Regulatory T Cells in Arthritis: Why Do they Fail?, pp. 185-199
Authors: (Halima Moncrieffe, Lucy R. Wedderburn, Rheumatology Unit, Institute of Child Health, University College London, London, United Kingdom)
Abstract: Regulatory T cells (Treg) are crucial for suppression of autoimmune responses and employ a number of mechanisms for controlling the immune response. Treg are abundant at the site of inflammation in arthritis yet fail to control the pathological process. Recently the characterisation of surface markers which help define Treg in inflammation have aided investigations into why this failure of immune regulation occurs and has increased our understanding of Treg mechanisms of action. These investigations are complex due to overlap of Treg markers with those found on activated cells. There is increasing evidence that Treg in arthritis have defects in suppressive function. Here we discuss defects in Treg from patients with inflammatory arthritis, with the focus on adult rheumatoid arthritis (RA), and childhood arthritis (juvenile idiopathic arthritis JIA). We review evidence for how these Treg defects might be affected by treatment and possible novel therapeutic strategies.