TY - JOUR AU - Kressler, Christopher AU - Gasparoni, Gilles AU - Nordström, Karl AU - Hamo, Dania AU - Salhab, Abdulrahman AU - Dimitropoulos, Christoforos AU - Tierling, Sascha AU - Reinke, Petra AU - Volk, Hans-Dieter AU - Walter, Jörn AU - Hamann, Alf AU - Polansky, Julia K. PY - 2021 M3 - Original Research TI - Targeted De-Methylation of the FOXP3-TSDR Is Sufficient to Induce Physiological FOXP3 Expression but Not a Functional Treg Phenotype JO - Frontiers in Immunology UR - https://www.frontiersin.org/articles/10.3389/fimmu.2020.609891 VL - 11 SN - 1664-3224 N2 - CD4+ regulatory T cells (Tregs) are key mediators of immunological tolerance and promising effector cells for immuno-suppressive adoptive cellular therapy to fight autoimmunity and chronic inflammation. Their functional stability is critical for their clinical utility and has been correlated to the demethylated state of the TSDR/CNS2 enhancer element in the Treg lineage transcription factor FOXP3. However, proof for a causal contribution of the TSDR de-methylation to FOXP3 stability and Treg induction is so far lacking. We here established a powerful transient-transfection CRISPR-Cas9-based epigenetic editing method for the selective de-methylation of the TSDR within the endogenous chromatin environment of a living cell. The induced de-methylated state was stable over weeks in clonal T cell proliferation cultures even after expression of the editing complex had ceased. Epigenetic editing of the TSDR resulted in FOXP3 expression, even in its physiological isoform distribution, proving a causal role for the de-methylated TSDR in FOXP3 regulation. However, successful FOXP3 induction was not associated with a switch towards a functional Treg phenotype, in contrast to what has been reported from FOXP3 overexpression approaches. Thus, TSDR de-methylation is required, but not sufficient for a stable Treg phenotype induction. Therefore, targeted demethylation of the TSDR may be a critical addition to published in vitro Treg induction protocols which so far lack FOXP3 stability. ER -