Narrative review outlines regulatory T cell therapy approaches for autoimmunity and graft-versus-host disease.

This narrative review examines the landscape of regulatory T cell (Treg) therapies, covering interventions like autologous Tregs expanded ex vivo, induction of regulatory phenotypes in conventional T cells, engineering of antigen-specific Tregs, and allogeneic off-the-shelf regulatory cell products. The scope extends to the use of induced pluripotent stem cells (iPSCs) in this context. The review addresses applications in autoimmunity, graft-versus-host disease, and solid organ transplantation, though specific patient populations and sample sizes are not reported in this synthesis.

The authors highlight that early-phase clinical trials with CD4+ Tregs have established an excellent safety profile. However, the review notes significant challenges associated with the technology, including variable cell quality, restricted scalability, and complex manufacturing requirements. These limitations suggest that widespread clinical implementation may face hurdles related to production consistency and availability.

Because this is a narrative review, no pooled effect sizes or specific adverse event rates are provided. The authors do not report primary or secondary outcomes, discontinuations, or specific tolerability metrics beyond the general safety profile mentioned. Consequently, the practice relevance remains theoretical until further clinical validation occurs. Clinicians should interpret these findings as a summary of potential avenues rather than established treatment standards.