As to the functional role these cells play in human pregnancy, more is needed to be done. It has recently been discovered that Treg cells of Foxp3 lineage display an unexpected plasticity and find more have a bifunctional potential depending on the physiological settings. Under most circumstances, Foxp3+ Treg cells suppress unwanted and unappropriate immune responses, but under other circumstances, Treg cells can transform to rapidly responsive helper cells capable to help initiate T-cell responses instead of suppressing them (reviewed by Mellor and Munn49). How the Foxp3+
Treg cell subsets in human pregnancy function under physiological and pathological conditions remains to be elucidated, and indeed, the phenotypic characterization of the three decidual Foxp3+ Treg cells described in this report, CD4+ CD25− Foxp3+,
CD4+ CD25+ Foxp3+, and CD4+ CD25++ Foxp3+, is a good start. Two main points are made in this study; first that the enrichment of Foxp3+ Treg cells in early human pregnancy is a local event, taking place in the pregnant uterine mucosa, the decidua, and comprising three main subsets, CD4+ CD25− Foxp3+, CD4+ CD25+ Foxp3+, and CD4+ CD25++ Foxp3+. The second is that cells, Daporinad cell line expressing Foxp3 gene at comparable levels to ‘classical’ Treg cells, are highly enriched in the CD4+ CD25− decidual T lymphocyte pool, suggesting that besides ‘classical’ Treg cells, there might be an additional reservoir of committed
‘naïve’ regulatory cells in decidua ready to regain CD25 expression and suppressive function upon activation/homeostatic expansion.34,40 Understanding the nature of the CD4+ CD25− Foxp3+ decidual cells and their role in decidua might hold the key to understanding the nature and function of the ‘classical’ Treg cells in Staurosporine research buy human pregnancy. Thus, further and deeper studies of the ‘cryptic’ CD4+ CD25− Foxp3+ cells34 in human decidua are needed before a definite opinion about their nature and role in pregnancy can be established. In addition, the report presented here illustrates that studies of the immune cells in peripheral blood during pregnancy should be handled and interpreted with care, because they might not reflect the immune system in decidua, and highlights the importance of immune-cell studies at the fetal–maternal interface for comprehension of the maternal immune regulation during pregnancy. We are very grateful to Dr. Vladimir Baranov for the useful discussions and valuable suggestions during the performance of this study, and for critically reading the manuscript. The donors of decidual and peripheral blood samples, the colleagues, and the operation staff at Norrland’s University Hospital are gratefully acknowledged.