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Tregs; are they only suppressor cells?


Dr. Mona Abdel-Halim

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I have been reading a lot last month about T regulatory cells (Tregs) and their role in MF. This subset of T cells are highly specialized subpopulation of CD4+ T cells which exert immunosuppressive effects. They help to check down autoimmune pathways and thus have beneficial effects on the host but being immunosuppressive they also exert suppressive effects on antitumor immune responses in various cancers. Accordingly, they seem to play a role in the etiopathogenesis of various malignancies including CTCLs. The sword by which they exert their immunosuppressive effects is TGF-β1.

What I found interesting is that recently in 2001, two researchers [i]Wang and Ke[/i]* have changed the perception of Tregs being only suppressor cells. In their article, they categorized four groups of Tregs in lymphomas: suppressor, malignant[i], [/i]tumor-killing or incompetent Tregs. The classification into four groups is significant in predicting prognosis and designing Tregs based immunotherapies for treating lymphomas. In patients with lymphomas where Tregs serve either as suppressor Tregs or malignant Tregs, anti-tumor cytotoxicity is suppressed thus decreased numbers of Tregs are associated with a good prognosis and increased numbers of Tregs are associated with a bad prognosis. In contrast, in patients with lymphomas where Tregs serve as tumor-killing Tregs and incompetent Tregs, anti-tumor cytotoxicity is enhanced or anti-autoimmune Tregs activities are weakened thus increased numbers of Tregs are associated with a good prognosis and reduced numbers of Tregs are associated with a poor prognosis. The exact mechanisms behind these effects are still unknown.

Although in our practice as dermatopathologists, we might not need this in depth information about underlying immunopathogenic mechanisms, it is interesting to keep updated every now and then about the latest in this field which is adding a lot to the understanding of skin diseases.

[b]*The Four Types of Tregs in Malignant Lymphomas[/b]
[i]Journal of Hematology & Oncology [/i]2011, [b]4[/b]:50 doi:10.1186/1756-8722-4-50
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