Vasoactive intestinal peptide (VIP) is a potent anti-inflammatory neuropeptide that, by inhibiting Th1-driven responses and inducing the emergence of regulatory T cells (T reg)
Regulatory T cells (T reg ) have emerged as a unique population of suppressor T cells orchestrating peripheral immune tolerance (54). Two major populations of T reg , with complementary and overlapping functions in the control of immune response in vivo, have been characterized: naturally occurring, thymus-generated CD4 ϩ CD25 ϩ Forkhead box protein 3 (FoxP3)-expressing T reg and peripherally induced T reg (38,54). Numerous studies have demonstrated the successful therapeutic use of antigen-specific T reg in various experimental models of autoimmune diseases and allogeneic transplantation, providing long-term tolerance by active and specific regulation of self-antigen-and alloantigen-specific T cells (7,38). However, the translation of important biological findings about T regbased immunotherapy to the clinic has been limited mainly by the inability to define their antigenic specificities and by the scarcity of circulating T reg . To solve this problem, two different strategies have been proposed, either facilitating in vivo T reg function or infusing T reg isolated and manipulated/expanded ex vivo. Several approaches have been used to expand naturally occurring human CD4 ϩ CD25 ϩ T reg , mainly by T-cell receptor (TCR)-CD28 stimulation in combination with interleukin 2 (IL-2) and/or 47). An alternative approach consists of the conversion of CD4 ϩ CD25 ϩ T reg from conventional CD4 T cells with inducible factors. Whereas a large body of literature has been dedicated to describing how T reg control ongoing immune responses and tolerance, especially regarding their phenotype, ontogeny, and mechanisms of suppression (38, 54), the endogenous molecules controlling the peripheral expansion or de novo generation of T reg remain largely unknown. For example, the suppressive cytokine transforming growth factor 1 (TGF-1) or immunosuppressive drugs, such as FK778, generate CD4 ϩ CD25 ϩ T reg from the CD4 ϩ CD25 Ϫ T-cell compartment (14,19,35,53,66, 67). The identification of additional T reg -inducing factors should extend the applicability of immunotherapy based on T reg in human patients. Vasoactive intestinal peptide (VIP) is an immunosuppressive neuropeptide with potent anti-inflammatory effects (16). VIP is produced by Th2 cells upon antigenic stimulation and mediates regulatory actions on both innate and adaptive immunity (16). Indeed, VIP-based therapy has been proven successful in the treatment of various experimental models of inflammatory and autoimmune disorders (25). Beside its inhibitory effect on inflammatory and Th1-driven responses, VIP induces the emergence of T reg in animals with experimental autoimmune encephalomyelitis and arthritis (20,26). The in vivo VIP-induced T reg seem to consist of two populations: a major population of FoxP3 ϩ CD4 ϩ CD25 ϩ T reg , the suppressive mechanism for which is mediated through direct cellular...