Development and Function of Effector Regulatory T Cells

Distinguishing self from nonself is a unique feature of the immune system. Although most self-reactive T cells are eliminated in the thymus, a few rogue cells escape the negative selection process and have the potential to mediate autoimmune disease. Over the last decade, there has been a vast improvement in our understanding of the cellular mechanisms that evolved to dampen the deleterious effects of these self-reactive T cells. In particular, T cells expressing the transcription factor FoxP3, known as regulatory T (Treg) cells, play a central role in maintaining immune homeostasis and suppressing autoimmune responses. In addition, Treg cells are endowed with the ability to suppress diverse inflammatory responses both in lymphoid and in nonlymphoid tissues. This requires Treg cells to undergo a peripheral differentiation and specialization program that results in the emergence of effector Treg (eTreg) cells that are characterized by their ability to produce high amounts of immunosuppressive molecules, including IL-10. This chapter discusses the recent advances in our understanding of the mechanisms governing the differentiation, migration, and maintenance of eTreg cells, in particular in nonlymphoid tissues, in health and disease.