Regulatory T cells (Tregs)
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Regulatory T-cells (Tregs) are a type of white blood cell that suppresses the body’s immune response and prevents unnecessary inflammation. Tregs are part of the immune system and can enter the brain and the spinal cord to reduce neuroinflammation.
In amyotrophic lateral sclerosis (ALS) — a progressive neurological condition marked by muscle weakness — it’s believed that Tregs lose their ability to effectively suppress the exacerbated response of the immune system, causing the disease to progress faster.
Clinical studies are underway to see if therapeutic strategies targeting Tregs, both drug- and cell-based, can become part of the ALS treatment landscape.
What are Tregs?
Tregs help control the body’s immune system’s response, protecting it from autoimmune diseases and helping control inflammation.
In ALS, however, Tregs become dysfunctional and their anti-inflammatory and immunosuppressive actions are reduced, resulting in neuroinflammation, inflammation in the brain and spinal cord, and impaired motor neuron function.
Tregs also affect disease progression, as decreased numbers of them in ALS patients are associated with a faster disease progression and increased mortality.
It’s for these reasons that Tregs are an attractive therapeutic target in ALS.
Research is mainly focused on whether boosting the levels and/or action of Tregs in the early stages of ALS would slow disease progression as part of an anti-inflammatory immune response.
Tregs and ALS
Both drug-based and cell-based therapies are being investigated as treatment options for improving Treg function in people living with ALS.
Data from a small study (NCT04055623) published in 2022 revealed that intravenous infusions of Tregs combined with injections under the skin, or subcutaneously, of interleukin-2 — a molecule important for Tregs’ development and activation — were safe and well tolerated in people with ALS. The therapy increased Treg immune suppressive function by about 26% over the placebo group during the 24-week trial.
Another small study (NCT03241784), also published in 2022, explored a combination of Tregs and IL-2 to reduce oxidative stress, a type of cellular damage implicated in ALS that activates the immune system. Results suggested the treatment could reduce oxidative stress and pro-inflammatory responses in ALS patients.
More studies are needed to see if Treg-based therapies can reduce neuroinflammation, protect motor neurons, and delay disease progression in people with ALS.
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FAQs about Tregs
Regulatory T-cells (Tregs) are part of the body’s immune system. Tregs are a type of white blood cell that works to suppress the immune response and limit excessive inflammation.
Research is ongoing to determine whether treatments based on regulatory T-cells (or Tregs) can help ease amyotrophic lateral sclerosis (ALS). Researchers want to see if boosting their levels and/or action in the early stages of ALS could slow disease progression.
A number of studies in people with amyotrophic lateral sclerosis (ALS) have shown it’s safe in a laboratory setting to collect and expand a patient’s own regulatory T-cells, boost their immunosuppressive action, and then infuse them back into that person. Although small in scale, such studies have shown the procedure is safe and well tolerated.
Research has made a link between decreasing regulatory T-cell (or Treg) levels in people with amyotrophic lateral sclerosis (ALS) and an increased rate of disease progression. Moreover, Tregs of ALS patients are known to become dysfunctional, with reduced anti-inflammatory and immunosuppressive actions, contributing to neuroinflammation and the disease symptoms.
Lifestyle factors such as military service, smoking, exposure to toxic chemicals, and strenuous exercise are risk factors for developing amyotrophic lateral sclerosis (ALS). Other possible risk factors include head trauma, electrical shock, and certain viral infections. Biological factors such as gender, age, and immune response also can contribute to developing the disease.
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