T-reg cells offer hope for aplastic anaemia patients What are the T-regs? T regulatory cells (Tregs) are a type of immune-modulatory cells within the immune system, that bring acceptance of self-antigens, and prevent self-directed attacks of the immune system against our own tissues and organs. They are pivotal at preventing auto-immune diseases. Often, a lot of auto-immune conditions have either dysfunctional or deficient Tregs, at the heart of it. Aplastic anaemia is a quintessential auto-immune disorder, where the immune system clears the stem cells (the queen bee cell within the bone marrow making all the different type of blood cells) within the bone marrow. This results in a deficiency of the blood making cells and the consequent downstream effects of low blood counts, in all types of blood cells. Immune suppression through immuno-suppressive treatment (IST) have been the cornerstone of treatments in aplastic anaemia, to stall and prevent the immune attack on the stem cells. Research studies from King's have previously shown that Tregs are not only deficient, but also dysfunctional in aplastic anaemia. This important finding, raises the spectre of harnessing the usefulness of these Tregs at suppressing the immune system and restoring the balance in the blood making factory within the bone marrow. Allogeneic Tregs (Tregs isolated and procured from other healthy donors) have been previously deployed at treating other ‘immune mediated conditions’ such as GvHD (graft versus host disease) and inflammatory bowel disease, as part of a research study, where they have been safely administered and tolerated. What the future holds We wish to study and explore the utility of Allogeneic Tregs (Tregs isolated and procured from the cord blood cells from the placenta, cultured and expanded under appropriate conditions in the laboratory and stored for therapeutic use) in the treatment of aplastic anaemia as a phase 1 research study at King’s college Hospital.