Regulatory T cells in immune-mediated renal disease

• Published in: Nephrology (Carlton, Vic.) Vol. 21; no. 2; pp. 86 - 96
• Main Authors: Ghali, Joanna R, Wang, Yuan Min, Holdsworth, Stephen R, Kitching, A Richard
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.02.2016
• Subjects: acute kidney injury; Animals; anti-cytoplasmic neutrophil antibody-associated vasculitis; anti-glomerular basement membrane disease; Autoimmune Diseases - immunology; Autoimmune Diseases - metabolism; Autoimmune Diseases - pathology; Autoimmune Diseases - therapy; Autoimmunity; Disease Models, Animal; Humans; Immune Tolerance; Immunotherapy - methods; Kidney Diseases - immunology; Kidney Diseases - metabolism; Kidney Diseases - pathology; Kidney Diseases - therapy; lupus erythematosus; Lymphocyte Activation; Mice; Phenotype; regulatory T cell; systemic; T-Lymphocytes, Regulatory - immunology; T-Lymphocytes, Regulatory - metabolism; T-Lymphocytes, Regulatory - pathology; T-Lymphocytes, Regulatory - transplantation; anti-glomerular basement membrane disease; systemic; acute kidney injury; regulatory T cell; anti-cytoplasmic neutrophil antibody-associated vasculitis; lupus erythematosus
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/nep.12574

Regulatory T cells (Tregs) are CD4+ T cells that can suppress immune responses by effector T cells, B cells and innate immune cells. This review discusses the role that Tregs play in murine models of immune‐mediated renal diseases and acute kidney injury and in human autoimmune kidney disease (such as systemic lupus erythematosus, anti‐glomerular basement membrane disease, anti‐neutrophil cytoplasmic antibody‐associated vasculitis). Current research suggests that Tregs may be reduced in number and/or have impaired regulatory function in these diseases. Tregs possess several mechanisms by which they can limit renal and systemic inflammatory immune responses. Potential therapeutic applications involving Tregs include in vivo induction of Tregs or inducing Tregs from naïve CD4+ T cells or expanding natural Tregs ex vivo, to use as a cellular therapy. At present, the optimal method of generating a phenotypically stable pool of Tregs with long‐lasting suppressive effects is not established, but human studies in renal transplantation are underway exploring the therapeutic potential of Tregs as a cellular therapy, and if successful may have a role as a novel therapy in immune‐mediated renal diseases. Summary at a Glance In this cutting edge review, Ghali et al. describe the ‘state of the art’ of the field of regulatory T cells, which are poised to impact in Nephrology and Transplantation.