Prenatal tolerance--a role for regulatory T cells?

Regulatory T cells (TR cells) play a major role in controlling immune self reactivity. However, little is known about their occurrence and functions in early developmental stages. In this issue of the European Journal of Immunology, Cupedo et al. report the presence of functional CD4+CD25+ TR cells in the human fetus. In contrast to previous studies, the analysis is performed on fetal thymus, spleen and lymph node samples in addition to cord blood cells. Interestingly, TR cells are present in all these organs from 14 weeks of gestation, along with FoxP3 (forkhead box protein 3) RNA, a marker for naturally arising TR cells. The fetal TR cells show, however, phenotypic differences depending on their location, possibly because of variations in their activation state. The emergence of TR cells so early in fetal development raises a number of questions about the mechanisms of self reactivity and tolerance in the prenatal stages, which may have important implications for our understanding of childhood pathologies.