In vitro expanded CD4⁺CD25⁺Foxp3⁺ regulatory T cells maintain a normal phenotype and suppress immune-mediated ocular surface inflammation

PURPOSE. To determine whether in vitro expanded CD4⁺CD25 ⁺Foxp3⁺ regulatory T cells can suppress immune-mediated ocular surface inflammation in a mouse model of dry eye. METHODS. C57BL/6 or BALB/c mice were exposed to a dry, desiccating environment produced by maintaining low humidity (<40%), injections of scopolamine, and air flow produced by a fan. CD4⁺CD25⁺ regulatory T cells were isolated and expanded in vitro in the presence of rmIL-2 and beads coated with anti-CD28 and anti-CD3. In vitro expanded regulatory T cells were phenotypically compared with freshly isolated regulatory T cells by flow cytometry and immunofluorescence. T-cell-deficient nude mice were reconstituted with CD4 ⁺ T-effector cells from donor mice exposed to a desiccating environment for 5 days, in combination with or without freshly isolated or in vitro expanded regulatory T cells. Tear cytokine levels were determined by a multiplex bead-based immunoassay. RESULTS. In vitro regulatory T cells maintained normal levels of CD4⁺, CD25⁺, and intracellular Foxp3⁺, as determined by flow cytometry and immunohistochemistry. Freshly isolated and in vitro regulatory T cells were titrated in the presence of CD4⁺ pathogenic T cells (CD4^+Path T cells) in reconstitution experiments and most efficiently ablated tear cytokine levels and conjunctival cellular infiltration at a ratio of 1:1 (T Regs: CD4 ^+Path). CONCLUSIONS. Regulatory T cells expressed CD4⁺, CD25⁺, and intracellular Foxp3⁺ at normal levels and retained their inhibitory function after in vitro expansion, providing a useful tool to determine the mechanism regulatory T cells use to sustain a homeostatic environment on the ocular surface.