Although a number of immunoregulatory cells have been described in the literature, [4–15], it is thought that CD4+ T cells expressing high levels of the interleukin MAPK Inhibitor Library in vivo (IL)-2 receptor α chain, CD25 are the most important in the maintenance of peripheral tolerance. These CD4+CD25hi regulatory T cells (Tregs) are derived developmentally

from the neonatal thymus [16], but can also be generated directly from naive precursors in the periphery through appropriate activation and cytokine receptor engagement (see below). The former, referred to as natural (n)Tregs, develop in response to self-antigens expressed in the thymus and maintain peripheral self-tolerance while the latter, referred to as induced

(i)Tregs, are thought to develop in response to environmental antigens and maintain tolerance to non-self components such as gut flora and ingested material. These two populations have few characteristics that can distinguish them in the peripheral CP-673451 research buy blood (differences between nTregs and iTregs are summarized in the review by Horwitz et al.[17]), therefore for the purposes of the present paper they will be considered together. The critical, non-redundant, importance of Tregs in mammalian biology is highlighted Etomidate by the development of life-threatening autoimmune diseases in both humans and mice who are deficient in this population (as a result of mutations in the FOXP3 and foxp3 genes, respectively; see below) [15,18–20]. While the precise means of Treg function are not entirely understood it is likely that they possess a functional

repertoire of suppressive mechanisms, which would be consistent with diverse descriptions of suppression through direct cell-to-cell contact, production of soluble mediators [21–23] and activity through intermediary cells [24,25]. As a result, Tregs have the in vitro ability to inhibit proliferation and production of cytokines [notably IL-2 and interferon (IFN)-γ] by non-regulatory, traditional T cells (CD4+CD25-) [26–29] as well as responses of CD8+ T cells, monocytes and natural killer (NK) cells [26,30,31]. These predicates translate in vivo to a greater number of functions other than the maintenance of tolerance to self-components (i.e. prevention of autoimmune disease) [32] and include control of allergic diseases [33], maintenance of gastrointestinal (GI) tolerance [34] and maternal acceptance of semi-allogeneic fetal antigens [35]. A detailed review on Treg functions is provided by O’Connor et al. in this series [36].