Regulatory T cell therapy as individualized medicine for asthma and allergy

Regulatory T cells have been identified as key players in the maintenance of peripheral tolerance, which prevents inappropriate immune responses to both self-antigens and innocuous allergens. This review aims to provide an update on our current understanding of the therapeutic potential of naturally occurring and adaptive regulatory T cell subsets in allergic and asthmatic disease.

Evidence is emerging that regulatory T cells control aberrant immune responses to allergens in health and exhibit impaired function in active disease. These data provide a rationale for developing therapeutic strategies that promote regulatory T cell numbers or function in patients.

Preclinical studies of adoptive transfer of antigen-specific regulatory T cells into mouse models of allergic airway disease ameliorate the inflammatory response and in some studies airway hyperresponsiveness. Although these studies are encouraging this remains an invasive and expensive therapeutic protocol for the treatment of allergic disease in humans and a number of concerns relating to safety and efficacy exist. Existing therapies, both allergen specific immunotherapy and nonspecific treatments such as glucocorticoids, induce IL-10 secreting T regulatory populations in patients. Strategies to combine allergen immunotherapy with add-on treatments or adjuvants with the potential to boost regulatory T cells, safety and efficacy remain a major research focus.