Regulatory T Cell Dysfunction and Immunotherapeutic Breakthroughs in Type 1 Diabetes

This review discusses the dysfunction of regulatory T cells (Tregs) in type 1 diabetes (T1D), focusing on their impaired role in maintaining immune tolerance due to genetic, epigenetic, and cytokine signaling issues. It highlights the unique characteristics of pancreatic Tregs, including their chemokine receptor expression, migratory capacity, and metabolic adaptation. The review also explores advancements in Treg-based immunotherapies, particularly genetically engineered Tregs (EngTregs) with stable expression of FoxP3 and antigen-specific receptors. Despite promising preclinical results, challenges remain in translating these therapies to clinical settings. The review emphasizes the potential of next-generation Treg therapies to achieve lasting immune tolerance in T1D.