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  • Review Article
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An update on regulatory T cells in transplant tolerance and rejection

Nature Reviews Nephrology volume 6, pages 577–583 (2010)Cite this article

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Abstract

Several types of T cells with immunosuppressive properties have been identified, but FOXP3+ regulatory T (TREG) cells have emerged as a dominant cell type; they are critically involved in the induction and maintenance of immune tolerance. Manipulation of this cell type for the induction of transplant tolerance including renal transplant tolerance has attracted considerable attention. Studies in this area have demonstrated unexpected complexities, and attempts to translate TREG cells towards clinical utility have met with unanticipated difficulties. In this Review, a broad overview is provided on recent progress in the study of TREG cells, focusing on challenges, opportunities, and emerging approaches in exploiting TREG cells for the induction of transplant tolerance.

Key Points

  • Regulatory T (TREG) cells are indispensable in transplant tolerance

  • TREG cells are heterogeneous and are not inherently stable; their suppressive programs can be turned off or they may be reprogrammed to become T-effector cells

  • Some effector cell types, such as memory T cells, can evade TREG-cell-mediated suppression

  • Mechanisms that regulate the in vivo induction and stability of TREG cells are poorly defined

  • The mechanism by which FOXP3+ TREG cells interact with other types of regulatory cells in transplant tolerance is unknown

  • Potential complications of immunodeficiency exist from nonspecific expansion of TREG cells

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Figure 1: Key features and differences between nTREG cells and iTREG cells.
Figure 2: Lineage plasticity of TREG cells in the periphery.
Figure 3: Evolution of TREG cells in transplant tolerance.

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Acknowledgements

X. C. Li and L. A. Turka are supported by the NIH, USA.

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Authors and Affiliations

  1. The Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, CLS-605, Boston, 02215, MA, USA

    Xian Chang Li & Laurence A. Turka

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  1. Xian Chang Li
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Contributions

X. C. Li researched data for the article and contributed to the discussion of content, writing the article, and reviewing/editing the manuscript before submission. L. A. Turka contributed to the discussion of content, writing the article, and reviewing/editing the manuscript before submission.

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Correspondence to Xian Chang Li.

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Competing interests

L. A. Turka declares that he has acted as a consultant for GlaxoSmithKline, Biogen IDEC and Bristol–Myers Squibb, and is a stockholder/director for Novartis. X. C. Li declares no competing interests.

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Li, X., Turka, L. An update on regulatory T cells in transplant tolerance and rejection. Nat Rev Nephrol 6, 577–583 (2010). https://doi.org/10.1038/nrneph.2010.101

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