Regulatory T cells in stroke inflammation: Therapeutic perspectives

Regulatory T cells are crucial immunomodulatory cells that play essential roles in both ischemic stroke and intracerebral hemorrhage. These cells are vital in post-stroke inflammation since they suppress immune responses and promote tissue repair. This review thoroughly examines the dynamic changes in the number and function of regulatory T cells and highlights their distinct roles at various stages of stroke progression. In the acute phase (within 5-7 days), regulatory T cells exert neuroprotective effects primarily by reducing inflammation. In the chronic phase (7 days post-onset), these cells support neuroregeneration and functional recovery. The review also explores the emerging role of regulatory T cells in the brain-gut axis, a key mediator of the systemic immune responses following stroke, and discusses its relevance in modulating post-stroke inflammation and repair. Various strategies aimed at enhancing regulatory T cell responses include adoptive transfer of regulatory T cells, administration of pharmacological agents, and induction of mucosal tolerance. All these approaches can potentially enhance the immunomodulatory and repair functions of regulatory T cells. Nevertheless, despite the promising preclinical results, the translation of regulatory T cell-based therapies into clinical practice is associated with challenges related to optimal timing, dosage, and long-term efficacy. Overall, targeting regulatory T cells is a novel and promising immunoregulatory approach for mitigating stroke-induced injury and promoting neural repair.