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Control of Foxp3 stability through modulation of TET activity
Open accessAbstract
Ten-eleven translocation (TET) enzymes oxidize 5-methylcytosine (5mC) to 5-hydroxymethylcytosine and other oxidized methylcytosines, intermediates in DNA demethylation. In this study, we examine the role of TET proteins in regulating Foxp3, a transcription factor essential for the development and function of regulatory T cells (T reg cells), a distinct lineage of CD4+ T cells that prevent autoimmunity and maintain immune homeostasis. We show that during T reg cell development in the thymus, TET proteins mediate the loss of 5mC in T reg cell–specific hypomethylated regions, including CNS1 and CNS2, intronic cis-regulatory elements in the Foxp3 locus. Similar to CNS2-deficient T reg cells, the stability of Foxp3 expression is markedly compromised in T reg cells from Tet2/Tet3 double-deficient mice. Vitamin C potentiates TET activity and acts through Tet2/Tet3 to increase the stability of Foxp3 expression in TGF-β–induced T reg cells. Our data suggest that targeting TET enzymes with small molecule activators such as vitamin C might increase induced T reg cell efficacy.
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![Figure 1. Double deficiency of Tet2 and Tet3 impairs the loss of 5mC. (A) Schematic representation of the Foxp3 locus. Top: Foxp3 transcript variants and mammalian conservation track are shown, and the conserved promoter region and the three conserved noncoding sequences corresponding to the intronic enhancers CNS1, CNS2, and CNS3 are highlighted with red triangles. Bottom: 11 CpG sites in the CNS2 region that were assessed to determine their methylation-hydroxymethylation status are indicated with red triangles. (B) Dynamic changes in 5mC, 5hmC, and C/5fC/5caC in the Foxp3 CNS2 enhancer during T reg cell lineage specification. The graphs depict the cytosine modification status of the 11 CpGs in the CNS2 region as determined by BS-seq and oxBS-seq in six different T cell subsets (DP, CD4 SP, precursor T reg cells [CD25+Foxp3− and CD25−Foxp3+], thymic T reg cells, and peripheral T reg cells) that together capture the sequential steps of differentiation that lead to T reg cell specification. Error bars (which in many cases are too small to be detectable) show mean ± SD of thousands of sequencing reads from two independent experiments. (C–H) Graphs depicting the percentage of 5mC + 5hmC determined by BS-seq in peripheral T reg cells in 11 CpGs in Foxp3 CNS2 (C), 4 CpGs in Foxp3 CNS1 (D), 4 CpGs in Il2ra intron 1a (E), 7 CpGs in Tnfrsf18 exon 5 (F), 6 CpGs in Ikzf4 intron 1b (G), and 5 CpGs in Ctla4 exon 2 (H). Error bars show mean ± SD of thousands of sequencing reads from three to four independent experiments.](/paper-figures/ab25722154704655aa5d01167fcb9aae/control-of-foxp3-stability-through-modulation-of-tet-activity-figure-1.jpg)







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“The catalytic activity of all three TET family members (TET1, 2 and 3) are induced by vitC,13, 26”
From Vitamin C-induced epigenomic remodelling in IDH1 mutant acute myeloid leukaemia (2018) · cites this paper as [26]
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BackgroundEpigenetics of Modified DNA Bases: 5-Methylcytosine and Beyond
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BackgroundHigh-dose vitamin C enhances cancer immunotherapy
Magrì, A., Germano, G., Lorenzato, A., Lamba, S., Chilà, R., Montone, M., Amodio, V., Ceruti, T., Sassi, F., Arena, S., et al. (2020) · Science Translational Medicine · doi:10.1126/scitranslmed.aay8707 · Cited by 285
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“For example, vitamin C potentiates ten-eleven translocation (TET) activity and acts through Tet2/Tet3 to increase the stability of Foxp3 expression in TGF-β -induced Tregs (112).”
TET (Ten-eleven translocation) family proteins: structure, biological functions and applications
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“Deletion of Tet2 blocks the demethylation effect of vitamin C (58, 59).”
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Ang, A., Pullar, J. M., Currie, M. J., & Vissers, M. C. M. (2018) · Biochemical Society Transactions · doi:10.1042/bst20180169 · Cited by 191
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Self-citationTET proteins regulate the lineage specification and TCR-mediated expansion of iNKT cells
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BackgroundResultInfluentialTET Enzymes and 5hmC in Adaptive and Innate Immune Systems
Lio, C. J., & Rao, A. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.00210 · Cited by 144
“Moreover, overexpression of the TET1 catalytic domain in CD4 cells induced to differentiate into Foxp3-expressing induced Treg cells (iTreg) in vitro and resulted in partial demethylation of CNS2 (65), suggesting that TET enzymes may be in constant balance with the methylation machinery.”
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“Recent research has shown that TET family proteins are extensively involved in this demethylation process and maintain Treg stability [34, 35].”
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“Ascorbic acid (vitamin C), a coenzyme for Tet enzymes that nonspecifically facilitates de novo demethylation of Foxp3 CNS2 in iTreg cells (22 – 24), enhanced the hypomethylation, enabling preparation of a homogenous population of Foxp3 CNS2 hypomethylated CD28( − ) iTregs (Fig.”
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“In the absence of TET2, such effect was most likely due to the enhanced enzymatic activity of other 1570 Cell Reports 15, 1566–1579, May 17, 2016 TET family members (Yue et al., 2016), since VitC treatment did not significantly increase the expression of any Tet mRNA (Figure S4).”
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Self-citationMutations in 5-methylcytosine oxidase TET2 and RhoA cooperatively disrupt T cell homeostasis
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“Cite this article as Cold Spring Harb Perspect Med doi: 10.1101/cshperspect.a026518 5 w w w .p er sp ec ti ve si n m ed ic in e. o rg with consistent effects in ES cells, mouse embryonic fibroblasts, Tregulatory cells (Nair et al. 2016; Yue et al. 2016), and melanoma cells (Gustafson et al. 2015).”
InfluentialFunctional CRISPR dissection of gene networks controlling human regulatory T cell identity
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“Thiswouldbe a significant improvement to the reported approaches, such as in vitro TGF-ß treatment together with vitamin-C, which was shown to induce TSDR de-methylation in mice due to enhanced TET activity, but only induced little demethylation in primary human naive T cells (59).”
BackgroundImprovement of Foxp3 stability through CNS2 demethylation by TET enzyme induction and activation
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“Moreover, inhibition of the Vitamin C transporter reverses the demethylation status of CNS2, both in Vitamin C-treated iTregs in vitro and in peripheral Tregs generated in vivo (Sasidharan Nair et al. 2016).”
BackgroundResultInfluentialSelf-citationSun, X., Cui, Y., Feng, H., Liu, H., & Liu, X. (2019) · The Journal of Experimental Medicine · doi:10.1084/jem.20190550 · Cited by 80
“It has been reported that TET-mediated active DNA demethylation maintains the demethylated status of CNS1 and CNS2 in the Foxp3 locus and regulates the stability of Foxp3 expression (Yue et al., 2016).”
InfluentialmiRNA142-3p targets Tet2 and impairs Treg differentiation and stability in models of type 1 diabetes
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Iizuka-Koga, M., Nakatsukasa, H., Ito, M., Akanuma, T., Lu, Q., & Yoshimura, A. (2017) · Journal of Autoimmunity · doi:10.1016/j.jaut.2017.07.002 · Cited by 79
Air pollution, epigenetics, and asthma
Ji, H., Myers, J. M. B., Brandt, E. B., Brokamp, C., Ryan, P., & Hershey, G. K. K. (2016) · Allergy Asthma and Clinical Immunology · doi:10.1186/s13223-016-0159-4 · Cited by 74
Treg programming and therapeutic reprogramming in cancer
Ayala, M. A. M., Li, Z., & DuPage, M. J. P. (2019) · Immunology · doi:10.1111/imm.13058 · Cited by 75
TET Methylcytosine Oxidases in T Cell and B Cell Development and Function
Tsagaratou, A., Lio, C. J., Yue, X., & Rao, A. (2017) · Frontiers in Immunology · doi:10.3389/fimmu.2017.00220 · Cited by 76
“Vitamin C had the same effects on iTregs differentiated from human peripheral blood T cells; and both human and mouse iTregs generated in the presence of vitamin C showed suppressor activity comparable to that observed in Tregs isolated ex vivo (26).”
BackgroundResultInfluentialSelf-citationRoles of TET and TDG in DNA demethylation in proliferating and non-proliferating immune cells
Onodera, A., González‐Avalos, E., Lio, C. J., Georges, R. O., Bellacosa, A., Nakayama, T., & Rao, A. (2021) · Genome biology · doi:10.1186/s13059-021-02384-1 · Cited by 78
“5mC in WT naïve T cells, drops to very low levels in differentiated T cells, and is absent in TET-deficient cells [24, 35, 36], leading us to refer sometimes to the results of bisulfite”
BackgroundMethodResultInfluentialSelf-citationRegulatory T Cells: Molecular and Cellular Basis for Immunoregulation
Togashi, Y., & Nishikawa, H. (2017) · Current topics in microbiology and immunology · doi:10.1007/82_2017_58 · Cited by 75
“For example, Vitamin C can potentiate Tregs by regulating the activity of TET enzymes, which demethylate Treg-specific hypomethylated regions, including the FOXP3 locus (Yue et al. 2016).”
BackgroundLorenzato, A., Magrì, A., Matafora, V., Audrito, V., Arcella, P., Lazzari, L., Montone, M., Lamba, S., Deaglio, S., Siena, S., et al. (2020) · Cancers · doi:10.3390/cancers12030685 · Cited by 76
“Indeed, it has been reported that VitC can act as an epigenetic remodeling agent on cancer cells [39,40], as well as on several non-neoplastic cell types, including immune cells [41,42].”
BackgroundDietary factors and their influence on immunotherapy strategies in oncology: a comprehensive review
Golonko, A., Pienkowski, T., Świsłocka, R., Orzechowska, S., Marszałek, K., Szczerbiński, Ł., Swiergiel, A. H., & Lewandowski, W. (2024) · Cell Death and Disease · doi:10.1038/s41419-024-06641-6 · Cited by 77
Tet2 deficiency drives liver microbiome dysbiosis triggering Tc1 cell autoimmune hepatitis
Pandey, S. P., Bender, M. J., McPherson, A. C., Phelps, C. M., Sanchez, L. M., Rana, M., Hedden, L., Sangani, K. A., Chen, L., Shapira, J. H., et al. (2022) · Cell Host & Microbe · doi:10.1016/j.chom.2022.05.006 · Cited by 72
Davletgildeeva, A. T., & Kuznetsov, N. A. (2024) · Biomolecules · doi:10.3390/biom14091117 · Cited by 76
“Moreover, TET1 is required for fi broblast On the contrary, vitamin C, which apparently ensures the reduction of Fe(III) to Fe(II) within the enzyme’s active site, is an activator of such enzymes [134,135]. reprogramming [148].”
BackgroundEpigenetic perspectives on systemic autoimmune disease
Karagianni, P., & Tzioufas, A. G. (2019) · Journal of Autoimmunity · doi:10.1016/j.jaut.2019.102315 · Cited by 68
Sex Hormones and Gender Influence the Expression of Markers of Regulatory T Cells in SLE Patients
Singh, R. P., & Bischoff, D. S. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.619268 · Cited by 70
“Although recent evidence suggests that FoxP3 protein stability is controlled by several proteins including cyclin dependent kinase−2 (CDK-2) (103), Pim-2 kinase (104), Nemo-like kinase, and CNS2 (non–coding sequence 2 demethylation by TET (ten-eleven translocation) protein (105, 106).”
BackgroundRegulatory T Cell Stability and Plasticity in Atherosclerosis
Ali, A. J., Makings, J., & Ley, K. (2020) · Cells · doi:10.3390/cells9122665 · Cited by 65
Nair, V. S., Song, M. H., Ko, M., & Oh, K. I. (2016) · Molecules and Cells · doi:10.14348/molcells.2016.0276 · Cited by 67
“Inflammatory cytokines cause CNS2 to be methylated in Tet2 Tregs Previously, it was shown that Tet family members including Tet1, Tet2 and Tet3 have an essential role in demethylating the CpG motifs of the Foxp3 enhancer, CNS2, during the development of Tregs and contribute to the stable expression of Foxp3 (Yang et a…”
InfluentialNakatsukasa, H., Oda, M., Yin, J., Chikuma, S., Ito, M., Iizuka-Koga, M., Someya, K., Kitagawa, Y., Ohkura, N., Sakaguchi, S., et al. (2019) · International Immunology · doi:10.1093/intimm/dxz008 · Cited by 64
Differential roles of regulatory T cells in acute respiratory infections
Jovisic, M., Mambetsariev, N., Singer, B. D., & Morales‐Nebreda, L. (2023) · Journal of Clinical Investigation · doi:10.1172/jci170505 · Cited by 68
Molecular regulation of peripheral B cells and their progeny in immunityPreprint
Boothby, M. R., Hodges, E. C., & Thomas, J. W. (2019) · Genes & Development · doi:10.1101/gad.320192.118 · Cited by 68
“However, amore robust understanding of the functions of the metabolite- and vitamin C-regulated TET dioxygenases (Sasidharan Nair et al. 2016; Yue et al. 2016) in mature B cells and humoral immunity will hinge on use of later-acting and conditional Cre transgenes.”
BackgroundKasahara, H., Kondo, T., Nakatsukasa, H., Chikuma, S., Ito, M., Ando, M., Kurebayashi, Y., Sekiya, T., Yamada, T., Okamoto, S., et al. (2017) · International Immunology · doi:10.1093/intimm/dxx060 · Cited by 61
Qi, T., Sun, M., Zhang, C., Chen, P., Xiao, C., & Chang, X. (2020) · Cell Reports · doi:10.1016/j.celrep.2020.108452 · Cited by 63
TET-Mediated Epigenetic Regulation in Immune Cell Development and Disease
Tsiouplis, N. J., Bailey, D. W., Chiou, L. F., Wissink, F. J., & Tsagaratou, A. (2021) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2020.623948 · Cited by 63
“severe impact on the stability of the Foxp3 expression due to aberrant methylation of the CNS2 locus (Yue et al., 2016).”
BackgroundSelf-citationChang, Y., Rossetti, M. M., Vlamakis, H. C., Casero, D., Sunga, G. M., Harre, N., Miller, S. A., Humphries, R. M., Stappenbeck, T. S., Simpson, K. W., et al. (2018) · Mucosal Immunology · doi:10.1038/s41385-018-0022-7 · Cited by 62
“Moreover, in mice ascorbate facilitates the demethylation of Foxp3 enhancer and promotes Treg cell function 59, 60 .”
Masiuk, K. E., Laborada, J., Roncarolo, M. G., Hollis, R. P., & Kohn, D. B. (2019) · Cell stem cell · doi:10.1016/j.stem.2018.12.003 · Cited by 61
Schlöder, J., Shahneh, F. Z., Schneider, F.-J., & Wieschendorf, B. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.973813 · Cited by 63
Genomic landscape of MDS/CMML associated with systemic inflammatory and autoimmune disease
Zhao, L., Boy, M., Azoulay, C., Clappier, E., Sébert, M., Amable, L., Klibi, J., Benlagha, K., Espéli, M., Balabanian, K., et al. (2021) · Leukemia · doi:10.1038/s41375-021-01152-1 · Cited by 59
New Treg cell-based therapies of autoimmune diseases: towards antigen-specific immune suppression
Mikami, N., Kawakami, R., & Sakaguchi, S. (2020) · Current Opinion in Immunology · doi:10.1016/j.coi.2020.07.004 · Cited by 56
Epigenetic Control of Regulatory T Cell Stability and Function: Implications for Translation
Joudi, A. M., Flores, C. P. R., & Singer, B. D. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.861607 · Cited by 61
“Vitamin C facilitates demethylation of the Foxp3 CNS2 enhancer region in a TET2/3dependent manner to increase the stability of FoxP3 expression in TGF-b-induced Treg cells (33, 98).”
BackgroundLu, P., Chen, L., Wan, J., Liu, W., Lou, S., & Shen, Z. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1179877 · Cited by 60
The transcription factor Batf3 inhibits the differentiation of regulatory T cells in the periphery
Lee, W., Kim, H. S., Hwang, S. S., & Lee, G. R. (2017) · Experimental & Molecular Medicine · doi:10.1038/emm.2017.157 · Cited by 59
Zhang, Z., Zhang, W., Guo, J. F., Gu, Q., Zhu, X., & Zhou, X. (2017) · The Journal of Immunology · doi:10.4049/jimmunol.1601409 · Cited by 58
“CNS2 to further ensure stable Foxp3 expression (14, 15).”
BackgroundZhong, F., Lin, Y., Zhao, L., Yang, C., Ye, Y., & Shen, Z. (2023) · British Journal of Cancer · doi:10.1038/s41416-023-02292-0 · Cited by 58
CMML: Clinical and molecular aspects
Itzykson, R., Duchmann, M., Lucas, N., & Solary, É. (2017) · International Journal of Hematology · doi:10.1007/s12185-017-2243-z · Cited by 64
“TET enzymes have been involved in normal innate and adaptive immunity [36, 37], but how TET2 mutations affect the function of normal T cells remains unclear.”
BackgroundTang, Y., Cui, G., Liu, H., Han, Y., Cai, C., Feng, Z., Shen, H., & Zeng, S. (2024) · 癌症:英文版 · doi:10.1002/cac2.12546 · Cited by 56
“The stability of FOXP3 expression is markedly compromised in Treg cells from TET2/TET3 double-deficient mice [292, 293].”
BackgroundVitamin C enhances the expression of IL17 in a Jmjd2-dependent manner
Song, M. H., Nair, V. S., & Oh, K. I. (2017) · BMB Reports · doi:10.5483/bmbrep.2017.50.1.193 · Cited by 55
“In this study, based on our previous report showing the role of vitamin C in Tregs, we investigated Th17 cells after vitamin C treatment and found that vitamin C exploited Jmjd2 histone demethylases to enhance the expression of IL17.”
InfluentialYuan, X., Yang, B.-H., Dong, Y. W., Yamamura, A., & Fu, W. (2017) · eLife · doi:10.7554/elife.29540 · Cited by 58
“DOI: https://doi.org/10.7554/eLife.29540 8 of 29 CRIg stabilizes Foxp3 expression in iTreg cells iTreg cells lose their expression of Foxp3 when they are restimulated with TCR signaling (Feng et al., 2014; Yue et al., 2016).”
BackgroundInfluentialNikolouli, E., Hardtke‐Wolenski, M., Hapke, M., Beckstette, M., Geffers, R., Floess, S., Jaeckel, E., & Huehn, J. (2017) · Frontiers in Immunology · doi:10.3389/fimmu.2017.00748 · Cited by 54
“Nevertheless, vitamin C-treated allo-iTregs displayed a significantly increased stability of Foxp3 expression upon in vivo transfer, in line with two recently published studies analyzing the stability of Foxp3 expression in polyclonal iTregs generated in presence of vitamin C after adoptive transfer into Rag2−/− or im…”
BackgroundResultInfluentialImproving the Efficacy of Regulatory T Cell Therapy
Baeten, P., Zeebroeck, L. V., Kleinewietfeld, M., Hellings, N., & Broux, B. (2021) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-021-08866-1 · Cited by 52
DNA Methylation in T-Cell Development and Differentiation
Correa, L. O., Jordan, M. S., & Carty, S. A. (2020) · Critical Reviews in Immunology · doi:10.1615/critrevimmunol.2020033728 · Cited by 52
The Plasticity and Stability of Regulatory T Cells during Viral-Induced Inflammatory Lesions
Bhela, S., Varanasi, S. K., Jaggi, U., Sloan, S. S., Rajasagi, N. K., & Rouse, B. T. (2017) · The Journal of Immunology · doi:10.4049/jimmunol.1700520 · Cited by 53
“A previous report had indicated that iTregs generated in the presence of vitamin C + RA could substantially stabilize Foxp3 expression in vitro and in vivo (29, 30).”
BackgroundControl of Foxp3 induction and maintenance by sequential histone acetylation and DNA demethylation
Li, J., Xu, B., He, M.-H., Zong, X., Cunningham, T. J., Sha, C., Fan, Y., Cross, R. J., Hanna, J. H., & Feng, Y. (2021) · Cell Reports · doi:10.1016/j.celrep.2021.110124 · Cited by 52
“Notably, 5-hydroxymethylcytosine (hmC) as an intermediate step of Tet/ASC-induced DNA demethylation has been captured in a broad range of the Foxp3 locus during Treg fate determination (Yue et al., 2021; Yue et al., 2016).”
BackgroundMethodResultInfluentialSakaguchi, S., Kawakami, R., & Mikami, N. (2023) · Immunotherapy Advances · doi:10.1093/immadv/ltad007 · Cited by 54
“Recent studies have demonstrated that nTregs transduced with an alloantigen-reactive TCR-CAR or single-chain Fv-CAR are more efficient than control Tregs in extending skin graft survival and suppressing GvHD in animal models [74–76].”
InfluentialMetabolic reprogramming of T regulatory cells in the hypoxic tumor microenvironment
Nair, V. S., Saleh, R., Toor, S. M., Cyprian, F. S., & Elkord, E. (2021) · Cancer Immunology Immunotherapy · doi:10.1007/s00262-020-02842-y · Cited by 51
The Adaptive Immune System in Multiple Sclerosis: An Estrogen-Mediated Point of View
Maglione, A., Rolla, S., Mercanti, S. F. D., Cutrupi, S., & Clerico, M. (2019) · Cells · doi:10.3390/cells8101280 · Cited by 48
“Moreover, the deletion of CNS2—a FOXP3 enhancer—led to reduced stability and the loss of FOXP3 expression in proliferating Treg cells [140,142,143].”
Background
Metadata
- Authors
- Yue, X., Trifari, S., Äijö, T., Tsagaratou, A., Pastor, W. A., Zepeda-Martínez, J. A., Lio, C.-W. J., Li, X., Huang, Y., Vijayanand, P., Lähdesmäki, H., & Rao, A.
- Affiliations
- La Jolla Institute for Immunology (US)
- Aalto University (FI)
- Corresponding author
- Rao, Anjana
- ORCID
- Venue
- Journal of Experimental Medicine
- Publisher
- Rockefeller University Press
- Published
- 2016-02-22
- Volume
- 213
- Issue
- 3
- Pages
- 377-397
- ISSN
- 0022-1007 (ISSN-L)
- 1540-9538
- PMC
- PMC4813667
- OpenAlex
- W2287054877
- Cited by
- 355
- References
- 60
- Citations by year
- 2026: 34 · 2025: 23 · 2024: 29 · 2023: 33 · 2022: 34 · 2021: 41 · 2020: 39 · 2019: 43 · 2018: 27 · 2017: 38 · 2016: 12
- FWCI
- 24.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Experimental Medicine (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Aaltodoc (Aalto University) (submittedVersion, cc-by-nc-sa)
- Funders
- National Institutes of Health (AI44432, CA151535, HL114093)
- Leukemia and Lymphoma Society (LLS TRP 6464-15)
- Academy of Finland
- Cancer Research Institute
- National Science Foundation
- California Institute for Regenerative Medicine, University of California, San Diego (TG2-01154)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Epigenetics and DNA Methylation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Genomics and Chromatin Dynamics
- Keywords
- Foxp3 stability, TET enzymes, TET2, TET3, regulatory T cells, DNA demethylation, 5-hydroxymethylcytosine, 5-methylcytosine, vitamin C, transcriptional regulation, small molecule activators
- MeSH terms
- Animals, Ascorbic Acid, Cell Differentiation, Cytosine, DNA-Binding Proteins, Humans, Male, Proto-Oncogene Proteins, DNA Methylation, 5-Methylcytosine, Dioxygenases, T-Lymphocytes, Regulatory, Mice, Forkhead Transcription Factors, Protein Stability, HEK293 Cells
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