Background: Deep vein thrombosis is associated with long-term complications, including venous thromboembolism, post-thrombotic syndrome and chronic thromboembolic pulmonary hypertension. CD4⁺Foxp3⁺ regulatory T (Treg) have a crucial role in tissue healing and maintenance -distinct from their role in suppression of immune responses. Less is known about the composition and function of infiltrating T cell populations, especially the contribution of Treg cells in post thrombotic inflammation.

Aims: Based on the observation that Treg accumulate in venous thrombi, we aimed to systematically clarify their functional role in venous clot resolution.

Methods: Experimental approaches included the selective manipulation of Treg numbers during thrombus resolution, comprehensive characterization of the histological and cellular changes induced by them, generation of Treg expression profiles and the identification of their clot-dissolving function.

Results: We describe a specialized population of resident ‘clot-busting’ Treg that develops in venous blood clots, is activated by monocyte-derived cytokines, and regulates thrombus resolution by imposing phenotypic and functional changes in the myeloid compartment.

Conclusions: Our study reveals a critical role of specialized Treg in order to blood clot resolution. These findings suggest that Treg cells and their function may offer new therapeutic opportunities for thrombus repair. Increasing Treg activity appears to be an attractive therapeutic approach for improving thrombus resolution and restoring organ function in chronic thromboinflammatory diseases.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/specialized-regulatory-t-cells-control-venous-blood-clot-resolution/