In a cohort of 26 Finnish patients with APS I, normal numbers of CD4+CD25high cells were found, but less FOXP3 mRNA was expressed, both in the CD25high subset and in the total T-cell population. These
alterations were accompanied by lower suppressive function towards effector cell proliferation than in healthy controls [22]. However, the frequency of CD4+CD25+ cells, which also contain activated cells, was much higher in patients with APS I than in controls [16]. The reported frequency of circulating immune cell subpopulations varies in different studies, and commonly only a limited number of patients with APS I has been studied. We here aimed to study a wide range of immune cell subsets relevant for characterizing thymic output of cells with regulatory functions as well as peripheral dysregulation of effector/memory cell subsets in a relatively large number of patients with APS I and their close relatives. Patients Selumetinib and control subjects. Nineteen Norwegian patients with APS (10 men, 9 women; mean age 34.1 years; range 18–58) and appropriate age- and sex-matched healthy controls (Ctrl 1; mean age 36.8 years, range 18–61) were included Cilomilast for immunophenotyping. We also included 18 close relatives (8 men, 10 women; mean age 47.2 years, range 18–70) and age- and sex-matched controls (Ctrl 2; mean age 43.2 years,
range 18–61). Two of the included relatives had self-reported autoimmune diseases, namely Sjøgren’s syndrome and coeliac disease, respectively. Not all subjects were examined for all immune cell subsets. Serum samples for autoantibody analyses were available from 37 Norwegian patients with APS I and 35 close relatives (parents,
siblings or other close family members). All patients had mutations and/or deletions in both AIRE alleles [23, 24] and most of the patients are reported on earlier [24]. All included patients signed a written consent form and were recruited via the Norwegian Registry for organ-specific autoimmune from diseases (ROAS). Family members of patients with APS I were recruited via the patients. Healthy controls were recruited from the blood bank at Haukeland University Hospital. Demographics of the patients and relatives and their AIRE mutations are summarized in Table S1. The study was approved by the local ethics committee. Flow cytometry. EDTA-Blood was collected, and peripheral blood mononuclear cells (PBMC) were isolated using Lymphoprep (Axis-Shield PoC AS, Oslo, Norway). We incubated 2 × 105 PBMC in 100 μl of PBS with labelled monoclonal antibodies [mAbs; Beckton Dickinson (BD) Biosciences] to human cell markers: CD3 (PE-Cy7; SK7 and PerCP; SK7), CD4 (PerCp; clone SK3 and PE-Cy7; clone SK3 and FITC; RPA-T4), CD5 (PE; UCHT2), CD8 [FITC; RPA-T8 and PE-Cy7; RPA-T8 and PE, RPA-T8 and PE (SK1)], CD11b/Mac-1 (PE; ICRF44), CD11c (APC; B-ly6), CD14 (PE-Cy7; M5E2 and PerCp; MϕP9), CD16 (FITC; 3G8), CD19 (FITC, HIB19), CD25 (APC; 2A3 and PE; 2A3), CD28 (APC; CD28.