Review Article

Regulatory T Cells in Respiratory Health and Diseases

Table 1

The role of regulatory T cells and different immunological biomarkers in regard to different respiratory diseases. “M” accounts for mouse models and “H” for human models.

Disease: mechanismsp.Biomarker studiedReference

Asthma
T-reg cells from patients with allergic asthma have lower expression of FoxP3, XCL1 and XCR1, leading to suboptimal inhibitory function. Also, impaired chemotactic response to CCL1 correlates with asthma severity.HFoxP3[79, 81, 122]
XCL1
XCR1
CCL1
Increased bronchial density of T-regs, effector T cells, proliferative T cells and activated CD8+ T cells in asthmatics exposed to occupational noxious stimulus shows that both the effector T cells and the inhibitory T-reg, system are activated in asthma.HCD4+[83]
CD8+
Airway hyper-reactiveness is modulated by regulatory T cells through induction of TGF-β. Regulatory T cells, modulate lung eosinophilia and Th2 response in allergen-induced airway inflammation.MTGF-β[77, 123]
IL-5
IL-13
Drugs targeting IL-5 decrease asthma exacerbation rate by up to 50% in patients with eosinophilic phenotype.HIL-5[124]

COPD
During COPD exacerbations, increased proportions of pro-inflammatory T-reg subpopulations and decreased proportion of suppressive T-regs are observed. Higher Th17 cell counts are also observed, decreasing the T-regs/Th17 ratio. Elevated regulatory T-cells are observed in pulmonary lymphoid follicles.HIL-17[55, 6466]
IFN-γ
TGF-β
IL-10
CD62L
FoxP3+
Regulatory T cells are present in lower counts in the small airways of patients with COPD as compared to healthy controls.HIL-10[56]
IL-17
TGF-β
Caveolin-1 plays a crucial role in the imbalance between Th17 and T-regs. Populations in patients with COPD.HCav-1[62]
TGF-β
IL-17
Peripheral blood T-regs from COPD have an impaired function to suppress CD4+ T-cell activation when stimulated in vitro.HFoxp3 CD4+[60]
CD45RO+
Proportion of circulating T-regs in COPD patients decreased significantly following long-term treatment with bronchodilators and inhaled steroids.HIL-17A[67]
IL-8
TNF-α
IL-10

IPF
Higher expression of Semaphorin 7a is observed on regulatory T cells from individuals with IPF.H/MSEMA7A[117]
TGF-β1
IFN-γ
IL-4
IL-10
IL-17A
Individuals with IPF have lower proportions of regulatory T cells in bronchoalveolar lavage and peripheral blood and these have limited inhibitory activity. Low T-reg cell counts are inversely correlated with disease severity.HTNF-α[108, 112]
IFN-γ
Ki-67

Lung cancer
Higher proportions of circulating regulatory T-cells are present on lung cancer patients. These are associated to worse clinical outcome.HIL-10[98, 125]
TGF-β
IFN-γ
Tumor production of PGE2 via COX-2 induces regulatory T cell activity by increasing expression of FoxP3. A positive correlation exists between the degree of Treg infiltration and COX-2 expression in NSCLC tumor samples. Recurrence free survival decreases with higher COX-2 expression.M / HCOX-2 & PGE2[126, 127]
EP2 & 4 R
FoxP3

Sarcoidosis
Higher counts of Th17 lymphocytes and lower counts of T-reg. Cells are observed in peripheral blood samples of patients with sarcoidosis.HROR-γt[42]
Circulating regulatory T cell counts are increased in sarcoidosis patients, however these have inefficient suppressive ability. Levels are reduced significantly following corticosteroid therapy.HIL-2[43, 128]
IL-17A
TGF-β1
IL-6
IFN-γ
IL-10
CCL20
A higher ratio of T-helper to T-suppressor cells are observed in the airways of patients with sarcoidosis. These imbalances lead to granuloma formation. Bronchial T-regs in active sarcoidosis highly express ICOS.HICOS ICOS-L[38, 39]