# Low dose IL-2 and human regulatory T cells

> **NIH NIH R01** · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · 2022 · $603,337

## Abstract

Current therapies for autoimmune diseases target the symptoms rather than the cause of autoimmunity. The
chronic use of immunosuppressants leads to deliberating side effects. An attractive alternative is to treat the
underlying cause by boosting regulatory T cells (Tregs) in patients with autoimmunity. Our group established
that IL-2 is an essential cytokine for Tregs. Moreover, we have established in pre-clinical studies that low IL-2R
signaling promotes Tregs but not T effector/memory (TEM) cells. This finding has led to the notion that low-dose
(LD) IL-2 may selectively expand Tregs. Importantly, LD IL-2 therapy has shown promising results in patients
with chronic GvHD, HCV vasculitis, and several autoimmune diseases. Correspondingly, several fundamental
questions emerge about LD IL-2 immunotherapy. These include: What is the selectivity of LD IL-2 for Tregs?
What is the mechanism by which Tregs preferentially respond to low levels of IL-2? Is there individual variation
in responsiveness to LD IL-2? What are the molecular consequences in Treg and Teff cells in response to LD
IL-2? Does chronic exposure to LD IL-2 alter the capacity of Tregs to respond to IL-2? Our supporting data has
defined a window of selectivity of human Tregs for IL-2R signaling when compared to CD45RO CD4 TEM
++
cells. However, the extent that Tregs exclusive respond to LD IL-2 remains a point of contention. We also have
preliminary data that IL-2-dependent gene activation in Tregs may vary in normal subjects. This latter point is
of interest because some individuals may be more suitable candidates for this therapy. We plan to build on
these results and capitalize on our expertise on IL-2 to better understand mechanistically the potential of LD IL-
2 as a treatment platform for autoimmune diseases. The premise of this application is: In comparison to TEM
cells, low levels of IL-2R signaling selectively and substantially activates an IL-2-dependent transcriptional
program in Tregs that is uniquely shaped by TCR and co-stimulatory signaling; this selective gene activation
varies between individuals and accounts for variable responses to LD IL-2 therapy. The following specific aims
are proposed to address this premise: 1) To establish the immediate and down-stream consequences of IL-2R
signaling by LD IL-2 on gene regulation in human Treg and Teff cells in vitro alone or in the context of TCR and
co-stimulatory signaling; 2) to evaluate cellular and molecular levels through which the response by human
Tregs varies to LD IL-2 in normal subjects and in patients with Type 1 diabetes; and 3) to evaluate the
consequence of IL-2 in Treg and TEM cells in patients undergoing LD IL-2 therapy. These experiments will
assess the outcome of IL-2R signaling due to variation of IL-2 dose and the type of autoimmune disease.

## Key facts

- **NIH application ID:** 10308487
- **Project number:** 5R01AI131648-05
- **Recipient organization:** UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
- **Principal Investigator:** Thomas R Malek
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $603,337
- **Award type:** 5
- **Project period:** 2017-11-21 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10308487

## Citation

> US National Institutes of Health, RePORTER application 10308487, Low dose IL-2 and human regulatory T cells (5R01AI131648-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10308487. Licensed CC0.

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