RT Journal Article SR Electronic T1 Long-term outcome of lung recipients: The role of CD4+CD25highCD127- treg JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA4637 DO 10.1183/13993003.congress-2016.PA4637 VO 48 IS suppl 60 A1 Davide Piloni A1 Monica Morosini A1 Sara Magni A1 Alice Balderacchi A1 Emanuela Cova A1 Simona Inghilleri A1 Luigia Scudeller A1 Tiberio Oggionni A1 Filippo Antonacci A1 Giulia Stella A1 Federica Meloni YR 2016 UL http://erj.ersjournals.com/content/48/suppl_60/PA4637.abstract AB The role of CD4+CD25highCD127- Treg cells in solid-organ transplant acceptance has been already studied, and while for kidney and liver an inverse correlation with long term graft survival was found; in lung transplant field, in particular with respect to association or prediction of CLAD, results are still controversial.Our study aims to analyze long term kinetic of CD4+CD25highCD127- Treg cells and test its association to several clinical and pharmacological variables(IS, azithromycin, extracorporeal photo-apheresis, infections, CLAD etc).From jan 2009 to dec 2014, 137 lung transplant recipients were submitted to an immunological follow up (I-FU)(105.9 months (6.7-310.5)). I-FU consisted of a complete peripheral immuno-phenotype inclusive of CD4+CD25highCD127- T cell counts and FOXP3 expression (1943 determinations analyzed). Linear OR regression models for repeated measures were used to test the association between Treg and relevant variables, adjusting for time from Tx. Ordered logistic models for panel data were used to test the association between CLAD onset/progression and Treg in the previous three months.Among the variables significantly associated at peripheral Treg cell counts at bivariate analysis: azathioprine therapy(p=0.03), ECP(p<0.001), RAS(p<0.001), BOS(p=0.03); only azathioprine therapy significance was lost in multivariate model. Treg cell counts were progressively decreased according to severity of CLAD dysfunction(p=0.009). Pts with higher mean peripheral CD4+CD25highCD127- Treg counts had a significantly lower risk(p=0.032) of CLADonset/progression in the following trimester. Our present data confirm animal observations on the protective role of this cell subset with respect to CLAD.