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Treg cell differentiation is the biological process in which precursor CD4+ T cells acquire a regulatory phenotype, primarily through the stable upregulation of the transcription factor Foxp3, resulting in their ability to suppress immune responses and maintain tolerance to self and non-self antigens. This process can occur both in the thymus (thymic Treg, tTreg) and in the periphery (peripheral Treg, pTreg or iTreg), is tightly regulated by T cell receptor signal strength, co-stimulation (CD28), cytokine milieu (especially TGF-β and IL-2), and several key signaling pathways (e.g., PI3K, NF-κB, mTOR)[1][3][5][7]. Aberrations in Treg differentiation are implicated in autoimmunity, chronic inflammation, and cancer[7].
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