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Abstract The COVID-19 pandemic has profoundly affected all aspects of our lives. Through real-time monitoring and rapid vaccine implementation, we succeeded in suppressing the spread of the disease and mitigating its consequences. Finally, conclusions can be summarized and drawn. Here, we use the example of Poland, which was seriously affected by the pandemic. Compared to other countries, Poland has not achieved impressive results in either testing or vaccination, which may explain its high mortality (case fatality rate, CFR 1.94%). Through retrospective analysis of data collected by the COVID-19 Data Portal Poland, we found significant regional differences in the number of tests performed, number of cases detected, number of COVID-19-related deaths, and vaccination rates. The Masovian, Greater Poland, and Pomeranian voivodeships, the country’s leaders in vaccination, reported high case numbers but low death rates. In contrast, the voivodeships in the eastern and southern parts of Poland (Subcarpathian, Podlaskie, Lublin, Opole), which documented low vaccination levels and low case numbers, had higher COVID-19-related mortality rates. The strong negative correlation between the CFR and the percentage of the population that was vaccinated in Poland supports the validity of vaccination. To gain insight into virus evolution, we sequenced more than 500 genomes and analyzed nearly 80 thousand SARS-CoV-2 genome sequences deposited in GISAID by Polish diagnostic centers. We showed that the SARS-CoV-2 variant distribution over time in Poland reflected that in Europe. Haplotype network analysis allowed us to follow the virus transmission routes and identify potential superspreaders in each pandemic wave.

Congenital and acquired musculoskeletal diseases in children are often unnoticed and develop asymptomatically and without pain. Left untreated and earlier diagnosed, they deepen, leading to early degenerative changes and subsequent disability. Developmental hip dysplasia, i.e. disturbances in the formation and development of the infant's hip, occurs in Poland in about 4% of the newborn population. The appearance and further development of pathological changes of the hip may occur in the intrauterine period, during delivery or in later childhood. Detection of a defect in the first week of a child's life allows for early treatment and healing. Therefore, it is important to carefully screen hip joints. The aim of the work is to present physiotherapeutic methods used in the treatment of hip dysplasia.

Perinatal brachial plexus injury are usually a consequence of shoulder dystocia during childbirth, after the birth of the head there are difficulties with the birth of the shoulders. In this situation, childbirth is stopped and the shoulders of the fetus are not born spontaneously. The development of medicine provides patients with access to many methods of treating this injury. An interdisciplinary team of specialists is needed to minimize the negative effects of damage that are perceived by the patient, sometimes throughout life. Knowledge about physiotherapy in perinatal damage of the shoulder plexus is of great importance for the future of a child who suffered perinatal trauma to the shoulder plexus. Therefore, this topic should be constantly developed and re-examined so that in the future we can provide patients with multi-specialist care.

The hand is an organ of our body that fulfills a lot of different functions. Through efficiently functioning upper limbs, we experience and learn, communicate with the world, and gain independence. In the cerebral palsy, the role of the therapist is to properly plan the hand therapy process, it requires him to have a good knowledge of what MPD is, which is associated with movement symptoms and coexisting disorders that affect the child's abnormal development. The physiotherapist must properly assess the child's functional level, anticipate and plan therapy so that the child reaches its maximum development potential. This is not an easy task because virtually every child with cerebral palsy is different, other are its movement limitations, accompanying symptoms and the environment in which he is brought up.

Obesity is Jena of the most common diseases of civilization twenty-first century. Affects people of all ages, it carries a number of complications, not only in terms of physical and mental health. I estimate that obese people have a greater sociological problems, and the level of self-acceptance in these individuals is much lower. Ways to deal with the problem of obesity are many, but one of the most effective physical activity is combined with diet. Epidemiological studies confirm the beneficial effect of physical activity to reduce the risk of obesity and its impact on the comprehensive treatment. Increasing energy expenditure affects not only the reduction of body fat. Regular physical activity increases muscle tissue and bone, and a decrease in resting and exercise blood pressure, pulse. Through physical activity, we are able to influence the lipid profile and glucose tolerance. Adaptation of physical activity should be an individual, it is recommended to increase daily physical activity for 30 minutes. The unit training should increase energy expenditure by 300 - 400kcal. Coexistence of diseases in obesity is a major limiting factor for some physical activity, however, there are forms of relieving traffic using such a resistance. Exercises in water or a bike. Objective: Effects of exercise and diet on body weight change in the composition and the results of biochemical blood. Methods: Case study of women - 40 years, BMI 36.06, a man - 39 years, BMI 46.69, using the same physical activity and diet throughout the year. Used in the study of body composition, performed every month, and the results of biochemical blood made prior to physical activity after switching diets, and after a year. Case study :To describe the changes in body composition under the influence of exercise and diet used a man and woman - marriage. The study lasted one year. Physical activity in both people was the same (frequency - 5 times a week). The diet consisted of the exclusion of sugar and fruits, junk food, highly processed foods. Eating regular meals. Both individuals are working as a sales representative. A woman born in 1976, 164 cm tall, 97 kg output. The man born in 1977, 178 cm tall 148kg weight output. In women, there were no chronic diseases in the male there is asthma and hypertension. Results: For one year body composition has changed significantly. In women reported weight loss of 33kg, U man of 51 kg. Loss of body fat in women was 35 kg and 2 kg gain muscle mass. One man, a decrease of 63 kg body fat to 16 kg and 4 kg increase in muscle mass. Blood biochemical parameters in both cases, have changed. Total cholesterol decreased in women with 288 mg / dl to 152 mg / dl in men with 325mg / dl to 157 mg / dl. In both sexes increased level of self-acceptance, mental health and general well-being. Additionally, in men increased capacity (FVC), and the blood pressure is normalized. Conclusions: Physical activity and diet changes the composition of body weight. The combination of exercise and diet affect the results of biochemical blood, normalization of blood pressure and asthma. Physical activity and diet is the prevention of diabetes, hypertension. The elimination of sugars and fruits is an effective method to reduce body fat. Weight loss is not linear. Physical activity affects the growth of muscle tissue.

Breast cancer is the most common cancer occurring in the female population. Early diagnosis and appropriately implemented treatment results in high curability. The method of choice is surgery, depending on the extent of the changes, a radical method is used, consisting in complete removal of the mammary gland, or sparing. Additional, complementary methods of treatment are radiation, chemotherapy and hormone therapy. Surgery involves interference with tissue continuity and hence scarring. During the procedure, mechanical long pectoral nerve injury may also occur. The paper presents an example of a case study using kinesiotaping as a complementary method of rehabilitation of women after mastectomy with long pectoral nerve damage. The paper analyzes available literature and own experience

Neurological therapy of the patients after stroke is mainly aimed at the greatest possible growth of the function. During the treatment there are various techniques according to Bobath concept designed to inhibit pathological movement patterns, as well as the stimulation of a physiological response. The aim of this paper is to discuss, on the basis of the presented case, rehabilitation methods of patient after ischemic stroke of the right hemisphere. The physiotherapy examination, based on the International Classification of ICF, assessing problems in the body structures, functions and activities and participation, showed a weakness of the lower trunk muscles, pelvic floor and left hip, muscles hypotonia of directly occupied side, as well as increased muscle tension in left upper limb. Problems of patient activity levels were independent standing up and able to stand without help and lack of left upper limb function activity. Neurological therapy included the muscle tone normalization, work on strengthen core, left hip and pelvis muscles, priming the correct loading of the directly occupied side during the position changes from sitting position to standing and walking, as well as learning of daily living activities.

Abstract In the gut, various subsets of intraepithelial T cells (IELs) respond to self or non-self-antigens derived from the body, diet, commensal and pathogenic microbiota. Dominant subset of IELs in the small intestine are TCRαβCD8αα+ cells, which are derived from immature thymocytes that express self-reactive TCRs. Although most of TCRαβCD8αα+ IELs are thymus-derived, their repertoire adapts to microbial flora. Here, using high throughput TCR sequencing we examined how clonal diversity of TCRαβCD8αα+ IELs changes upon exposure to commensal-derived antigens. We found that fraction of CD8αα+ IELs and CD4+ T cells express identical αβTCRs and this overlap raised parallel to a surge in the diversity of microbial flora. We also found that an opportunistic pathogen (Staphylococcus aureus) isolated from mouse small intestine specifically activated CD8αα+ IELs and CD4+ derived T cell hybridomas suggesting that some of TCRαβCD8αα+ clones with microbial specificities have extrathymic origin. We also report that CD8ααCD4+ IELs and Foxp3CD4+ T cells from the small intestine shared many αβTCRs, regardless whether the later subset was isolated from Foxp3CNS1 sufficient or Foxp3CNS1 deficient mice that lacks peripherally-derived Tregs. Overall, our results imply that repertoire of TCRαβCD8αα+ in small intestine expends in situ in response to changes in microbial flora.

Perinatal brachial plexus injury are usually a consequence of shoulder dystocia during childbirth, after the birth of the head there are difficulties with the birth of the shoulders. In this situation, childbirth is stopped and the shoulders of the fetus are not born spontaneously. The development of medicine provides patients with access to many methods of treating this injury. An interdisciplinary team of specialists is needed to minimize the negative effects of damage that are perceived by the patient, sometimes throughout life. Knowledge about physiotherapy in perinatal damage of the shoulder plexus is of great importance for the future of a child who suffered perinatal trauma to the shoulder plexus. Therefore, this topic should be constantly developed and re-examined so that in the future we can provide patients with multi-specialist care.

The hand is an organ of our body that fulfills a lot of different functions. Through efficiently functioning upper limbs, we experience and learn, communicate with the world, and gain independence. In the cerebral palsy, the role of the therapist is to properly plan the hand therapy process, it requires him to have a good knowledge of what MPD is, which is associated with movement symptoms and coexisting disorders that affect the child's abnormal development. The physiotherapist must properly assess the child's functional level, anticipate and plan therapy so that the child reaches its maximum development potential. This is not an easy task because virtually every child with cerebral palsy is different, other are its movement limitations, accompanying symptoms and the environment in which he is brought up.

Congenital and acquired musculoskeletal diseases in children are often unnoticed and develop asymptomatically and without pain. Left untreated and earlier diagnosed, they deepen, leading to early degenerative changes and subsequent disability. Developmental hip dysplasia, i.e. disturbances in the formation and development of the infant's hip, occurs in Poland in about 4% of the newborn population. The appearance and further development of pathological changes of the hip may occur in the intrauterine period, during delivery or in later childhood. Detection of a defect in the first week of a child's life allows for early treatment and healing. Therefore, it is important to carefully screen hip joints. The aim of the work is to present physiotherapeutic methods used in the treatment of hip dysplasia.

Skin is an important organ of the senses, acts as a protective barrier to protect our body against physical, chemical and biological factors. In cases of extensive injuries, postoperative complications or infections, a skin transplant may be necessary. It is important that the patient after the surgical intervention can return to health and full physical fitness as soon as possible. A team of specialists together with a physiotherapist is essential to treat the patient. The case describes a patient who got traffic accident and suffered extensive traumatic wounds and a lower limb tissue defect that was stocked with autogenic transplant. As a result of the injuries suffered, the patient experienced pain and discomfort and reduced daily activities. After the kinesiotherapeutic intervention, the patient's condition has improved significantly, affecting the positive aspect of changing the quality of life.

Undoubtedly, the fashion of running comes. Initially people used to run for fun, pleasure, to forget about worries or problems. With time, however, was no longer just about the idea itself, people more and more fascinated with jogging went one step further. At the same time, not realizing how important changes may occur in their body. These are usually overload or inflammatory changes. The aim of this paper is to present the most frequent injuries of long distance runners and the main predisposing factors for their trauma. The work will also cover the possibility of prevention of these injuries. The most important factors predisposing to injury include: the awareness of running people, the overweight and obesity, the incorrect running pattern and the inappropriate training plan. The consequences of these factors may be: runner's knee, leg overload syndrome, Achilles tendonitis, plantar fasciitis, fatigue fractures, and iliotibial-band syndrome. The injuries are, unfortunately, inscribed into the life of every runner, regardless of the level of advancement. However, it is worth remembering that they can be effectively prevented, and at the moment of their appearance, effectively heal. The injuries of runners depend primarily on their approach to practicing this form of physical activity, to a lesser extent from genetic or mechanical factors.

Basketball is a sports discipline in which the ankle sprain is the most common injury. It is considered to be an aggravated activity by its dimension of teamwork, contact and requiring a variety of motion dynamics. The aim of this paper is to identify basketball game elements that contribute to the development of traumatic torsion injuries, to present methods of injury prevention and to present possible methods for the rehabilitation of athletes in different stages of injury healing. A sprain and a torsion of the ankle is not a traumatic event defined at one time, but is often a cycle of repetitive trauma. It is also important to educate competitors not to underestimate these types of injuries and to treat them with serious medical and rehabilitation procedures. Rehabilitation of the ankle joint is dependent on the degree of injury, and above all on the extent of the damaged tissue. In order to avoid trauma, proprioception and global stabilization training play a very important role. Unstable ankle instability is associated with serious complications.

The running pattern is individual for each runner, regardless of distance. We can characterize it as the sum of the data of the runner (age, height, training time, etc.) and the parameters of his run. Building the proper technique should focus first and foremost on the work of movement coordination and the power of the runner. In training the correct running steps we can use similar tools as working on deep feeling. The aim of this paper was to define what we can call a running pattern, what is its influence in long-distance running, and the relationship between the training technique and the running pattern. The importance of a running pattern in long-distance racing is immense, as the more distracted and departed from the norm, the greater the harm to the body will cause it to repetition in long run. Putting on training exercises that shape the technique is very important and affects the running pattern significantly.

Osgood-Schlatter disease is most often seen in adolescents in intensive growth. However, the disease is more common in males than females, which may have a bearing on the greater physical activity of boys. Since the onset of the disease, the symptoms resolve spontaneously in over 90% of patients in 12-24 months. Although the disease has been known for over 100 years, the cause of its origins has so far been raised by a number of doubts. The aim of the study was to obtain information on how often Osgood-Schlater disease occurs in adolescents who practice football and influence of the intensity of training on occurrence of this condition among young players. The research material was a group of 21 boys from 12-14 years of age training football. The study was conducted in the Pomeranian Football Club with the permission of parents and coaches. The survey techniques in their own construction was used to answer the question of how often sterile tibial necrosis of tibia in boys training football occurs. Analysis of the collected data showed that the intensity of training did not influence the occurrence of Osgood-Schlatter disease. Rehabilitation and correct attitude have a great impact on rapid recovery and prevent recurrence. The frequency of Osgood-Schlater's disease in adolescence training football depends on many factors. The disease is most often seen in adolescents during rapid growth as confirmed by the results of the study.

Breast cancer is the most common cancer occurring in the female population. Early diagnosis and appropriately implemented treatment results in high curability. The method of choice is surgery, depending on the extent of the changes, a radical method is used, consisting in complete removal of the mammary gland, or sparing. Additional, complementary methods of treatment are radiation, chemotherapy and hormone therapy. Surgery involves interference with tissue continuity and hence scarring. During the procedure, mechanical long pectoral nerve injury may also occur. The paper presents an example of a case study using kinesiotaping as a complementary method of rehabilitation of women after mastectomy with long pectoral nerve damage. The paper analyzes available literature and own experience

Obesity is Jena of the most common diseases of civilization twenty-first century. Affects people of all ages, it carries a number of complications, not only in terms of physical and mental health. I estimate that obese people have a greater sociological problems, and the level of self-acceptance in these individuals is much lower. Ways to deal with the problem of obesity are many, but one of the most effective physical activity is combined with diet. Epidemiological studies confirm the beneficial effect of physical activity to reduce the risk of obesity and its impact on the comprehensive treatment. Increasing energy expenditure affects not only the reduction of body fat. Regular physical activity increases muscle tissue and bone, and a decrease in resting and exercise blood pressure, pulse. Through physical activity, we are able to influence the lipid profile and glucose tolerance. Adaptation of physical activity should be an individual, it is recommended to increase daily physical activity for 30 minutes. The unit training should increase energy expenditure by 300 - 400kcal. Coexistence of diseases in obesity is a major limiting factor for some physical activity, however, there are forms of relieving traffic using such a resistance. Exercises in water or a bike. Objective: Effects of exercise and diet on body weight change in the composition and the results of biochemical blood. Methods: Case study of women - 40 years, BMI 36.06, a man - 39 years, BMI 46.69, using the same physical activity and diet throughout the year. Used in the study of body composition, performed every month, and the results of biochemical blood made prior to physical activity after switching diets, and after a year. Case study :To describe the changes in body composition under the influence of exercise and diet used a man and woman - marriage. The study lasted one year. Physical activity in both people was the same (frequency - 5 times a week). The diet consisted of the exclusion of sugar and fruits, junk food, highly processed foods. Eating regular meals. Both individuals are working as a sales representative. A woman born in 1976, 164 cm tall, 97 kg output. The man born in 1977, 178 cm tall 148kg weight output. In women, there were no chronic diseases in the male there is asthma and hypertension. Results: For one year body composition has changed significantly. In women reported weight loss of 33kg, U man of 51 kg. Loss of body fat in women was 35 kg and 2 kg gain muscle mass. One man, a decrease of 63 kg body fat to 16 kg and 4 kg increase in muscle mass. Blood biochemical parameters in both cases, have changed. Total cholesterol decreased in women with 288 mg / dl to 152 mg / dl in men with 325mg / dl to 157 mg / dl. In both sexes increased level of self-acceptance, mental health and general well-being. Additionally, in men increased capacity (FVC), and the blood pressure is normalized. Conclusions: Physical activity and diet changes the composition of body weight. The combination of exercise and diet affect the results of biochemical blood, normalization of blood pressure and asthma. Physical activity and diet is the prevention of diabetes, hypertension. The elimination of sugars and fruits is an effective method to reduce body fat. Weight loss is not linear. Physical activity affects the growth of muscle tissue.

Neurological therapy of the patients after stroke is mainly aimed at the greatest possible growth of the function. During the treatment there are various techniques according to Bobath concept designed to inhibit pathological movement patterns, as well as the stimulation of a physiological response. The aim of this paper is to discuss, on the basis of the presented case, rehabilitation methods of patient after ischemic stroke of the right hemisphere. The physiotherapy examination, based on the International Classification of ICF, assessing problems in the body structures, functions and activities and participation, showed a weakness of the lower trunk muscles, pelvic floor and left hip, muscles hypotonia of directly occupied side, as well as increased muscle tension in left upper limb. Problems of patient activity levels were independent standing up and able to stand without help and lack of left upper limb function activity. Neurological therapy included the muscle tone normalization, work on strengthen core, left hip and pelvis muscles, priming the correct loading of the directly occupied side during the position changes from sitting position to standing and walking, as well as learning of daily living activities.

Acute schistosomiasis is characterized by pro-inflammatory responses against tissue- or organ-trapped parasite eggs along with granuloma formation. Here, we describe studies in Cx3cr1−/− mice and demonstrate the role of Cx3cr1 in the pathoetiology of granuloma formation during acute schistosomiasis. Mice deficient in Cx3cr1 were protected from granuloma formation and hepatic injury induced by Schistosoma japonicum eggs, as manifested by reduced body weight loss and attenuated hepatomegaly along with preserved liver function. Notably, S. japonicum infection induced high levels of hepatic Cx3cr1 expression, which was predominantly expressed by infiltrating macrophages. Loss of Cx3cr1 rendered macrophages preferentially towards M2 polarization, which then led to a characteristic switch of the host immune defense from a conventional Th1 to a typical Th2 response during acute schistosomiasis. This immune switch caused by Cx3cr1 deficiency was probably associated with enhanced STAT6/PPAR-γ signaling and increased expression of indoleamine 2,3-dioxygenase (IDO), an enzyme that promotes M2 polarization of macrophages. Taken together, our data provide evidence suggesting that CX3CR1 could be a viable therapeutic target for treatment of acute schistosomiasis.

Skin is an important organ of the senses, acts as a protective barrier to protect our body against physical, chemical and biological factors. In cases of extensive injuries, postoperative complications or infections, a skin transplant may be necessary. It is important that the patient after the surgical intervention can return to health and full physical fitness as soon as possible. A team of specialists together with a physiotherapist is essential to treat the patient. The case describes a patient who got traffic accident and suffered extensive traumatic wounds and a lower limb tissue defect that was stocked with autogenic transplant. As a result of the injuries suffered, the patient experienced pain and discomfort and reduced daily activities. After the kinesiotherapeutic intervention, the patient's condition has improved significantly, affecting the positive aspect of changing the quality of life.

Basketball is a sports discipline in which the ankle sprain is the most common injury. It is considered to be an aggravated activity by its dimension of teamwork, contact and requiring a variety of motion dynamics. The aim of this paper is to identify basketball game elements that contribute to the development of traumatic torsion injuries, to present methods of injury prevention and to present possible methods for the rehabilitation of athletes in different stages of injury healing. A sprain and a torsion of the ankle is not a traumatic event defined at one time, but is often a cycle of repetitive trauma. It is also important to educate competitors not to underestimate these types of injuries and to treat them with serious medical and rehabilitation procedures. Rehabilitation of the ankle joint is dependent on the degree of injury, and above all on the extent of the damaged tissue. In order to avoid trauma, proprioception and global stabilization training play a very important role. Unstable ankle instability is associated with serious complications.

Undoubtedly, the fashion of running comes. Initially people used to run for fun, pleasure, to forget about worries or problems. With time, however, was no longer just about the idea itself, people more and more fascinated with jogging went one step further. At the same time, not realizing how important changes may occur in their body. These are usually overload or inflammatory changes. The aim of this paper is to present the most frequent injuries of long distance runners and the main predisposing factors for their trauma. The work will also cover the possibility of prevention of these injuries. The most important factors predisposing to injury include: the awareness of running people, the overweight and obesity, the incorrect running pattern and the inappropriate training plan. The consequences of these factors may be: runner's knee, leg overload syndrome, Achilles tendonitis, plantar fasciitis, fatigue fractures, and iliotibial-band syndrome. The injuries are, unfortunately, inscribed into the life of every runner, regardless of the level of advancement. However, it is worth remembering that they can be effectively prevented, and at the moment of their appearance, effectively heal. The injuries of runners depend primarily on their approach to practicing this form of physical activity, to a lesser extent from genetic or mechanical factors.

The running pattern is individual for each runner, regardless of distance. We can characterize it as the sum of the data of the runner (age, height, training time, etc.) and the parameters of his run. Building the proper technique should focus first and foremost on the work of movement coordination and the power of the runner. In training the correct running steps we can use similar tools as working on deep feeling. The aim of this paper was to define what we can call a running pattern, what is its influence in long-distance running, and the relationship between the training technique and the running pattern. The importance of a running pattern in long-distance racing is immense, as the more distracted and departed from the norm, the greater the harm to the body will cause it to repetition in long run. Putting on training exercises that shape the technique is very important and affects the running pattern significantly.

Osgood-Schlatter disease is most often seen in adolescents in intensive growth. However, the disease is more common in males than females, which may have a bearing on the greater physical activity of boys. Since the onset of the disease, the symptoms resolve spontaneously in over 90% of patients in 12-24 months. Although the disease has been known for over 100 years, the cause of its origins has so far been raised by a number of doubts. The aim of the study was to obtain information on how often Osgood-Schlater disease occurs in adolescents who practice football and influence of the intensity of training on occurrence of this condition among young players. The research material was a group of 21 boys from 12-14 years of age training football. The study was conducted in the Pomeranian Football Club with the permission of parents and coaches. The survey techniques in their own construction was used to answer the question of how often sterile tibial necrosis of tibia in boys training football occurs. Analysis of the collected data showed that the intensity of training did not influence the occurrence of Osgood-Schlatter disease. Rehabilitation and correct attitude have a great impact on rapid recovery and prevent recurrence. The frequency of Osgood-Schlater's disease in adolescence training football depends on many factors. The disease is most often seen in adolescents during rapid growth as confirmed by the results of the study.

The presence of Foxp3(+) regulatory CD4(+) T cells in tumor lesions is considered one of the major causes of ineffective immune response in cancer. It is not clear whether intratumoral T(reg) cells represent T(reg) cells pre-existing in healthy mice, or arise from tumor-specific effector CD4(+) T cells and thus representing adaptive T(reg) cells. The generation of T(reg) population in tumors could be further complicated by recent evidence showing that both in humans and mice the peripheral population of T(reg) cells is heterogenous and consists of subsets which may differentially respond to tumor-derived antigens. We have studied T(reg) cells in cancer in experimental mice that express naturally selected, polyclonal repertoire of CD4(+) T cells and which preserve the heterogeneity of the T(reg) population. The majority of T(reg) cells present in healthy mice maintained a stable suppressor phenotype, expressed high level of Foxp3 and an exclusive set of TCRs not used by naive CD4(+) T cells. A small T(reg) subset, utilized TCRs shared with effector T cells and expressed a lower level of Foxp3. We show that response to tumor-derived antigens induced efficient clonal recruitment and expansion of antigen-specific effector and T(reg) cells. However, the population of T(reg) cells in tumors was dominated by cells expressing TCRs shared with effector CD4(+) T cells. In contrast, T(reg) cells expressing an exclusive set of TCRs, that dominate in healthy mice, accounted for only a small fraction of all T(reg) cells in tumor lesions. Our results suggest that the T(reg) repertoire in tumors is generated by conversion of effector CD4(+) T cells or expansion of a minor subset of T(reg) cells. In conclusion, successful cancer immunotherapy may depend on the ability to block upregulation of Foxp3 in effector CD4(+) T cells and/or selectively inhibiting the expansion of a minor T(reg) subset.