allergy and Clinical Immunology 2007 120, 744-750DOI: (10.1016/j.jaci.2007.08.044) Copyright © 2007 American Academy of Allergy, Asthma & Immunology Terms and Conditions