Research advances on targeted-Treg therapies on immune-mediated kidney diseases

Autoimmun Rev. 2023 Feb;22(2):103257. doi: 10.1016/j.autrev.2022.103257. Epub 2022 Dec 20.

Abstract

The primary function of regulatory T cells (Tregs) is blocking the pathogenic immunological response mediated by autoreactive cells, establishing and maintaining immune homeostasis in tissues. Kidney diseases are often caused by Immune imbalance, including alloimmune graft damage after renal transplantation, direct immune-mediated kidney diseases like membranous nephropathy (MN) and anti-glomerular basement membrane (anti-GBM) glomerulonephritis, as well as indirect immune-mediated ones like Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAVs), IgA nephropathy (IgAN) and lupus nephritis (LN). Treg cells are deficient numerically and/or functionally in those kidney diseases. Targeted-Treg therapies, including adoptive Tregs transfer therapy and low-dose IL-2 therapy, have begun to thrive in treating autoimmune diseases in recent years. However, the clinical use of targeted Treg-therapies is rarely mentioned in those kidney diseases above except for kidney transplantation. This article mainly discusses the newest progressions of targeted-Treg therapies in those specific examples of immune-mediated kidney diseases. Meanwhile, we also reviewed the main factors that affect Treg development and differentiation, hoping to inspire new strategies to develop target Tregs-therapies. Lastly, we emphasize the significant impediments and prospects to the clinical translation of target-Treg therapy. We advocate for more preclinical and clinical studies on target Tregs-therapies to decipher Tregs in those diseases.

Keywords: Anti-neutrophil cytoplasmic antibody-associated vasculitis; Direct-immune mediated kidney disease; IgA nephropathy; Kidney transplantation; Lupus nephritis; Regulatory T-lymphocytes.

Publication types

  • Review

MeSH terms

  • Glomerulonephritis*
  • Glomerulonephritis, IGA*
  • Humans
  • Kidney Glomerulus
  • Lupus Nephritis* / pathology
  • T-Lymphocytes, Regulatory