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MSC + Tregs refers to a combination cell therapy using mesenchymal stromal (or stem) cells (MSCs) and regulatory T cells (Tregs). Both are advanced cell-based immunotherapies with potent immunomodulatory properties. - **Mesenchymal stromal/stem cells** are multipotent adult stem cells known for their ability to modulate immune responses, suppress inflammation, and promote tissue repair. They exert their effects by secreting anti-inflammatory cytokines such as transforming growth factor-beta 1 (TGF-β1), indoleamine 2,3- dioxygenase (IDO), prostaglandin E2 (PGE2), interleukin-6 (IL-6), nitric oxide, and galectin-1[2]. These factors suppress effector immune cell proliferation—including CD4+ and CD8+ T lymphocytes—and induce the formation of regulatory immune subsets. - **Regulatory T cells** are a specialized subset of CD4+ lymphocytes characterized by high expression of CD25 and Foxp3. They play a central role in maintaining immune tolerance by suppressing autoreactive or overactive immune responses. The combination approach leverages the ability of MSCs to induce or expand functional regulatory T cell populations from conventional CD4+ lymphocytes via epigenetic reprogramming mechanisms involving increased expression of PD-L1 on MSCs, higher PD-1 on induced-Treg-like populations, secretion of anti-inflammatory cytokines like TGF-β1, and modulation through IDO activity[1][2][3]. This results in enhanced generation or expansion of stable Foxp3+CD25highCD127low regulatory populations that can further contribute to suppression of pathological immunity. The combined use is being explored for autoimmune diseases, transplant tolerance induction, sepsis management, and other conditions where excessive or misdirected immunity is pathogenic.
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