Article Text
Abstract
The prevalence of IBD is rising in the Western world. Despite an increasing repertoire of therapeutic targets, a significant proportion of patients suffer chronic morbidity. Studies in mice and humans have highlighted the critical role of regulatory T cells in immune homeostasis, with defects in number and suppressive function of regulatory T cells seen in patients with Crohn’s disease. We review the function of regulatory T cells and the pathways by which they exert immune tolerance in the intestinal mucosa. We explore the principles and challenges of manufacturing a cell therapy, and discuss clinical trial evidence to date for their safety and efficacy in human disease, with particular focus on the development of a regulatory T-cell therapy for Crohn’s disease.
- Crohn's disease
- immunology
- immunoregulation
- intestinal T cells
- T lymphocytes
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Footnotes
JNC and OSO contributed equally.
Contributors JNC and OSO performed a systematic literature search. JNC, OSO and ST wrote the manuscript and created the table and figures. GML and PMI reviewed the article and contributed to critical revisions of the manuscript. All authors have approved the final version of this article.
Disclaimer The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR or the Department of Health.
Competing interests PMI is the Chief Investigator and GML is the Chief Scientific Investigator on the Medical Research Council-funded TRIBUTE trial of Treg immunotherapy in CD (ClinicalTrials.gov NCT03185000).
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.