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We wanted to identify the role and regulation of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup>\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>25<jats:sup>+<\/jats:sup>\u00a0FoxP3<jats:sup>+<\/jats:sup> Treg cells in B\u2010cell acute lymphoblastic leukaemia (B\u2010<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>). We have included patients at diagnosis (<jats:italic>n\u00a0<\/jats:italic>=\u00a054), patients in clinical remission (<jats:italic>n\u00a0<\/jats:italic>=\u00a032) and normal healthy individuals (<jats:italic>n\u00a0<\/jats:italic>=\u00a035). These diagnosed patients demonstrated a lower number of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup>\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>25<jats:sup>+<\/jats:sup> cells co\u2010expressing a higher level of FoxP3, interleukin\u201010, transforming growth factor\u2010<jats:italic>\u03b2<\/jats:italic> and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>152\/<jats:styled-content style=\"fixed-case\">CTLA<\/jats:styled-content>\u20104 than the normal population. Treg cells from patients showed a higher suppressive capability on <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup>\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>25<jats:sup><jats:italic>\u2212<\/jats:italic><\/jats:sup> responder T (Tresp) cells than normal. The frequency and immunosuppressive potential of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup>\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>25<jats:sup>+<\/jats:sup>\u00a0FoxP3<jats:sup>+<\/jats:sup> Treg cells became high with the progression of malignancy in B\u2010<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>. Relative distribution of Tresp and Treg cells was only ~5\u00a0:\u00a01 in B\u2010<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> but ~35\u00a0:\u00a01 in normal healthy individuals, further confirming the elevated immunosuppression in patients. A co\u2010culture study at these definite <jats:italic>ex vivo<\/jats:italic> ratios, indicated that Treg cells from B\u2010<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> patients exhibited higher immunosuppression than Treg cells from normal healthy individuals. After chemotherapy using the <jats:styled-content style=\"fixed-case\">MCP<\/jats:styled-content>841 protocol, the frequency of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup>\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>25<jats:sup>+<\/jats:sup> cells was gradually enhanced with the reduction of FoxP3, interleukin\u201010 positivity corresponded with disease presentation, indicating reduced immunosuppression. Taken together, our study indicated that the <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup>\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>25<jats:sup>+<\/jats:sup>\u00a0FoxP3<jats:sup>+<\/jats:sup> Treg cells played an important role in immunosuppression, resulting in a positive disease\u2010correlation in these patients. To the best of our knowledge, this is the first detailed report on the frequency, regulation and functionality of Treg cells in B\u2010<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/imm.12237","type":"journal-article","created":{"date-parts":[[2013,12,19]],"date-time":"2013-12-19T13:24:51Z","timestamp":1387459491000},"page":"124-139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Critical stoichiometric ratio of <scp>CD<\/scp>4<sup>+<\/sup>\u00a0<scp>CD<\/scp>25<sup>+<\/sup>\u00a0FoxP3<sup>+<\/sup> regulatory T cells and <scp>CD<\/scp>4<sup>+<\/sup>\u00a0<scp>CD<\/scp>25<sup>\u2212<\/sup> responder T cells influence immunosuppression in patients with B\u2010cell acute lymphoblastic leukaemia"],"prefix":"10.1111","volume":"142","author":[{"given":"Kaushik","family":"Bhattacharya","sequence":"first","affiliation":[{"name":"Cancer Biology and Inflammatory Disorder 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