Two FOXP3+CD4+ T cell subpopulations distinctly control the prognosis of colorectal cancers
Abstract
CD4(+) T cells that express the forkhead box P3 (FOXP3) transcription factor function as regulatory T (Treg) cells and hinder effective immune responses against cancer cells. Abundant Treg cell infiltration into tumors is associated with poor clinical outcomes in various types of cancers. However, the role of Treg cells is controversial in colorectal cancers (CRCs), in which FOXP3(+) T cell infiltration indicated better prognosis in some studies. Here we show that CRCs, which are commonly infiltrated by suppression-competent FOXP3(hi) Treg cells, can be classified into two types by the degree of additional infiltration of FOXP3(lo) nonsuppressive T cells. The latter, which are distinguished from FOXP3(+) Treg cells by non-expression of the naive T cell marker CD45RA and instability of FOXP3, secreted inflammatory cytokines. Indeed, CRCs with abundant infiltration of FOXP3(lo) T cells showed significantly better prognosis than those with predominantly FOXP3(hi) Treg cell infiltration. Development of such inflammatory FOXP3(lo) non-Treg cells may depend on secretion of interleukin (IL)-12 and transforming growth factor (TGF)-β by tissues and their presence was correlated with tumor invasion by intestinal bacteria, especially Fusobacterium nucleatum. Thus, functionally distinct subpopulations of tumor-infiltrating FOXP3(+) T cells contribute in opposing ways to determining CRC prognosis. Depletion of FOXP3(hi) Treg cells from tumor tissues, which would augment antitumor immunity, could thus be used as an effective treatment strategy for CRCs and other cancers, whereas strategies that locally increase the population of FOXP3(lo) non-Treg cells could be used to suppress or prevent tumor formation.
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In colorectal cancer patients, FoxP3low Tregs in type B lose their immune suppression capabilities, secrete IL-17 and IFN-γ, and confer a favorable prognosis for patients.
“FoxP3low Tregs in type B CRC lose their immune suppression capabilities, secrete IL-17 and IFN-γ, and confer a favorable prognosis for patients [22].”
From Potential anti-tumor effects of regulatory T cells in the tumor microenvironment: a review (2024) · cites this paper as [22]
FoxP3low non-Tregs with high infiltration in colorectal cancer patients exhibited a superior prognosis.
“The third group of FoxP3low non-Tregs with high infiltration in CRC patients exhibited a superior prognosis [22].”
From Potential anti-tumor effects of regulatory T cells in the tumor microenvironment: a review (2024) · cites this paper as [22]
Tregs with low expression of FOXP3 exhibited markedly lower expression of immunosuppressive molecules, indicating better prognosis in CRC patients, compared to Tregs with high expression of FOXP3.
“Tregs with low expression of FOXP3 exhibited markedly lower expression of immunosuppressive molecules, indicating better prognosis in CRC patients, compared to Tregs with high expression of FOXP3 [51].”
From Gut microbiota-mediated immunomodulation in tumor (2021) · cites this paper as [51]
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Adoptive Treg Cell Therapy in a Patient With Systemic Lupus Erythematosus
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- Authors
- Saito, T., Nishikawa, H., Wada, H., Nagano, Y., Sugiyama, D., Atarashi, K., Maeda, Y., Hamaguchi, M., Ohkura, N., Sato, E., Nagase, H., Nishimura, J., Yamamoto, H., Takiguchi, S., Tanoue, T., Suda, W., Morita, H., Hattori, M., Honda, K., Mori, M., Doki, Y., & Sakaguchi, S.
- Affiliations
- Immunology Frontier Research Center, The University of Osaka (JP)
- The University of Osaka (JP)
- RIKEN Center for Integrative Medical Sciences (JP)
- Tokyo Medical University (JP)
- The University of Tokyo (JP)
- Azabu University (JP)
- Corresponding author
- Nishikawa, Hiroyoshi
- Sakaguchi, Shimon
- ORCID
- Venue
- Nature Medicine
- Published
- 2016-04-25
- Volume
- 22
- Issue
- 6
- Pages
- 679-684
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- OpenAlex
- W2344037260
- Cited by
- 871
- References
- 34
- Citations by year
- 2026: 48 · 2025: 67 · 2024: 106 · 2023: 73 · 2022: 129 · 2021: 132 · 2020: 88 · 2019: 75 · 2018: 75 · 2017: 62 · 2016: 13
- FWCI
- 45.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nature Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (15H04744, 15H06880, 16H06295, 15H06878, 16K15551)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Immunology and Microbiology › Immunology › Immune cells in cancer
- Keywords
- Foxp3, regulatory T cells, colorectal cancer, tumor-infiltrating T cells, CD4+ T cells, prognosis, CD45RA, IL-12, TGF-beta, Fusobacterium nucleatum, intestinal bacteria, tumor invasion, antitumor immunity, Treg depletion
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Neoplasm Staging, Prognosis, Digestive System Surgical Procedures, Colorectal Neoplasms, CD4-Positive T-Lymphocytes, Survival Rate, T-Lymphocyte Subsets, Lymphocytes, Tumor-Infiltrating, T-Lymphocytes, Regulatory, Forkhead Transcription Factors, Interleukin-12 Subunit p35, Transforming Growth Factor beta1
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