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Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown cause characterized by expansion of autoreactive lymphocytes. Regulatory T cells (T regs ) are a component of the normal immune system and contribute to the maintenance of peripheral tolerance. T reg  abnormalities have been associated with several autoimmune diseases and there is interest in the role of T regs  in SLE. We previously demonstrated that transfer of expanded CD4 + CD25 + CD62L HI  T regs  slows the development of lupus in (NZBxNZW)F 1  (B/W) mice. However in the absence of T reg  specific surface antigens, cell purification remains a compromise between the breadth and purity of the population isolated. Importantly, purified populations always contain Foxp3 −  effector T cells (T effs ) that theoretically could exacerbate autoimmunity in the recipient. Here we explore the impact of transferring the more comprehensive, but less pure T reg  subset defined by CD4 + CD25 +  expression on development of murine lupus. All cells were FACS sorted and expanded prior to adoptive transfer. Development of proteinuria and survival were measured. We found that exogenous expansion of CD4 + CD25 +  cells produced a population containing 70–85% CD4 + Foxp3 + T regs . Expanded T regs  had higher CTLA-4 and Foxp3 expression, increased  in vitro  suppression capacity, and prolonged  in vivo  survival as compared to freshly isolated cells. Adoptive transfer of expanded CD4 + CD25 +  T regs  inhibited the onset of glomerulonephritis and prolonged survival in mice. Importantly the population of T eff  contained within the adoptively transferred cells had reduced survival and proliferation capacity as compared to either co-transferred T regs  or transferred T effs  expanded in the absence of T regs . These studies demonstrate that adoptive transfer of expanded CD4 + CD25 + Foxp3 + T regs  has the capacity to inhibit the onset of murine lupus and that this capacity is significant despite transfer of co-cultured T eff  cells. These data indicate that when co-expanded with regulatory T cells, exogenously activated T effs  from autoimmune patients may not pose a significant risk of promoting disease.

Suppression of Glomerulonephritis in NZB/NZW Lupus Prone Mice by Adoptive Transfer of Ex Vivo Expanded Regulatory T Cells