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We hypothesised that Treg could be defective in either numbers and\/or function and therefore unable to ensure the physiological equilibrium of the immune system in patients with IRD. Phenotypic and functional CD4<jats:sup>+<\/jats:sup> T\u2010cell subsets of eight late\u2010stage HIV patients with nadir CD4 count &lt;50 cells\/\u03bcL, who developed mycobacterial IRD upon commencing cART were compared with six therapy naive HIV<jats:sup>+<\/jats:sup> patients (nadir CD4 count &lt;50 cells\/\u03bcL), who did not develop an IRD after cART. <jats:italic>Mycobacterium<\/jats:italic>\u2010<jats:italic>avium<\/jats:italic>\u2010specific CD4<jats:sup>+<\/jats:sup> T cells from IRD patients produced high levels of IFN\u2010\u03b3 and IL\u20102 compared with controls (<jats:italic>p<\/jats:italic>&lt;0.001). Surprisingly, we found a significant expansion of CD127<jats:sup>lo<\/jats:sup>Foxp3<jats:sup>+<\/jats:sup>CD25<jats:sup>+<\/jats:sup> Treg in IRD patients and a higher ratio of Treg to effector\/memory subsets (<jats:italic>p<\/jats:italic>&lt;0.001). <jats:italic>In vitro<\/jats:italic> suppression assays demonstrated reduced functional capacity of suppressor cells and diminished IL\u201010 secretion in IRD patients. Plasma levels of IL\u20107 were increased in patients and, interestingly, exogenous IL\u20107 and other cytokines strongly inhibited Treg suppression. These data suggest that despite substantial Treg expansion in IRD, their ability to induce suppression, and thereby downregulate aberrant immune responses, is compromised.<\/jats:p>","DOI":"10.1002\/eji.200838630","type":"journal-article","created":{"date-parts":[[2009,1,29]],"date-time":"2009-01-29T06:54:57Z","timestamp":1233212097000},"page":"391-403","source":"Crossref","is-referenced-by-count":100,"title":["Proliferation of weakly suppressive regulatory CD4<sup>+<\/sup> T cells is associated with over\u2010active CD4<sup>+<\/sup> T\u2010cell responses in HIV\u2010positive patients with mycobacterial immune restoration disease"],"prefix":"10.1002","volume":"39","author":[{"given":"Nabila","family":"Seddiki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah 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