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Functional Regulatory T Cells Accumulate in Aged Hosts and Promote Chronic Infectious Disease Reactivation
Open accessAbstract
Declines in immune function are well described in the elderly and are considered to contribute significantly to the disease burden in this population. Regulatory T cells (Tregs), a CD4+ T cell subset usually characterized by high CD25 expression, control the intensity of immune responses both in rodents and humans. However, because CD25 expression does not define all Tregs, especially in aged hosts, we characterized Tregs by the expression of FOXP3, a transcription factor crucial for Treg differentiation and function. The proportion of FOXP3+CD4+ Tregs increased in the blood of the elderly and the lymphoid tissues of aged mice. The expression of functional markers, such as CTLA-4 and GITR, was either preserved or increased on FOXP3+ Tregs from aged hosts, depending on the tissue analyzed. In vitro depletion of peripheral Tregs from elderly humans improves effector T cell responses in most subjects. Importantly, Tregs from old FoxP3-GFP knock-in mice were suppressive, exhibiting a higher level of suppression per cell than young Tregs. The increased proportion of Tregs in aged mice was associated with the spontaneous reactivation of chronic Leishmania major infection in old mice, likely because old Tregs efficiently suppressed the production of IFN-γ by effector T cells. Finally, in vivo depletion of Tregs in old mice attenuated disease severity. Accumulation of functional Tregs in aged hosts could therefore play an important role in the frequent reactivation of chronic infections that occurs in aging. Manipulation of Treg numbers and/or activity may be envisioned to enhance the control of infectious diseases in this fragile population.
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“Moreover, aged skin exhibits increased numbers of regulatory T cells (Tregs)166 and elevated expression of the immunosuppressive receptor PD-1,165,167 which may contribute to weakened adaptive immunity.”
From Inflammation and aging: signaling pathways and intervention therapies (2023) · cites this paper as [166]
Experimental — accuracy not yet measuredIn the citing paper
“Total CD4+ Treg cell numbers in blood are largely stable or increased”
From Successful and Maladaptive T Cell Aging (2017) · cites this paper as Lages et al., 2008
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Citations
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BackgroundThe presence of Tregs does not preclude immunity to reinfection with Leishmania braziliensis
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Cho, H., Kikuchi, M., Li, Y., Nakamoto, N., Amorosa, V., Valiga, M. E., & Chang, K. (2014) · Frontiers in Immunology · doi:10.3389/fimmu.2014.00265 · Cited by 18
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“In any event, the CD4þ CD25þ T cells represented around 10% of the CD4 T cells in control and SCNT cattle, similar to what has been found in the mouse (Lages et al., 2008) and in humans ( Jonuleit et al.”
InfluentialHuang, M., Greig, N. H., Luo, W., Tweedie, D., Schwartz, J. B., Longo, D. L., Ferrucci, L., Ershler, W. B., & Goetzl, E. J. (2010) · Clinical Immunology · doi:10.1016/j.clim.2010.11.002 · Cited by 17
“aspects of dysregulated T cell function regularly observed in immunosenescence include formation of a less effective synapse between antigen-presenting cells and T cells, decreases in some enhancing subsets of T cells, and increases in the number and especially activities of suppressor Treg subsets [16–20].”
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BackgroundThe difficult management of anaphylaxis in the elderly
González‐de‐Olano, D., Lombardo, C., & Gonzalez-Mancebo, E. (2016) · Current Opinion in Allergy and Clinical Immunology · doi:10.1097/aci.0000000000000280 · Cited by 16
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Paracrine FGF21 dynamically modulates mTOR signaling to regulate thymus function across the lifespan
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Nutrition as a Tool to Reverse Immunosenescence?
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“Immune senescence leads to a reduction of T helper (Th)1 cell-driven immunity and a shift towards Th2 polarization, indicated by elevated serum antibody levels, peripheral eosinophilia, and/or tissue eosinophil infiltration (13) and a reduced activity of T regulatory (Treg) cells (14, 15).”
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BackgroundReduced immune-regulatory molecule expression on human colonic memory CD4 T cells in older adults
Dillon, S. M., Thompson, T. A., Christians, A. J., McCarter, M. D., & Wilson, C. C. (2021) · Immunity & Ageing · doi:10.1186/s12979-021-00217-0 · Cited by 14
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Enhancing thymic function improves T-cell reconstitution and immune responses in aged mice
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Testicular immunosenescence: a key player in age-related spermatogenic decline
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“The adjustment for age and sex was performed in order to avoid misinterpretation of the data since all pre-diabetic individuals in our study were male and some subsets of immune cells tend to change with age [32] and could differ in number in male compared to female [33].”
BackgroundMethodThe Effect of Oral Tolerance on the Allergic Airway Response in Younger and Aged Mice
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“…studies are required to investigate whether these findings extend to aging-induced susceptibility to pathogens that cause more persistent infection (Lages et al., 2008), and the use of accelerated aging mice to dissect the immune pathogenesis of aging increasingly recognized to parallel latent…”
BackgroundInfluentialLost in translation: mice, men and cutaneous immunity in old age
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“FoxP3? regulatory T cells (Treg) (Lages et al. 2008), although we also found increased CD4 and CD8 T cells present in old skin, in contrast to the very few found in the skin of adult mice (Table 1).”
Snodgrass, R. G., Jiang, X., Stephensen, C. B., & Laugero, K. D. (2023) · Immunity & Ageing · doi:10.1186/s12979-023-00357-5 · Cited by 12
“Such discordances between studies may stem from different phenotypic markers used to define Treg populations such as CD3 + CD4 + CD25 + CD127low [41–44], CD4 + FoxP3+ [38, 40], and CD4 + CD25 + FoxP3+ [45].”
BackgroundResultAgeing of T-dependent B cell responses
Martinez, F., Novarino, J., Mejía, J. E., Fazilleau, N., & Aloulou, M. (2021) · Immunology Letters · doi:10.1016/j.imlet.2021.03.012 · Cited by 15
Regulatory T cells and vaccine effectiveness in older adults. Challenges and prospects
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“Accumulation of Tregs during aging has been described in mice and humans (Pieren et al., 2019; Lages et al., 2008; Sharma et al., 2006; Gregg et al., 2005; Nishioka et al., 2006; Elyahu et al., 2019) and is thought to limit protective immune responses.”
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Regulatory T-Cells, FoxP3 and Atherosclerosis
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“Indeed, reports [34,35] have shown that the presence of increased Treg populations in agedmice are responsible for the lack of appropriate pro-inflammatory response against infections by Treg suppression of IFN-g production.”
Backgroundde Andrade, R. M., Hygino, J., Kasahara, T. M., Vieira, M. M. M., Xavier, L. F., Blanco, B., Damasco, P. V., Silva, R. M., de Lima, D. B., Oliveira, A. L. V. S. M., et al. (2012) · Clinical Immunology · doi:10.1016/j.clim.2012.08.002 · Cited by 10
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“This is in agreement with previous reports that suggested that the percentage of CD4? lymphocytes expressing CD25 increased with age [22–24].”
ResultFeatures of T-cell subset composition in a D-galactose-induced senescence mouse model
Kawata, K., Suzuki, T., Ozawa, K., & Sekiguchi, M. (2021) · EXPERIMENTAL ANIMALS · doi:10.1538/expanim.20-0095 · Cited by 10
Ludwig, L. M., Roach, L. E., Katz, S. G., & LaBelle, J. L. (2020) · APOPTOSIS · doi:10.1007/s10495-020-01593-6 · Cited by 11
Mortality and prognosis in herpes simplex Virus-1 encephalitis long-term follow up study
Katson, M., Gorenshtein, A., Pepys, J., Mina, Y., & Shelly, S. (2024) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2024.123330 · Cited by 10
Fisher, J. S., Adán‐Barrientos, I., Kumar, N., & Lancaster, J. N. (2024) · Aging Cell · doi:10.1111/acel.14140 · Cited by 8
The role of age‐related T‐cell differentiation in patients with renal replacement therapy
Schaier, M., Leick, A., Uhlmann, L., Kälble, F., Eckstein, V., Ho, A. D., Meuer, S. C., Mahnke, K., Sommerer, C., Zeier, M. G., et al. (2017) · Immunology and Cell Biology · doi:10.1038/icb.2017.57 · Cited by 9
da Silva, P. H. L., de Castro, K. K. G., Mendes, M. A., Leal-Calvo, T., Leal, J. M. P., Nery, J. A. D. C., Sarno, E. N., Lourenço, R. A., Moraes, M. O., Lara, F. A., et al. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.647385 · Cited by 9
“In fact, CMV seropositivity seems to be a determinant factor of life expectancy, CMV individuals who present other risk factors, such as increase in CD8CD28 cells tend to have a shorter life span (54, 55).”
BackgroundThe ageing immune system and its clinical implications
Wordsworth, D., & Dunn‐Walters, D. K. (2010) · Reviews in Clinical Gerontology · doi:10.1017/s0959259810000407 · Cited by 9
Changes in Immune Function in Asthma in the Elderly
Mathur, S. K., & Nyenhuis, S. M. (2009) · Aging Health · doi:10.2217/ahe.09.47 · Cited by 9
“In addition, an increased proportion of FOXP3+ CD4+ T regulatory cells with intact suppressive capabilities have been found in elderly subjects, which may help explain the decreased T-cell functional activities described above[35].”
BackgroundStacy, S., Williams, E. L., Standifer, N. E., Pasquali, A., Krolick, K. A., Infante, A. J., & Kraig, E. (2010) · The Journal of Immunology · doi:10.4049/jimmunol.0901618 · Cited by 9
“Moreover, suppressive functions of Tregs are generally well maintained (18).”
BackgroundAged regulatory T cells fail to control autoimmune lacrimal gland pathogenic CD4+ T cells
Scholand, K. K., Schaefer, L., Govindarajan, G., Yu, Z., Galletti, J. G., & de Paiva, C. S. (2025) · GeroScience · doi:10.1007/s11357-025-01576-y · Cited by 8
“Despite this increase in inflammation, aging is also accompanied by an accumulation of Tregs [29–31].”
Ageing-Associated Transcriptomic Alterations in Peri-Implantitis Pathology: A Bioinformatic Study
Tian, Z. (2022) · Disease Markers · doi:10.1155/2022/8456968 · Cited by 8
“impaired T cell function and immune responses, and chronic disease occurrence [42].”
BackgroundImmunosenescence Does Not Abrogate Engraftment of Murine Allogeneic Bone Marrow
Hock, K., Oberhuber, R., Lee, Y.-L., Wrba, F., Wekerle, T., & Tullius, S. G. (2013) · Transplantation · doi:10.1097/tp.0b013e3182954618 · Cited by 8
Ulndreaj, A., Ávila, A., Hong, J., Zhou, C., Fehlings, M. G., & Vidal, P. M. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms231911496 · Cited by 8
“During aging certain T cells subsets accumulate in the spleen and peripheral lymph nodes [33].”
BackgroundNacka-Aleksić, M., Pilipović, I., Stojić-Vukanić, Z., Kosec, D., Bufan, B., Vujnović, I., Arsenović-Ranin, N., Dimitrijević, M., & Leposavić, G. (2015) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2015.09.004 · Cited by 6
Critical influence of the thymus on peripheral T cell homeostasis
Vianna, P. H. O., Canto, F. B., Nogueira, J. D. S., Nunes, C. F. C. G., Bonomo, A. C., & Fucs, R. (2016) · Immunity Inflammation and Disease · doi:10.1002/iid3.132 · Cited by 8
Neațu, M., Hera-Drăguț, A., Ioniță, I., Jugurt, A., Davidescu, E. I., & Popescu, B. O. (2024) · Biomedicines · doi:10.3390/biomedicines12081890 · Cited by 7
Skin immunity and inflammation: cellular interactions and communication
Narayanan, D., Sim, S.-L., & Kumari, S. (2025) · Clinical & Translational Immunology · doi:10.1002/cti2.70053 · Cited by 10
“20,21 UV exposure also modulates melanocytes, innate cells with the capacity to moderate local immune diversity and provide photoprotection as well as serve as a first line of defence during infection.”
Mechanisms of age-related Treg dysfunction in an arthritic environment
Nishiyama, T., Ohyama, A., Miki, H., Asashima, H., Kondo, Y., Tsuboi, H., Ohno, H., Shimano, H., & Matsumoto, I. (2024) · Clinical Immunology · doi:10.1016/j.clim.2024.110337 · Cited by 7
Barthlott, T., Bosch, A. J. T., Berkemeier, C. M., Nogales‐Cadenas, R., Jeker, L. T., Keller, M. P., Pascual-Montano, A., & Holländer, G. A. (2015) · European Journal of Immunology · doi:10.1002/eji.201445235 · Cited by 9
Increased plasma concentrations of interleukin 35 in patients with coronary artery disease
Gorzelak‐Pabiś, P., Chałubiński, M., Wojdan, K., Łuczak, E., Duraj, I., Możdżan, M., & Broncel, M. (2017) · Archives of Medical Science · doi:10.5114/aoms.2016.63751 · Cited by 7
Chetty-Sebastian, D., & Assounga, A. G. H. (2023) · BMC Cancer · doi:10.1186/s12885-023-11345-9 · Cited by 6
“It has been suggested that the accumulation of Treg frequency in older individuals can promote chronic infectious disease reactivation [64].”
BackgroundWang, Y., Nag, M., Tuohy, J. L., & Fogle, J. E. (2017) · Veterinary Sciences · doi:10.3390/vetsci4010012 · Cited by 6
Eledo, B. O. (2017) · American Journal of Laboratory Medicine · doi:10.11648/j.ajlm.20170206.14 · Cited by 6
Cutaneous adaptive immunity and uraemia: a narrative review
Zibandeh, N., Li, Z., Ogg, G. S., & Bottomley, M. J. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1464338 · Cited by 6
Deng, H., Mao, G., Zhang, J., Wang, Z., & Li, D.-D. (2010) · Molecular Immunology · doi:10.1016/j.molimm.2010.07.015 · Cited by 5
The late effects of radiation on lifespan, lymphocyte proliferation and p53 haplodeficiency in mice
Okazaki, R., Mabuchi, Y., Yoshida, Y., Suzuki, S., Ding, N., Matsuzaki, Y., Ootsuyama, A., & Norimura, T. (2010) · International Journal of Radiation Biology · doi:10.3109/09553002.2010.496031 · Cited by 5
“In mice over 20 months of age, decline in immune function is well established as compared to mice at approximately three months of age (Haynes and Eaton 2005, Lages et al. 2008).”
BackgroundImmunity, Inflammation, and Aging
Meyer, K. C. (2013) · Elsevier eBooks · doi:10.1016/b978-0-12-397803-5.00003-4 · Cited by 5
Nutraceuticals in immunosenescence
Magrone, T., & Jirillo, E. (2015) · Anti‐ageing nutrients · doi:10.1002/9781118823408.ch5 · Cited by 4
Jung, M., Kim, H., Choi, E., Shin, M., & Shin, S. J. (2024) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2024.2317439 · Cited by 5
Mechanisms of Immune Protection to Pneumococcal Infection in the Young and the Elderly
Baxendale, H., & Brown, J. (2011) · Springer eBooks · doi:10.1007/978-3-0346-0219-8_5 · Cited by 4
“Increased numbers and/or function of regulatory T cells have been described in the elderly [339, 340] in association with shifts in T cell repertoires [341, 342] and impaired ability to generate effective memory responses [343].”
BackgroundWigand, M. C. C., Jeske, S. S., Hahn, J., Doescher, J., Laban, S. A., Hoffmann, T. K., & Schuler, P. J. (2019) · HNO · doi:10.1007/s00106-019-00758-3 · Cited by 4
AGE-DEPENDENT CHANGES OF T-REGULATORY AND Th17 SUBSET LEVELS IN PERIPHERAL BLOOD FROM HEALTHY HUMANS
Топтыгина, А. П., Semikina, E. L., Петричук, С. В., Шакирович, З. Р., Курбатова, О. В., Анатольевна, К. Е., & Komakh, Y. A. (2017) · Medical Immunology (Russia) · doi:10.15789/1563-0625-2017-4-409-421 · Cited by 4
TREG cells in transplantation—a double-edged sword?
Lakkis, F. G. (2014) · Nature Reviews Nephrology · doi:10.1038/nrneph.2014.35 · Cited by 4
The Evolving Field of Regenerative Aesthetics: A Review and Case Series
Corduff, N., Goldie, K., Lin, F. G., Lowe, S., Siew, T. W., Vachiramon, V., Chao, Y. Y. Y., Lesthari, N. I., Ong-Amoranto, B., Lim, T. S., et al. (2025) · Cureus · doi:10.7759/cureus.87878 · Cited by 7
Male rat leukocyte population dynamics predict a window for intervention in aging
Yanai, H., Dunn, C., Park, B., Coletta, C. E., McDevitt, R. A., McNeely, T. L., Leone, M., Wersto, R. P., Perdue, K. A., & Beerman, I. (2022) · eLife · doi:10.7554/elife.76808 · Cited by 3
“These results support previous findings that report an agedependent accumulation of regulatory T cells (Tregs) (Chiu et al., 2007; Lages et al., 2008; Sharma et al., 2006).”
ResultDeciphering Novel Communication Patterns in T Regulatory Cells From Very Old Adults
McTaggart, T., Lim, J. X., Smith, K. J., Heaney, B., McDonald, D., Hulme, G., Hussain, R., Coxhead, J. M., Mann, D. A., Sayer, A. A., et al. (2025) · Aging Cell · doi:10.1111/acel.70044 · Cited by 4
“…reports demonstrate an increase in Treg numbers (Gregg et al. 2005) with an enhanced suppressor function (Sun et al. 2012; Vukmanovic-Stejic et al. 2013; Lages et al. 2008) whereas in other studies, Treg function has been shown to be diminished with age (Guo et al. 2020; Tsaknaridis et al. 2003).”
A comprehensive analysis of the immune system in healthy Vietnamese people
Huynh, C. D., Nguyen, M. P., Ngo, D. T., Nguyen, X., Nguyen, D. T., Thi, H., Le, T. H., Hoang, M. D., Linh, L. K., Nguyen, K. Q., et al. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e30647 · Cited by 4
“Notably, the increased occurrence of Treg cell populations (CD4 + CD25 + and CD4 + FOXP3 + ) has been well-documented [28,29].”
BackgroundSingh, B., & Rai, A. K. (2022) · Human Immunology · doi:10.1016/j.humimm.2022.10.002 · Cited by 3
Kayes, T., & Braley‐Mullen, H. (2013) · Cellular Immunology · doi:10.1016/j.cellimm.2013.09.003 · Cited by 3
“In both humans [22,23] and mice [23–25] it has been shown that T regs can increase in number with age.”
Senescencia del sistema inmune y alteraciones relacionadas con el asma
Vega-Robledo, G. B., & Rico-Rosillo, M. G. (2017) · Revista Alergia México · doi:10.29262/ram.v64i2.264 · Cited by 3
Metadata
- Authors
- Lages, C. S., Suffia, I., Velilla, P. A., Huang, B., Warshaw, G., Hildeman, D. A., Belkaid, Y., & Chougnet, C.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- National Institutes of Health (US)
- Division of Molecular Immunology
- University of Cincinnati (US)
- Mucosal Immunology Unit, Laboratory of Parasitic Diseases, National Institute for Allergy and Infectious Diseases, National Institutes of Health , Bethesda, MD 20892
- Corresponding author
- Chougnet, Claire
- Venue
- The Journal of Immunology
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-08-01
- Volume
- 181
- Issue
- 3
- Pages
- 1835-1848
- ISSN
- 0022-1767 (ISSN-L)
- 1550-6606
- PMC
- PMC2587319
- OpenAlex
- W1510545292
- Cited by
- 399
- References
- 104
- Citations by year
- 2026: 18 · 2025: 17 · 2024: 21 · 2023: 15 · 2022: 22 · 2021: 36 · 2020: 17 · 2019: 21 · 2018: 14 · 2017: 34 · 2016: 16 · 2015: 24 · 2014: 24 · 2013: 27 · 2012: 18
- FWCI
- 10.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Immunology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (R21AG025149, AG025149)
- National Institute of Allergy and Infectious Diseases (R01AI057753)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Keywords
- regulatory T cells, immunosenescence, aging, Foxp3, Leishmania major, CTLA-4, GITR, Treg depletion, effector T cells, CD4+ T cells
- MeSH terms
- Adult, Aged, Aging, Animals, Antibodies, Cell Movement, Chronic Disease, Health, Humans, Mice, Inbred C57BL, Phenotype, Biomarkers, Cytokines, Leishmaniasis, Cutaneous, CD3 Complex, Leishmania major, Cell Proliferation, T-Lymphocytes, Regulatory, Mice
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