Regulatory T cells (Tregs) are critical to the maintenance of immune cell homeostasis as evidenced by the
catastrophic consequences of genetic or physical ablation of the Treg population. Specifically, Treg cells
maintain order in the immune system by enforcing a dominant negative regulation on other immune cells.
Broadly classified into natural or adaptive (induced) Tregs; natural Tregs are CD4+CD25+ T-cells which develop,
and emigrate from the thymus to perform their key role in immune homeostasis. Adaptive Tregs are non-
regulatory CD4+ T-cells which acquire CD25 (IL-2R alpha) expression outside of the thymus, and are typically
induced by inflammation and disease processes, such as autoimmunity and cancer.
Precise understanding of the immunosuppressive mechanism of T regulatory cells remains elusive, although
there is increasing evidence that Tregs manifest their function through a myriad of mechanisms that include
the secretion of immunosuppressive soluble factors such as IL-9, IL-10 and TGF beta, cell contact mediated
regulation via the high affinity TCR and other costimulatory molecules such as CTLA-4, GITR, and cytolytic
activity. Understanding the mechanisms by which Treg cells exert their influence is an area of intense research
with broad implications for the development of therapeutic strategies for many disease processes including
cancer, diabetes, and Immune mediated diseases.
Under the influence of TGF beta, adaptive Treg cells mature in peripheral sites,
including mucosa-associated lymphoid tissue (MALT), from CD4+ Treg precursors,
where they acquire the expression of markers typical of Tregs, including CD25, CTLA4
and GITR / AITR. Upon up-regulation of the transcription factor Foxp3, Treg cells begin
their suppressive effect. This includes the secretion of cytokines including IL-10 and
TGF beta which may induce cell-cycle arrest or apoptosis in effector T cells, and
blocking co-stimulation and maturation of dendritic cells.