IntroductionBone marrow transplantation (BMT) is a potentially curative treatment for both hematologic and nonhematologic diseases, but the wider use of allogeneic BMT is limited by the frequent and severe outcome of graft-versus-host disease (GVHD). 1 Unfortunately, efforts to reduce GVHD by removing donor T cells from the graft have resulted in poor engraftment and elevated disease recurrence, indicating a pivotal role of donor T cells in promoting engraftment of the donor hematopoietic compartment. 2,3 CD8 T cells have been found to be much more potent facilitators of both initial and long-term engraftment than CD4 T cells in murine transplantation models. 4,5 However, both CD8 and CD4 T cells are capable of mediating GVHD. Moreover, attempting to reduce GVHD by limiting perforin and FasL function has not prevented GVHD, and CD8 T cells would likely have detrimental effects on engraftment and the capacity for graft-versus-leukemia (GVL) responses. 5-9 Therefore, identifying cell populations capable of supporting allogeneic hematopoietic stem/progenitor cell (HSPC) engraftment without inducing GVHD could circumvent the hazards of conventional T cells, thereby broadening the pool of acceptable donors.Although unfractionated CD4 T cells have not been shown to possess efficient facilitating potential, the CD25 ϩ regulatory fraction, representing approximately 10% of peripheral CD4 T cells, represents a potentially attractive alternative to CD8 T cells for promotion of engraftment. 4,5 Identified by their role in suppressing autoimmunity, CD4 ϩ CD25 ϩ T cells have demonstrated a capacity to inhibit T-cell activation in vitro and T-cell-mediated autoimmune disease in vivo. 10,11 This T-cell suppression has been employed to inhibit alloreactive responses and prevent GVHD in murine models of hematopoietic transplantation. [12][13][14][15] Although suppression has been demonstrated in vitro to require signaling via their antigen receptor, CD4 ϩ CD25 ϩ suppressor cells and responder T cells can have distinct T-cell-receptor (TCR) specificities. 16,17 Little is presently understood regarding CD4 ϩ CD25 ϩ antigen recognition in vivo. With regard to their application to transplantations, it is interesting to consider the possibility that donor CD4 ϩ CD25 ϩ T cells could be activated by transplanted selfantigens and/or recipient-derived alloantigens. 16,[18][19][20][21][22] We therefore hypothesized that appropriate TCR signaling of donor CD4 ϩ CD25 ϩ T cells would occur after transplantation, and this population could assist donor HSPCs in overcoming the host resistance independent of the specter of GVHD.The present studies have assessed the capacity of donor CD4 ϩ CD25 ϩ T cells to support engraftment of donor bone marrow grafts in a complete major histocompatibility complex (MHC)-mismatched (B6 3 BALB/c) BMT model. The transplantation of CD4 ϩ CD25 ϩ T cells into sublethally conditioned recipients resulted in decreased rejection of both lineage-committed and multipotential donor hematopoietic progenitors within the firs...