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The aim of this study was to evaluate the role of T- and B-regulatory cells (Tregs and Bregs) in the pathogenesis of idiopathic granulomatous mastitis (IGM). This study includes 47 patients with pathologically proven IGM (Group P) and 26 healthy subjects (Group C). The patients in Group P were divided into two groups according to whether their lesions were active (Group P A , n: 21) or in remission (Group P R , n: 26). By using flow-cytometry, the frequencies of CD3 + CD4 + CD45RA − Foxp3 high  activated Tregs (aTregs), CD3 + CD4 + CD45RA − Foxp3 low  non-suppressive Tregs, CD3 + CD4 + CD45RA + Foxp3 low  resting Tregs (rTregs), CD3 + CD4 + CD25 + Foxp3 −  T-effector cells (Teff), total Tregs and Bregs were analyzed in all subjects. The frequency of the Teff cells was statistically higher in Group P when compared with Group C ( p  =.004). The Foxp3 expression of Treg cells and the frequency of non-suppressive Tregs in Group P were statistically lower than Group C ( p  =.032 and  p  =.02, respectively). In addition, Group P R ’s Foxp3 expressions were statistically lower than Group C ( p  =.027); Group P R ’s aTregs ratio was statistically lower than Group P A  ( p  =.021); and the non-suppressive Tregs ratio of Group P R  was lower than both Group P A  and Group C ( p  =.006 and  p  &lt;.0001). No significant differences were seen Bregs and B cell subsets. Significant changes in Foxp3 expression and Treg subsets were seen in patients with active IGM lesion and in remission. This study shows an intrinsic defect of Tregs in patients with IGM.

The Role of Regulatory T and B Cells in the Etiopathogenesis of Idiopathic Granulomatous Mastitis