- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN, United States
Foxp3-expressing CD4 regulatory T (Treg) cells are essential for maintaining immune tolerance through antigen-specific and bystander suppression modes. They carry a diverse T-cell antigen receptor (TCR) repertoire against a broad spectrum of antigens. The TCR repertoire acquired during Treg induction exhibits significant variations across antigens, leading to uncertainty in target coverage and representation. Accumulating reports indicate a remarkable complexity in the functional modes of Treg cells under various immunological contexts, presenting significant challenges for further investigation. In this article, we propose that the relative significance and capabilities of Treg suppression modes shift according to the levels of specific antigens and the resulting TCR signal strength. Testing the applicability of this model and identifying its modifiers would offer valuable insights for basic research and translational applications.
Introduction
Treg cells are induced in the thymus or periphery, playing a dominant role in suppressing conventional T (Tcon) cells that mount inflammatory responses to self-antigens and foreign antigens in the periphery (1, 2). Forkhead box protein P3 (Foxp3) is exclusively expressed by Treg cells, acting as the master regulator of Treg fate and immune suppressive function (3–5). Over two decades of intensive research have yielded remarkable progress in understanding the immunological roles and underlying mechanisms of Treg cells across diverse contexts, thanks to the utilization of various animal models (6–8). However, the mechanisms by which Foxp3 regulates gene expression remain to be fully explored (9–11). Accumulating reports have unveiled the increasing complexity of Treg function in various immunological settings. This poses significant challenges in comprehending the fundamental principles governing intricate Treg function required for basic and translational research.
Several mechanisms are known to mediate the immunosuppressive function of Treg cells, directly or through antigen-presenting cells (APCs). However, since Treg cells possess a diverse TCR repertoire targeting numerous antigens and most research was conducted with polyclonal Treg cells with undetermined antigen specificity, the behaviors of Treg cells have been elusive, regarding the target specificity in suppressing Tcon cells. This introduces additional complexity to the mechanisms that mediate Treg function. The natural variations in Treg induction across antigens (12–19), which affects target coverage and representation, raise questions about the underlying principles and mechanisms by which T-cell immune tolerance is reliably maintained.
In a recent study, Klawon et al. explored prostate-specific Treg cells when the cognate antigen is presented at the endogenous level or delivered presumably at a higher level through engineered Listeria monocytogenes, revealing the capabilities of distinct Treg suppression mechanisms (20). These findings reignite the unresolved questions about the immunological contexts, determinants, capabilities, and limitations of Treg bystander and antigen-specific suppressions. In this article, we examine published reports and delve into a theoretical analysis. This leads to a coherent model in which the relative significance and capabilities of Treg suppression modes shift in response to the TCR signal strength (above the tonic or basal level) resulting from antigen load.
Treg cells suppress Tcon cells through two distinct modes
Treg cells are induced in tolerogenic environments, such as thymic medulla and intestines upon antigen or agonist stimulation through unique APCs (21–27). This enables the adaptive immune system to develop a tolerance memory during initial encounter with self-antigens and harmless foreign antigens, such as those in food and commensal microbiome. The mechanisms by which Treg cells are exclusively induced by these specialized APCs remain to be fully elucidated. Treg cells are required to suppress Tcon cells throughout an animal’s lifespan (6). This process is believed to be overall antigen-specific, ensuring that the response of Tcon cells to unrelated antigens, such as pathogens, is not interfered with.
Treg cells suppress Tcon cells through various mechanisms, which can be categorized into two basic modes: antigen-specific and bystander suppressions (Figure 1). The antigen specificity of Treg-mediated immunosuppression is evident in three key features. First, Treg cells continuously rely on TCR signaling, likely exceeding tonic strength, to maintain their activated state and execute immune regulatory function (1, 28–30). Second, Treg cells possess an advantage over Tcon cells during antigen recognition. For example, they carry a TCR repertoire with a higher affinity for self-antigens (31). Treg cells also remain in an active state even in the absence of immune challenges. This is achieved through specialized regulatory circuits, which are partially dependent on Foxp3 but independent of TCR affinity (32–37). Third, during interaction with APCs, Treg cells deplete costimulatory receptors CD80/CD86 and peptide-major histocompatibility complex class II (MHC II) complexes on APCs (36, 38, 39). These, along with other mechanisms that require further investigation, allow Treg cells to surpass Tcon cells in antigen binding, thereby achieving antigen-specific suppression.
Figure 1. The two modes of suppression mechanisms employed by Treg cells. Tcon cells are restricted by Treg cells through various mechanisms, which can be categorized into antigen-specific and bystander suppression modes. Treg cells recognizing the same antigen as the Tcon cells exerts antigen-specific suppression (top). This is primarily accomplished through competition for antigen binding via overlapping TCR repertoires and the depletion of co-stimulatory receptors CD80/CD86 and peptide-MHC II on APCs. These antigen-engaged Treg cells also restrain the activation and proliferation of Tcon cells by depleting local IL-2 (IL-2 sink) through IL-2 receptor containing high-affinity subunit CD25, or secreting immune-suppressive molecules, such as IL-10, TGF-β, and soluble CD137 (sCD137). For simplicity, other factors that mediate the suppressive functions of Treg cells are not shown. These collectively suppress Tcon cells, where antigen-specific mechanisms are dominant. Polyclonal Treg cells, upon activation by different antigens, can also suppress Tcon cells of unrelated antigen specificity within proximity through these mechanisms, except for antigen competition, which is commonly referred to as bystander suppression (bottom). Notably, bystander suppression mode also relies on TCR signaling Treg cells received in the past. DC, dendritic cell. This figure was created using Biorender.com.
Treg cells also suppress Tcon cell activation and proliferation via extrinsic factors. For example, elevated expression of the high-affinity subunit of the interleukin (IL)-2 receptor, CD25, enables Treg cells to deplete local IL-2, serving as an IL-2 sink (40); Treg cells secrete soluble factors like transforming growth factor beta (TGF-β), IL-10, and soluble CD137 (sCD137, also known as 4-1BB or Tnfrsf9) (41), which are elevated after antigen stimulation, to suppress Tcon cells (8, 10); Treg cells express high-level ectonucleoside triphosphate diphosphohydrolase 1 (CD39) and ecto-5’-nucleotidase (CD73) that convert ATP to adenosine to activate adenosine receptors to suppress Tcon cells and other immune cells (42). These mechanisms, while also contributing to antigen-specific suppression, can potentially restrict Tcon cells that react to unrelated antigens presented by APCs in the same environment, known as Treg bystander suppression (Figure 1). Similarly, the downregulation of CD80/CD86 on APCs by Treg cells may potentially facilitate immune suppression across a wider range of antigenic stimuli.
Treg bystander and antigen-specific suppressions are interconnected. Antigen stimulation is required to maintain Treg survival, activation, and suppressive function. Though separated in space and time, it may promote Treg’s bystander suppression. The existence of these two distinct categories of suppression mechanisms raises questions about their interrelation, capabilities, limitations, and suitable contexts during Treg-mediated immune tolerance.
Treg induction introduces variations in target coverage and representation
To gain insights into the interplay between Treg antigen-specific and bystander suppressions, it is important to examine the target coverage and representation of Treg cells. Treg cells carry a diverse TCR repertoire that targets an astronomical number of peptide antigens (43). Considering potential self-peptides (greater than 1011) and the number of Treg cells per mouse (less than 107), the number of Treg cells would vary significantly for individual peptides. This variation would be more pronounced for peptides expressed at low levels by APCs during Treg induction or for peptides that trigger low-level TCR signaling, which is unfavorable for Treg induction.
Thymic precursor cells expressing TCRs with high reactivity to self-antigens or agonists undergo apoptosis (negative selection) and those with moderate reactivity differentiate into Treg cells in the presence of IL-2 by inducing the expression of Foxp3 and functional genes, such as CD25 and CTLA-4 (Figure 2A) (12, 44). CD4 naïve T cells can also differentiate into Treg cells in the periphery upon antigen stimulation under favorable conditions, such as IL-2, TGF-β, and retinoic acid (45–48). The TCR repertoire, once acquired during Treg induction, is inherited throughout Treg lifespan.
Figure 2. The relationship between the induction of polyclonal Treg cells and the capacity for immune tolerance. (A) A schematic diagram illustrates thymic T-cell selection and Treg induction. Aire is specifically expressed by mTECs to facilitate the expression of tissue-restricted self-antigens through a process known as thymic mimicry (21–23, 91). Precursor cells subjected to strong stimulation by self-antigens undergo apoptosis (thymic negative selection). Those receiving moderate stimulation differentiate into Treg cells. The remaining cells contribute to the Tcon cell pool. (B) Foxp3 induction during Treg development is facilitated by three enhancers CNS0, CNS1, and CNS3. These enhancers are regulated by Treg-inducing signals, as indicated by arrows. For simplicity, other factors interacting with these enhancers, such as transcription factors and epigenetic modifications, are not depicted. The lengths of genetic elements are not drawn to scale. Since Foxp3 is exclusively expressed by Treg cells to drive cell fate and immune suppressive function, except for specific conditions like colonic Treg cells (35), examining these Foxp3 enhancers offers a unique approach to explore the causal role of the induction efficiency of polyclonal Treg cells in immune tolerance. Pro, promoter. (C) Treg induction efficiency, which is linked to the probability of target coverage and autoimmune status, is assessed in mice deficient in Aire, CNS0, or CNS3, either individually or in combinations. The y-axis represents the relative severity (not drawn to scale) of autoimmune inflammation in specific-pathogen-free facilities.
Treg induction, like other T-cell fate determination processes, exhibits considerable variations depending on the peptide antigens (13, 16, 17, 45, 49–52). Precursor cells expressing the same TCRs can be induced into Treg cells or remain as Tcon cells (Figure 2A). This aligns with the presence of overlapping TCRs in Treg and Tcon cells (15, 53, 54). Given that peptide antigens elicit a wide range of TCR signal strengths and peptide abundance varies significantly (31, 50, 52, 55, 56), Treg induction for individual peptide antigens would exhibit substantial variations. As a result, there would be considerable fluctuations on the coverage and representation of Treg cells across different peptide antigens. While experimental measurements are necessary to define this uncertainty, a critical question arises about how Treg cells can effectively control overrepresented Tcon cells to achieve robust tolerance.
Immune tolerance and polyclonal Treg induction regulated by Foxp3 enhancers
Studies of polyclonal Treg induction through the regulation of the Foxp3 gene by its enhancers have provided a unique approach to assess the significance of varying Treg induction and target representation. This is because perturbations of these enhancers do not directly affect Treg function (Figure 2B) (13, 49, 57, 58). Two of these enhancers, designated as conserved non-coding sequences (CNS) CNS0 and CNS3, exert significant influence on the induction of both thymic and peripheral Treg cells. CNS0 senses the IL-2-STAT5 signaling, while CNS3 is involved in the NF-κB signaling (13, 49, 58, 59). They are also regulated by histone H3 lysine four methylation (13, 49, 59–61). CNS1 is a response element for the TGF-β-Smad signaling, mainly contributing to Treg induction in the periphery (49, 62).
Ablation of CNS0 or CNS3 alone in mice results in a moderate reduction of Treg induction (Figure 2C) (13, 49, 57, 58). This does not lead to Tcon activation or autoimmune responses, suggesting that the remaining Treg cells can effectively suppress Tcon cells. Deletion of both CNS0 and CNS3 further reduces Treg induction by approximately 100-fold, causing multiorgan autoimmune inflammation and a shortened lifespan comparable to Foxp3 deletion (3, 4, 14, 59). Although the stability of the Treg lineage is also partially compromised, the significantly reduced target coverage and representation, ultimately determined by Treg induction, seem to play a major role (13, 14, 49, 59).
This is consistent with the additive effects of Aire-CNS0 and Aire-CNS3 double deficiencies. Nuclear protein Aire is expressed in medullary thymic epithelial cells (mTECs) to facilitate the expression of tissue-restricted self-antigens for thymic negative selection and Treg induction (63). Mice lacking Aire develop late-onset autoimmune disease (23). Combined deletion of Aire with CNS0 or with CNS3 drastically exacerbates the disease severity, along with a further reduction of Treg induction (Figure 2C) (13, 58).
These results collectively indicate that the efficient induction of polyclonal Treg cells is essential for effective suppression of autoreactive Tcon cells. Unsurprisingly, Treg cells expressing monoclonal TCRs or a reduced TCR repertoire exhibit limited suppressive capability (64, 65). However, the relative significance and capacity of antigen-specific and bystander suppressions of polyclonal Treg cells have not been defined by these studies.
The suppression modes of Treg cells against specific antigens
The investigation of antigen-specific Treg cells has been hindered by their scarcity, identification, and manipulation in native conditions (16–18). In addition, Treg cells are closely connected to other tolerance programs, such as thymic negative selection, anergy, and exhaustion of Tcon cells, making it difficult to interpret the results when Treg cells are perturbed. For instance, Shin et al. demonstrated that self-antigens exposed during lung injury induce Treg cell expansion, but the ablation of Treg cells does not result in Tcon cell proliferation. This suggests that Tcon cell anergy or exhaustion occurs in this context (66).
Klawon et al. examined prostate-specific Treg and Tcon cells against the C4 peptide of transient receptor potential channel–associated factor 3 (TCAF3) in mice (20). C4 is presented by mTECs via MHC II to induce Treg cells without causing significant negative selection (67). Whereas ablation of all Treg cells results in prostatitis, depletion of C4-specific Treg cells through conditional deletion of C4 in mTECs does not activate Tcon cells expressing C4-specific MJ23 transgenic TCR, either in the steady state or after innate immune activation by LPS, poly(I:C), or L. monocytogenes infection. Thus, polyclonal Treg cells can successfully suppress Tcon cells with an unrelated antigen specificity in this context (Figure 3A).
Figure 3. Evaluation of the suppression modes of antigen-specific Treg cells. (A) Klawon et al. recently employed MJ23 TCR transgenic mice and conditional deletion of the C4 epitope of prostate antigen TCAF3 in mTECs to demonstrate that thymic Treg cells against the C4 peptide are dispensable for suppressing related TCR-transgenic Tcon cells in the otherwise wild-type background (20). However, when polyclonal Treg cells are depleted, mice develop prostatitis, which is mediated by Tcon cells. These findings indicate that polyclonal Treg cells can effectively suppress C4-specific MJ23 Tcon cells within the same microenvironment through bystander suppression. A schematic model illustrates how general T-cell immune tolerance is maintained in the resting state to oppose inherent variations in Treg induction and target coverage or representation. (B) When the C4 peptide is delivered to mice via Listeria monocytogenes, presumably at a higher level, C4-specific Treg cells are now indispensable for suppressing MJ23 Tcon cells (20). Mice lacking C4-specific Treg cells fail to restrain MJ23 Tcon cells after infection with L. monocytogenes expressing C4 peptide, despite the presence of bystander suppression from polyclonal Treg cells. Consequently, Treg antigen-specific suppression plays a dominant role in conferring tolerance to particular targets that induce Treg cells during previous exposure. This mechanism ensures that the inflammatory response of Tcon cells to other abundant antigens, such as pathogens and neoantigens, remains unaffected in the absence of matched Treg cells.
When C4 peptide is delivered via L. monocytogenes, presumably at a higher level, C4-specific Tcon cells can be fully suppressed in wild-type mice but not in mice lacking C4-specific Treg cells (20), indicating a crucial role of antigen-specific suppression by Treg cells (Figure 3B). Likewise, Tcon cell response to LLO190–201 epitope derived from L. monocytogenes is not affected by C4-specific Treg cells (20).
Antigen load appears to be a key determinant of the relative significance of antigen-specific and bystander suppression modes of Treg cells (20, 68). At low levels of antigens, bystander suppression by polyclonal Treg cells is sufficient to control unrelated Tcon cells. However, when the antigen level is high, antigen-specific suppression becomes dominant.
Treg suppression modes related to antigen load and resulting TCR signal strength
In contrast to Klawon et al.’s observations, the deletion of insulin expression in mTEC in mice impairs the generation of insulin-specific Tregs, resulting in autoimmune diabetes (69). These differences could be attributed to additional factors, such as varying antigen levels, TCR signal strengths, persistence of antigen stimulation, or the nature of tissue environments including APCs. Besides, self-antigens presented at higher levels postnatally often disrupt established immune tolerance, presumably by surpassing antigen-specific Treg suppression (70, 71). For instance, tyrosinase-related proteins (TRPs) TRP-1 and TRP-2 when expressed via vaccinia virus induce an autoimmune attack on melanocytes in mice (72). Immunization of animals with high levels of self-antigens expressed by the central nervous system induces multiple sclerosis (73, 74).
Although the precise causes of these different outcomes remain to be determined, a general relationship emerges between antigen load, which determines the strengths of TCR signaling, and the suppression mechanisms, capacity, and extent of immune tolerance demonstrated by Treg cells (Figure 4A). The capacity of antigen-specific suppression of Treg cells is established during Treg induction, reflected by the target representation. When antigen levels are relatively low, bystander and antigen-specific suppressions can effectively maintain immune tolerance. However, as antigen load increases, there is a greater reliance on antigen-specific suppressions. However, excessive antigen stimulation can overwhelm Treg suppressive capacity. If the corresponding Tcon cells are not in non-functional states, such as anergy and exhaustion (66, 75, 76), they would become activated and trigger inflammatory responses.
Figure 4. The relativity of Treg suppression modes and tolerance capacity. (A) An integrated model illustrates the causal role of relative antigen load and the resulting TCR signal strength. Antigen load is defined as the relative levels of specific peptide antigen or epitope that binds to corresponding TCRs to induce signal transduction above the tonic or basal level. The TCR signal strength is reflected by the magnitude of downstream signal transduction, gene expression, and T-cell activity depending on cell types. The antigen load or TCR signal strength determines the relative importance of suppression modes in maintaining immune tolerance, which is exhibited following Treg deficiency. As antigen level increases, Treg antigen-specific suppression is gradually surpassed, thereby unleashing Tcon cells to initiate inflammatory responses. This response curve may be modified by Treg and Tcon intrinsic and extrinsic factors. Several such factors are listed. (B) The positive and negative signals acting on Tcon cells. For simplicity, these signals are not depicted in detail. The positive signals (red) from TCR and co-stimulatory receptors are countered by Treg antigen-specific (black) and bystander (blue) suppression mechanisms, which may be separated in space and time. The relative weights of negative and positive signals determine the outcome of Tcon cells, namely non-reactivity or inflammatory response. (C) The relative significance of Treg suppression modes when antigens are presented at varying levels. This model applies to Treg cells that recognize a specific antigen in the presence of polyclonal Treg cells. Line thickness represents the signal strength.
This response curve may be shifted by additional factors that modulate Treg and Tcon cells, such as antigen persistence that impacts Treg and Tcon cells differentially and innate signals that favor Tcon cells and inflammatory response.
Treg suppression and antigen stimulation are weighted by Tcon cells
By analyzing the input signals and outcomes from the perspective of Tcon cells, we can gain a deeper understanding of Treg suppression modes. Treg suppression and antigen stimulation are negative and positive regulators, respectively (Figure 4B). They may act on Tcon cells separately in space and time. Their relative weights determine whether Tcon cells are ultimately activated to initiate an inflammatory response. At low levels of antigen stimulation, weak TCR signaling in Tcon cells can be readily overridden by Treg bystander suppression (Figure 4C). However, the potency of anti-inflammatory molecules secreted by Treg cells is limited. When antigens are abundant and TCR signaling is potentially high on Tcon cells, Treg cells predominantly suppress Tcon cells in an antigen-specific manner, primarily by restricting antigen stimulation. High-affinity TCRs, a pre-active state, and depletion of co-stimulatory receptors CD80/CD86 and peptide-MHC II complexes on APCs enable Treg cells to outcompete Tcon cells during antigen stimulation (12, 31, 36, 38, 39). Notably, depleting IL-2 (IL-2 sink) or secretion of TGF-β by Treg cells as bystander suppression mechanisms can downregulate TCR signaling in Tcon cells (77–80). A further increase in antigen load and TCR signaling would eventually overpower Treg suppression, leading to the activation of Tcon cells, unless other tolerance programs are induced in the meantime (Figure 4A). Innate signals and proinflammatory cytokines, although present in low concentrations initially, may promote Tcon polarization and the inflammatory response.
How TCR signaling and Treg suppression are mechanistically integrated by Tcon cells remains to be fully elucidated. In vivo visualization of the proximity of Treg, Tcon, and APCs has yielded valuable insights (20, 81). Treg bystander suppression does not impact Tcon cell priming, indicating that it operates at a later stage, such as during stimulation-induced Tcon cell proliferation (20). In contrast, Treg antigen-specific suppression seems to exert its effects through both Tcon cell priming and proliferation. The distinct outcomes reflect the quantitative differences in TCR signal strengths involved in different suppression mechanisms. This process may also be influenced by various factors related to infection, aging, cancer, and sex through antigen presentation and the function of Treg and Tcon cells.
Discussion
Extensive research conducted over the past two decades has revealed increasing complexities on Treg suppression modes, applicable conditions, and constraints. Here, we propose a unified model that illustrates how the relative significance and capabilities of Treg bystander and antigen-specific suppression modes are shifted by the levels of cognate antigens and resulting TCR signal strengths. It distills the intricate interactions among Treg target coverage and representation, Tcon reactivity, APCs, antigen load, and TCR signal strength. When applicable, additional modulators can be readily incorporated into this model.
Our simplified formula facilitates further investigation of the fundamental principles and mechanisms underlying Treg-mediated immune tolerance, such as how robust T-cell tolerance is established and maintained by Treg cells that have inherent variations in target coverage and representation, how immune tolerance is disrupted when Tcon cells surpass Treg suppression to cause autoimmune inflammation upon genetic and environmental perturbations, and how immune homeostasis and tolerance can be reversed by Treg cells following autoimmune dysregulation. Our model also helps elucidate the modulators of Treg suppression mechanisms, including the incorporation of new Tregs, clonal competition, lineage stability, and functional plasticity. These variables remain poorly defined due to technical challenges.
Treg cells hold great promise for therapeutic applications (82–85). Exploration of our formula may lead to new strategies on reducing Treg suppression for cancer treatment while maintaining tolerance to normal tissues, if the antigen levels vary and the relative significance of Treg suppression modes differ in these two settings. It may facilitate the development of innovative methodologies for utilizing polyclonal or antigen-specific Treg cells to treat immunological diseases. The strategies can be tailored based on the levels of relevant antigens and the desired potency of suppression. For instance, experimental autoimmune encephalomyelitis can be mitigated by both antigen-specific and bystander suppression modes of Treg cells introduced via noninflammatory mRNA vaccine (71). Furthermore, Treg function can be selectively enhanced beyond the natural capacity through various approaches, such as directing Treg cells to specific antigens via TCRs or chimeric antigen receptors, enhancing Treg lineage stability and fitness, or increasing suppressive function. Our model also offers a simple framework for designing and evaluating engineered Treg cells.
Model limitations and other hypotheses
This theoretical analysis assumes that the Treg representation established during Treg induction is not compensated by clonal expansion based on antigen levels at the Treg functional stage. However, a certain degree of proliferation could be involved, allowing for a range of antigen-level increases. Experimental measurements are necessary to test these possibilities and identify the factors limiting Treg clonal expansion and functionality.
Our current model simplifies the analysis by treating thymic-derived Treg cells as a homogeneous population. This model would become more complex in various contexts involving different antigen levels, response curves, mechanisms and magnitudes of Treg bystander and antigen-specific suppressions, as well as the numbers, reactivity, and effector functions of target Tcon cells. Treg cells also regulate many other cell types, a topic not covered in this paper.
This model may also apply to peripheral Treg cells, but exhibit distinct response curves due to varying antigen load and regulatory mechanisms (2). For instance, IL-10 plays a more significant role in Treg cells suppressing inflammation at the mucosal interface (8, 86). Antigens in food and the commensal microbiota are often presented at high levels (87, 88), leading to a primary reliance on antigen-specific suppression by Treg cells. A high representation of these Treg cells would be crucial for adequate tolerance.
Treg cells differentiate into various subsets, including tissue-resident Treg cells, Th1-like Tregs, Th2-like Tregs, follicular Treg (Tfr) cells, and Th17-like Treg cells (1, 2, 89). These Treg cells suppress Tcon differentiation and function under special environments through additional mechanisms. The same principles discussed in this paper would govern their suppression modes. The relative importance of antigen-specific and bystander suppressions would vary due to quantitative differences in suppressive molecules, such as the levels of CD25, IL-10, and CTLA-4, as well as the activity of Tcon cells.
Furthermore, the tissue repair function of Treg cells, such as the secretion of amphiregulin (Areg) upon IL-18 or IL-33 stimulation (90), may be comparable to Treg bystander suppression. However, the connection with antigen-specific Treg function remains to be fully elucidated.
Further experiments conducted under these conditions will test the model’s applicability and quantify the variables and modifiers involved. This would provide deeper mechanistic insights and strengthen the principles underlying complex Treg function.
Data availability statement
The original contributions presented in the study are included in the article/supplementary material. Further inquiries can be directed to the corresponding author.
Author contributions
YF: Conceptualization, Writing – review & editing, Funding acquisition, Supervision, Visualization, Resources, Writing – original draft. LB: Investigation, Writing – original draft, Visualization. VC: Visualization, Validation, Writing – review & editing.
Funding
The author(s) declared that financial support was received for this work and/or its publication. LB was supported by the George J. Mitchell Endowed Fellowship of the Academic Programs Office of St. Jude Children’s Research Hospital. This work was supported by the American Lebanese Syrian Associated Charities (St. Jude Children’s Research Hospital) and National Institutes of Health grants R01 AI153138 (YF), R21 AI146614 (YF), and R03 AI159289 (YF).
Conflict of interest
The authors declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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References
1. Dikiy S and Rudensky AY. Principles of regulatory T cell function. Immunity. (2023) 56:240–55. doi: 10.1016/j.immuni.2023.01.004
2. Sakaguchi S, Mikami N, Wing JB, Tanaka A, Ichiyama K, and Ohkura N. Regulatory T cells and human disease. Annu Rev Immunol. (2020) 38:541–66. doi: 10.1146/annurev-immunol-042718-041717
3. Brunkow ME, Jeffery EW, Hjerrild KA, Paeper B, Clark LB, Yasayko SA, et al. Disruption of a new forkhead/winged-helix protein, scurfin, results in the fatal lymphoproliferative disorder of the scurfy mouse. Nat Genet. (2001) 27:68–73. doi: 10.1038/83784
4. Fontenot JD, Gavin MA, and Rudensky AY. Foxp3 programs the development and function of CD4+CD25+ regulatory T cells. Nat Immunol. (2003) 4:330–6. doi: 10.1038/ni904
5. Hori S, Nomura T, and Sakaguchi S. Control of regulatory T cell development by the transcription factor Foxp3. Science. (2003) 299:1057–61. doi: 10.1126/science.1079490
6. Kim JM, Rasmussen JP, and Rudensky AY. Regulatory T cells prevent catastrophic autoimmunity throughout the lifespan of mice. Nat Immunol. (2007) 8:191–7. doi: 10.1038/ni1428
7. Rubtsov YP, Niec RE, Josefowicz S, Li L, Darce J, Mathis D, et al. Stability of the regulatory T cell lineage in vivo. Science. (2010) 329:1667–71. doi: 10.1126/science.1191996
8. Rubtsov YP, Rasmussen JP, Chi EY, Fontenot J, Castelli L, Ye X, et al. Regulatory T cell-derived interleukin-10 limits inflammation at environmental interfaces. Immunity. (2008) 28:546–58. doi: 10.1016/j.immuni.2008.02.017
9. He M and Feng Y. Elusive modes of Foxp3 activity in versatile regulatory T cells. Front Immunol. (2024) 15:1533823. doi: 10.3389/fimmu.2024.1533823
10. He M, Zong X, Xu B, Qi W, Huang W, Djekidel MN, et al. Dynamic Foxp3-chromatin interaction controls tunable Treg cell function. J Exp Med. (2024) 221. doi: 10.1084/jem.20232068
11. Jager C, Dimitrova P, Sun Q, Tennebroek J, Marchiori E, Jaritz M, et al. Inducible protein degradation reveals inflammation-dependent function of the T(reg) cell lineage-defining transcription factor Foxp3. Sci Immunol. (2025) 10:eadr7057. doi: 10.1126/sciimmunol.adr7057
12. Ashby KM and Hogquist KA. A guide to thymic selection of T cells. Nat Rev Immunol. (2024) 24:103–17. doi: 10.1038/s41577-023-00911-8
13. Feng Y, van der Veeken J, Shugay M, Putintseva EV, Osmanbeyoglu HU, Dikiy S, et al. A mechanism for expansion of regulatory T-cell repertoire and its role in self-tolerance. Nature. (2015) 528:132–6. doi: 10.1038/nature16141
14. Zong X, Hao X, Xu B, Crawford JC, Wright S, Li J, et al. Foxp3 enhancers synergize to maximize regulatory T cell suppressive capacity. J Exp Med. (2021) 218. doi: 10.1084/jem.20202415
15. Hsieh CS, Zheng Y, Liang Y, Fontenot JD, and Rudensky AY. An intersection between the self-reactive regulatory and nonregulatory T cell receptor repertoires. Nat Immunol. (2006) 7:401–10. doi: 10.1038/ni1318
16. Bautista JL, Lio CW, Lathrop SK, Forbush K, Liang Y, Luo J, et al. Intraclonal competition limits the fate determination of regulatory T cells in the thymus. Nat Immunol. (2009) 10:610–7. doi: 10.1038/ni.1739
17. Malhotra D, Linehan JL, Dileepan T, Lee YJ, Purtha WE, Lu JV, et al. Tolerance is established in polyclonal CD4 T cells by distinct mechanisms, according to self-peptide expression patterns. Nat Immunol. (2016) 17:187–95. doi: 10.1038/ni.3327
18. Legoux FP, Lim JB, Cauley AW, Dikiy S, Ertelt J, Mariani TJ, et al. CD4+ T cell tolerance to tissue-restricted self antigens is mediated by antigen-specific regulatory T cells rather than deletion. Immunity. (2015) 43:896–908. doi: 10.1016/j.immuni.2015.10.011
19. Hong SW, Krueger PD, Osum KC, Dileepan T, Herman A, Mueller DL, et al. Immune tolerance of food is mediated by layers of CD4(+) T cell dysfunction. Nature. (2022) 607:762–8. doi: 10.1038/s41586-022-04916-6
20. Klawon DEJ, Pagane N, Walker MT, Ganci NK, Miller CH, Gai E, et al. Regulatory T cells constrain T cells of shared specificity to enforce tolerance during infection. Science. (2025) 387:eadk3248. doi: 10.1126/science.adk3248
21. Michelson DA, Hase K, Kaisho T, Benoist C, and Mathis D. Thymic epithelial cells co-opt lineage-defining transcription factors to eliminate autoreactive T cells. Cell. (2022) 185:2542–58.e18. doi: 10.1016/j.cell.2022.05.018
22. Huisman BD, Michelson DA, Rubin SA, Kohlsaat K, Gomarga W, Fang Y, et al. Cross-species analyses of thymic mimetic cells reveal evolutionarily ancient origins and both conserved and species-specific elements. Immunity. (2025) 58:108–23.e7. doi: 10.1016/j.immuni.2024.11.025
23. Anderson MS, Venanzi ES, Klein L, Chen Z, Berzins SP, Turley SJ, et al. Projection of an immunological self shadow within the thymus by the aire protein. Science. (2002) 298:1395–401. doi: 10.1126/science.1075958
24. Rodrigues PF, Wu S, Trsan T, Panda SK, Fachi JL, Liu Y, et al. Rorgammat-positive dendritic cells are required for the induction of peripheral regulatory T cells in response to oral antigens. Cell. (2025) 188:2720–37.e22. doi: 10.1016/j.cell.2025.03.020
25. Akagbosu B, Tayyebi Z, Shibu G, Paucar Iza YA, Deep D, Parisotto YF, et al. Novel antigen-presenting cell imparts T(reg)-dependent tolerance to gut microbiota. Nature. (2022) 610:752–60. doi: 10.1038/s41586-022-05309-5
26. Fu L, Upadhyay R, Pokrovskii M, Chen FM, Romero-Meza G, Griesemer A, et al. PRDM16-dependent antigen-presenting cells induce tolerance to gut antigens. Nature. (2025) 642:756–65. doi: 10.1038/s41586-025-08982-4
27. Lyu M, Suzuki H, Kang L, Gaspal F, Zhou W, Goc J, et al. ILC3s select microbiota-specific regulatory T cells to establish tolerance in the gut. Nature. (2022) 610:744–51. doi: 10.1038/s41586-022-05141-x
28. Sakaguchi S, Yamaguchi T, Nomura T, and Ono M. Regulatory T cells and immune tolerance. Cell. (2008) 133:775–87. doi: 10.1016/j.cell.2008.05.009
29. Levine AG, Arvey A, Jin W, and Rudensky AY. Continuous requirement for the TCR in regulatory T cell function. Nat Immunol. (2014) 15:1070–8. doi: 10.1038/ni.3004
30. Schmidt AM, Lu W, Sindhava VJ, Huang Y, Burkhardt JK, Yang E, et al. Regulatory T cells require TCR signaling for their suppressive function. J Immunol. (2015) 194:4362–70. doi: 10.4049/jimmunol.1402384
31. Moran AE, Holzapfel KL, Xing Y, Cunningham NR, Maltzman JS, Punt J, et al. T cell receptor signal strength in Treg and iNKT cell development demonstrated by a novel fluorescent reporter mouse. J Exp Med. (2011) 208:1279–89. doi: 10.1084/jem.20110308
32. Chowdhary K, Leon J, Mathis D, and Benoist C. An integrated transcription factor framework for Treg identity and diversity. Proc Natl Acad Sci U S A. (2024) 121:e2411301121. doi: 10.1073/pnas.2411301121
33. Fu W, Ergun A, Lu T, Hill JA, Haxhinasto S, Fassett MS, et al. A multiply redundant genetic switch ‘locks in’ the transcriptional signature of regulatory T cells. Nat Immunol. (2012) 13:972–80. doi: 10.1038/ni.2420
34. Gavin MA, Rasmussen JP, Fontenot JD, Vasta V, Manganiello VC, Beavo JA, et al. Foxp3-dependent programme of regulatory T-cell differentiation. Nature. (2007) 445:771–5. doi: 10.1038/nature05543
35. van der Veeken J, Campbell C, Pritykin Y, Schizas M, Verter J, Hu W, et al. Genetic tracing reveals transcription factor Foxp3-dependent and Foxp3-independent functionality of peripherally induced Treg cells. Immunity. (2022) 55:1173–84.e7. doi: 10.1016/j.immuni.2022.05.010
36. Akkaya B, Oya Y, Akkaya M, Al Souz J, Holstein AH, Kamenyeva O, et al. Regulatory T cells mediate specific suppression by depleting peptide-MHC class II from dendritic cells. Nat Immunol. (2019) 20:218–31. doi: 10.1038/s41590-018-0280-2
37. Li J, Xu B, He M, Zong X, Cunningham T, Sha C, et al. Control of Foxp3 induction and maintenance by sequential histone acetylation and DNA demethylation. Cell Rep. (2021) 37:110124. doi: 10.1016/j.celrep.2021.110124
38. Qureshi OS, Zheng Y, Nakamura K, Attridge K, Manzotti C, Schmidt EM, et al. Trans-endocytosis of CD80 and CD86: A molecular basis for the cell extrinsic function of CTLA-4. Science. (2011) 332:600–3. doi: 10.1126/science.1202947
39. Tekguc M, Wing JB, Osaki M, Long J, and Sakaguchi S. Treg-expressed CTLA-4 depletes CD80/CD86 by trogocytosis, releasing free PD-L1 on antigen-presenting cells. Proc Natl Acad Sci U S A. (2021) 118. doi: 10.1073/pnas.2023739118
40. Busse D, de la Rosa M, Hobiger K, Thurley K, Flossdorf M, Scheffold A, et al. Competing feedback loops shape IL-2 signaling between helper and regulatory T lymphocytes in cellular microenvironments. Proc Natl Acad Sci U S A. (2010) 107:3058–63. doi: 10.1073/pnas.0812851107
41. Rojas M, Heuer LS, Zhang W, Sweeney N, Ramirez-Santana C, Leung PSC, et al. Alternate splicing converts human CD137 from costimulatory to immunosuppressive function. J Autoimmun. (2025) 157:103498. doi: 10.1016/j.jaut.2025.103498
42. Tan SN, Hao J, Ge J, Yang Y, Liu L, Huang J, et al. Regulatory T cells converted from Th1 cells in tumors suppress cancer immunity via CD39. J Exp Med. (2025) 222. doi: 10.1084/jem.20240445
43. Pacholczyk R and Kern J. The T-cell receptor repertoire of regulatory T cells. Immunology. (2008) 125:450–8. doi: 10.1111/j.1365-2567.2008.02992.x
44. Savage PA, Klawon DEJ, and Miller CH. Regulatory T cell development. Annu Rev Immunol. (2020) 38:421–53. doi: 10.1146/annurev-immunol-100219-020937
45. Chen W, Jin W, Hardegen N, Lei KJ, Li L, Marinos N, et al. Conversion of peripheral CD4+CD25- naive T cells to CD4+CD25+ regulatory T cells by TGF-beta induction of transcription factor Foxp3. J Exp Med. (2003) 198:1875–86. doi: 10.1084/jem.20030152
46. Elias KM, Laurence A, Davidson TS, Stephens G, Kanno Y, Shevach EM, et al. Retinoic acid inhibits Th17 polarization and enhances FoxP3 expression through a Stat-3/Stat-5 independent signaling pathway. Blood. (2008) 111:1013–20. doi: 10.1182/blood-2007-06-096438
47. Hill JA, Hall JA, Sun C-M, Cai Q, Ghyselinck N, Chambon P, et al. Retinoic acid enhances Foxp3 induction indirectly by relieving inhibition from CD4+ CD44hi Cells. Immunity. (2008) 29:758–70. doi: 10.1016/j.immuni.2008.09.018
48. Mucida D, Pino-Lagos K, Kim G, Nowak E, Benson MJ, Kronenberg M, et al. Retinoic acid can directly promote TGF-[beta]-mediated foxp3+ Treg cell conversion of naive T cells. Immunity. (2009) 30:471–2. doi: 10.1016/j.immuni.2009.03.008
49. Zheng Y, Josefowicz S, Chaudhry A, Peng XP, Forbush K, and Rudensky AY. Role of conserved non-coding DNA elements in the Foxp3 gene in regulatory T-cell fate. Nature. (2010) 463:808–12. doi: 10.1038/nature08750
50. Gottschalk RA, Corse E, and Allison JP. TCR ligand density and affinity determine peripheral induction of Foxp3 in vivo. J Exp Med. (2010) 207:1701–11. doi: 10.1084/jem.20091999
51. Hassler T, Urmann E, Teschner S, Federle C, Dileepan T, Schober K, et al. Inventories of naive and tolerant mouse CD4 T cell repertoires reveal a hierarchy of deleted and diverted T cell receptors. Proc Natl Acad Sci U S A. (2019) 116:18537–43. doi: 10.1073/pnas.1907615116
52. Leonard JD, Gilmore DC, Dileepan T, Nawrocka WI, Chao JL, Schoenbach MH, et al. Identification of natural regulatory T cell epitopes reveals convergence on a dominant autoantigen. Immunity. (2017) 47:107–17 e8. doi: 10.1016/j.immuni.2017.06.015
53. Nakonechnaya TO, Moltedo B, Putintseva EV, Leyn S, Bolotin DA, Britanova OV, et al. Convergence, plasticity, and tissue residence of regulatory T cell response via TCR repertoire prism. Elife. (2024) 12. doi: 10.7554/eLife.89382
54. Bolotin DA, Poslavsky S, Davydov AN, Frenkel FE, Fanchi L, Zolotareva OI, et al. Antigen receptor repertoire profiling from RNA-seq data. Nat Biotechnol. (2017) 35:908–11. doi: 10.1038/nbt.3979
55. Fernandes RA, Li C, Wang G, Yang X, Savvides CS, Glassman CR, et al. Discovery of surrogate agonists for visceral fat Treg cells that modulate metabolic indices in vivo. Elife. (2020) 9. doi: 10.7554/eLife.58463
56. Yang PP, Li YJ, Cao Y, Zhang L, Wang JQ, Lai Z, et al. Rapid discovery of self-assembling peptides with one-bead one-compound peptide library. Nat Commun. (2021) 12:4494. doi: 10.1038/s41467-021-24597-5
57. Feng Y, Arvey A, Chinen T, van der Veeken J, Gasteiger G, and Rudensky AY. Control of the inheritance of regulatory T cell identity by a cis element in the Foxp3 locus. Cell. (2014) 158:749–63. doi: 10.1016/j.cell.2014.07.031
58. Dikiy S, Li J, Bai L, Jiang M, Janke L, Zong X, et al. A distal Foxp3 enhancer enables interleukin-2 dependent thymic Treg cell lineage commitment for robust immune tolerance. Immunity. (2021) 54:931–46.e11. doi: 10.1016/j.immuni.2021.03.020
59. Kawakami R, Kitagawa Y, Chen KY, Arai M, Ohara D, Nakamura Y, et al. Distinct Foxp3 enhancer elements coordinate development, maintenance, and function of regulatory T cells. Immunity. (2021) 54:947–61.e8. doi: 10.1016/j.immuni.2021.04.005
60. Placek K, Hu G, Cui K, Zhang D, Ding Y, Lee JE, et al. MLL4 prepares the enhancer landscape for Foxp3 induction via chromatin looping. Nat Immunol. (2017) 18:1035–45. doi: 10.1038/ni.3812
61. Kitagawa Y, Ohkura N, Kidani Y, Vandenbon A, Hirota K, Kawakami R, et al. Guidance of regulatory T cell development by Satb1-dependent super-enhancer establishment. Nat Immunol. (2017) 18:173–83. doi: 10.1038/ni.3646
62. Josefowicz SZ, Niec RE, Kim HY, Treuting P, Chinen T, Zheng Y, et al. Extrathymically generated regulatory T cells control mucosal TH2 inflammation. Nature. (2012) 482:395–9. doi: 10.1038/nature10772
63. Mathis D and Benoist C. Aire. Annu Rev Immunol. (2009) 27:287–312. doi: 10.1146/annurev.immunol.25.022106.141532
64. Levine AG, Hemmers S, Baptista AP, Schizas M, Faire MB, Moltedo B, et al. Suppression of lethal autoimmunity by regulatory T cells with a single TCR specificity. J Exp Med. (2017) 214:609–22. doi: 10.1084/jem.20161318
65. Nishio J, Baba M, Atarashi K, Tanoue T, Negishi H, Yanai H, et al. Requirement of full TCR repertoire for regulatory T cells to maintain intestinal homeostasis. Proc Natl Acad Sci U S A. (2015) 112:12770–5. doi: 10.1073/pnas.1516617112
66. Shin DS, Ratnapriya S, Cashin CN, Kuhn LF, Rahimi RA, Anthony RM, et al. Lung injury induces a polarized immune response by self-antigen-specific CD4(+) Foxp3(+) regulatory T cells. Cell Rep. (2023) 42:112839. doi: 10.1016/j.celrep.2023.112839
67. Malchow S, Leventhal DS, Nishi S, Fischer BI, Shen L, Paner GP, et al. Aire-dependent thymic development of tumor-associated regulatory T cells. Science. (2013) 339:1219–24. doi: 10.1126/science.1233913
68. Kawakami R and Sakaguchi S. T(reg) cells augment self-tolerance during infection. Nat Immunol. (2025) 26:650–2. doi: 10.1038/s41590-025-02141-7
69. Fan Y, Rudert WA, Grupillo M, He J, Sisino G, and Trucco M. Thymus-specific deletion of insulin induces autoimmune diabetes. EMBO J. (2009) 28:2812–24. doi: 10.1038/emboj.2009.212
70. Steinman L, Ho PP, Robinson WH, Utz PJ, and Villoslada P. Antigen-specific tolerance to self-antigens in protein replacement therapy, gene therapy and autoimmunity. Curr Opin Immunol. (2019) 61:46–53. doi: 10.1016/j.coi.2019.07.011
71. Krienke C, Kolb L, Diken E, Streuber M, Kirchhoff S, Bukur T, et al. A noninflammatory mRNA vaccine for treatment of experimental autoimmune encephalomyelitis. Science. (2021) 371:145–53. doi: 10.1126/science.aay3638
72. Overwijk WW, Lee DS, Surman DR, Irvine KR, Touloukian CE, Chan CC, et al. Vaccination with a recombinant vaccinia virus encoding a “self” antigen induces autoimmune vitiligo and tumor cell destruction in mice: requirement for CD4(+) T lymphocytes. Proc Natl Acad Sci U S A. (1999) 96:2982–7. doi: 10.1073/pnas.96.6.2982
73. Webster KE, Walters S, Kohler RE, Mrkvan T, Boyman O, Surh CD, et al. In vivo expansion of T reg cells with IL-2-mAb complexes: induction of resistance to EAE and long-term acceptance of islet allografts without immunosuppression. J Exp Med. (2009) 206:751–60. doi: 10.1084/jem.20082824
74. Rangachari M and Kuchroo VK. Using EAE to better understand principles of immune function and autoimmune pathology. J Autoimmun. (2013) 45:31–9. doi: 10.1016/j.jaut.2013.06.008
75. Schwartz RH. T cell anergy. Annu Rev Immunol. (2003) 21:305–34. doi: 10.1146/annurev.immunol.21.120601.141110
76. Roncarolo MG, Gregori S, Bacchetta R, Battaglia M, and Gagliani N. The biology of T regulatory type 1 cells and their therapeutic application in immune-mediated diseases. Immunity. (2018) 49:1004–19. doi: 10.1016/j.immuni.2018.12.001
77. Au-Yeung BB, Smith GA, Mueller JL, Heyn CS, Jaszczak RG, Weiss A, et al. IL-2 modulates the TCR signaling threshold for CD8 but not CD4 T cell proliferation on a single-cell level. J Immunol. (2017) 198:2445–56. doi: 10.4049/jimmunol.1601453
78. Cheng LE, Ohlen C, Nelson BH, and Greenberg PD. Enhanced signaling through the IL-2 receptor in CD8+ T cells regulated by antigen recognition results in preferential proliferation and expansion of responding CD8+ T cells rather than promotion of cell death. Proc Natl Acad Sci U S A. (2002) 99:3001–6. doi: 10.1073/pnas.052676899
79. Cattley RT, Lee M, Boggess WC, and Hawse WF. Transforming growth factor beta (TGF-beta) receptor signaling regulates kinase networks and phosphatidylinositol metabolism during T-cell activation. J Biol Chem. (2020) 295:8236–51. doi: 10.1074/jbc.RA120.012572
80. Tu E, Chia CPZ, Chen W, Zhang D, Park SA, Jin W, et al. T cell receptor-regulated TGF-beta type I receptor expression determines T cell quiescence and activation. Immunity. (2018) 48:745–59.e6. doi: 10.1016/j.immuni.2018.03.025
81. Wong HS, Park K, Gola A, Baptista AP, Miller CH, Deep D, et al. A local regulatory T cell feedback circuit maintains immune homeostasis by pruning self-activated T cells. Cell. (2021) 184:3981–97.e22. doi: 10.1016/j.cell.2021.05.028
82. Hu W, Wang ZM, Feng Y, Schizas M, Hoyos BE, van der Veeken J, et al. Regulatory T cells function in established systemic inflammation and reverse fatal autoimmunity. Nat Immunol. (2021) 22:1163–74. doi: 10.1038/s41590-021-01001-4
83. Raffin C, Vo LT, and Bluestone JA. T(reg) cell-based therapies: challenges and perspectives. Nat Rev Immunol. (2020) 20:158–72. doi: 10.1038/s41577-019-0232-6
84. Uenishi GI, Repic M, Yam JY, Landuyt A, Saikumar-Lakshmi P, Guo T, et al. GNTI-122: an autologous antigen-specific engineered Treg cell therapy for type 1 diabetes. JCI Insight. (2024) 9. doi: 10.1172/jci.insight.171844
85. Doglio M, Ugolini A, Bercher-Brayer C, Camisa B, Toma C, Norata R, et al. Regulatory T cells expressing CD19-targeted chimeric antigen receptor restore homeostasis in Systemic Lupus Erythematosus. Nat Commun. (2024) 15:2542. doi: 10.1038/s41467-024-46448-9
86. Schmitt EG, Haribhai D, Williams JB, Aggarwal P, Jia S, Charbonnier LM, et al. IL-10 produced by induced regulatory T cells (iTregs) controls colitis and pathogenic ex-iTregs during immunotherapy. J Immunol. (2012) 189:5638–48. doi: 10.4049/jimmunol.1200936
87. Ramanan D, Pratama A, Zhu Y, Venezia O, Sassone-Corsi M, Chowdhary K, et al. Regulatory T cells in the face of the intestinal microbiota. Nat Rev Immunol. (2023) 23:749–62. doi: 10.1038/s41577-023-00890-w
88. Arai M, Kawakami R, Nakamura Y, Naito Y, Motooka D, Sugimoto A, et al. Oral antigen exposure under costimulation blockade induces Treg cells to establish immune tolerance. J Exp Med. (2026) 223. doi: 10.1084/jem.20251635
89. Panduro M, Benoist C, and Mathis D. Tissue tregs. Annu Rev Immunol. (2016) 34:609–33. doi: 10.1146/annurev-immunol-032712-095948
90. Arpaia N, Green JA, Moltedo B, Arvey A, Hemmers S, Yuan S, et al. A distinct function of regulatory T cells in tissue protection. Cell. (2015) 162:1078–89. doi: 10.1016/j.cell.2015.08.021
Keywords: antigen load, antigen-specific suppression, bystander suppression, immune tolerance, regulatory T cells, TCR repertoire
Citation: Bai L, Choudhary V and Feng Y (2026) The relativity of regulatory T cell suppression modes. Front. Immunol. 17:1771099. doi: 10.3389/fimmu.2026.1771099
Received: 18 December 2025; Accepted: 23 January 2026; Revised: 19 January 2026;
Published: 10 February 2026.
Edited by:
Maria-Luisa Alegre, The University of Chicago, United StatesReviewed by:
Manuel Rojas, University of California, Davis, United StatesJiejie Geng, Air Force Medical University, China
Copyright © 2026 Bai, Choudhary and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Yongqiang Feng, WW9uZy5GZW5nQHN0anVkZS5vcmc=
†These authors have contributed equally to this work
Vivek Choudhary†