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Treg Cells in AML: The Immune System's Double-Edged Sword
Posted: May 08, 2024
Treg Cells in AML: The Immune System's Double-Edged Sword image

The human immune system relies on a delicate balance. T cells, a specific type of lymphocyte, play a critical role in recognizing and eliminating harmful invaders like viruses and bacteria. However, an overly reactive immune response can damage healthy tissues. This is where Regulatory T cells (Tregs) come in. Tregs act as a control mechanism, fine-tuning the activity of other T cells. They ensure the immune system focuses its efforts on genuine threats while maintaining tolerance towards healthy tissues. Understanding the function of Tregs is essential because imbalances in their activity can contribute to various diseases.

Tregs can be involved in tumor growth and progression in AML. They suppress a normal immune response, which allows cancer to proliferate. A higher number of Tregs impairs the antileukemic activity of normal T cells. Research has shown that an increase in the frequency of blood and marrow Tregs is observed in patients with acute myeloid leukemia (AML).

Treating Tregs presents a promising treatment option for patients. Normally, the immune system is highly active against leukemic cells. Tregs have a significant infiltration rate in the bone marrow and peripheral blood which then contributes to a greater number of leukemic blasts.

Treg cells may also be a marker for relapsed or refractory AML. The progression of the disease is critically dependent on the bone marrow microenvironment, and normal T cells are prominent in the anti-tumor immune response. AML patients who have increased Tregs frequencies and function in bone marrow and peripheral blood have poorer prognosis. 

The bone marrow microenvironment is highly susceptible to Treg cells. The stronger the suppression of the immune system (immunosuppression) in this microenvironment, the greater the chance of disease progression and relapsed or refractory disease occurrence. Restoring the balance of the bone marrow immune system may be a key factor in the prevention of tumor growth and relapse. 

“The proportion of T-regs in the bone marrow was still higher than in peripheral blood even if AML patients achieved complete remission, which might be one of the potential reasons for AML relapse after long-term complete remission in some AML patients.” 

Current Research Efforts Try to Restore Weakened T cell Activity and Reduce Treg Activity

  • Vitamins D, vitamin B7, and vitamin A have been shown to reduce the functionality of Treg cells
  • FOXP3 can act as a Treg cell regulator
  • Pharmacologic options to reduce Treg levels: denileukin diftitox, ipilimumab, among others

Data on Tregs and AML have been accumulating rapidly. Results so far are consistent: increased Tregs are associated with poor prognosis AML, and their depletion improves patient outcomes.

Learn more about the role of the immune system in acute myeloid leukemia with HealthTree University for AML!

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Sources:

The author Lisa Foster

about the author
Lisa Foster

Lisa Foster is a mom of 3 daughters, a puzzle lover, writer and HealthTree advocate. She believes in the mission of the foundation and the team that builds it forward. She calls Houston, Texas home. 

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