Elevated levels of intracellular cyclic adenosine monophosphate (cAMP) in naturally occurring T regulatory (nTreg) cells play a key role in nTreg-cell-mediated suppression. Upon contact with nTreg cells, cAMP is transferred from nTreg cells into activated target CD4 + T cells and/or antigen-presenting cells (APCs) via gap junctions to suppress CD4+
T-cell function. cAMP facilitates the expression and nuclear function of a potent transcriptional inhibitor, inducible cAMP early repressor (ICER), resulting in ICER-mediated suppression of interleukin-2 (IL-2). Furthermore, ICER inhibits transcription of nuclearfactor of activated T cell c1/α (NFATc1/α) and forms inhibitory complexes with preexisting NFATc1/c2, thereby inhibiting NFAT-driven transcription, including that of IL-2. In addition to its suppressive effects mediated via ICER, cAMP can also modulate the levels of surface-expressed cytotoxic T lymphocyte antigen-4 (CTLA-4) and its cognate B7 ligands on conventional CD4 + T cells and/or APCs, fine-tuning suppression. These cAMP-driven nTreg-cell suppression mechanisms are the focus of this review.
Keywords: CD4+ T cells r Costimulatory molecules r Gene regulation r Regulatory T (Treg) cells r Signal transduction
IntroductionNaturally occurring CD4 + T regulatory (nTreg) cells are essential for maintaining peripheral tolerance; they prevent autoimmunity and limit chronic inflammatory diseases [1]. Immune responses, both protective and harmful, are principally mediated by T and B cells, which possess enormous diversity in antigen recognition, potent effector functions, and long-lasting immunologic memory. Every adaptive immune response involves the recruitment and activation of not only effector T and B cells but also nTreg cells, and the balance between effector and regulatory lymphocytes is criticalCorrespondence: Dr. Josef Bodor e-mail: bodor@uni-mainz.de for the proper control of adaptive immune responses. This balance is also critical for establishing or breaching tolerance against selfand nonself-antigens. Aside from peripheral conversion, the majority of nTreg cells are generated in the thymus with their frequency increasing from the late CD4 + CD8 + double positive to the CD4 + CD8 − single positive stage [2,3]. Remarkably, this coincides with the stage of thymic development during which human medullary thymocytes acquire cyclic AMP (cAMP) mediated expression of inducible cAMP early repressor (ICER) [4]. As ICER is a mediator of nTregcell suppression (see below and the section cAMP and Foxp3 direct ICER-mediated suppression), this suggests that competence to suppress develops in nTreg cells simultaneously with the ability of CD4 + T cells to be suppressed via upregulation of ICER.nTreg cells can have both beneficial effects, for example, preventing autoimmune diseases, and deleterious effects, for Eur. J. Immunol. 2012Immunol. . 42: 1375Immunol. -1384 example, impairing effective antitumor responses. Understanding the mechanisms of immunological self-tolerance, including those regulated by nTreg cells...