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Background  Forkhead box protein 3 (FoxP3) is an important factor for development and function of Regulatory T cells (Treg). Studies have found an association between common gene polymorphisms in  FoxP3  and some infectious diseases. The aim of this study was to evaluate possible associations between two Single nucleotide polymorphisms (SNPs) in the promoter of the  FoxP3  gene to susceptibility to tuberculosis (TB) and the alteration of  Foxp3  gene expression.    Methods  The pattern distribution of genotype at two position, −3279 A > C (rs3761548) and −924 A > G (rs2232365) on the promoter of  FoxP3  gene was evaluated using polymerase chain reaction-single specific primer (PCR-SSP) method in 183 tuberculosis patients and 183 healthy control. In addition the quantity of  FoxP3  gene expression at mRNA level was identified by the real-time PCR.    Results  The frequency of G allele at −924 A > G was significantly higher was higher in TB patients (59.5%) than control group (39.5%) ( P  ≤ 0.05). In addition, our data viewed approximately 5- folds more  FoxP3  gene expression in female patients with GG genotype in comparison to female healthy cases with the same genotype ( P  ≤ 0.001). There was no statistically significant differences between the distribution pattern of −3279 A > C polymorphism in patients and healthy individuals along with it effect on the  FoxP3  gene expression among both groups ( P  > 0.05).    Conclusions  Our outcome suggests that the −924 A > G polymorphism leads to enhance  FoxP3  gene expression and susceptibility to tuberculosis in the sex dependent manner. This event may rise the count of Treg cells and modulate the immune response against tuberculosis.

G allele at −924 A > G position of FoxP3 gene promoter as a risk factor for tuberculosis