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Life sciences · Journal article
Gut · November 4, 2026
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Background Regulatory T cells (Tregs) are fundamentally important for maintaining immune homeostasis, and their potent immune-suppressive roles make them attractive immunotherapeutic targets in cancer. Moreover, tissue-Tregs are emerging as regulators of tissue-repair and epithelial cell homeostasis. Objective To explore whether tissue-Tregs populate the exocrine pancreas and assess their function in pancreatic diseases. Design Tregs were characterised in mouse and human pancreas using high-parameter flow cytometry, multiplex immunofluorescence, histology and RNA-sequencing. Functional roles of pancreatic Tregs were studied in mouse models of pancreatitis and pancreatic cancer with Treg depletion, along with co-culture of pancreatic Tregs with acinar cells. Results We describe a rare population of tissue-Tregs in the exocrine pancreas. We show that these cells share common features of tissue-Tregs, including expression of the IL-33 receptor ST2 and production of the epithelial growth factor amphiregulin, and display an oligoclonal T cell receptor repertoire. In acute pancreatitis, we show that pancreatic Tregs rapidly expand on release of IL-33 by fibroblasts. Moreover, depletion of Tregs after initiation of pancreatic injury impairs the regeneration of the exocrine parenchyma. This effect is due, in part, through a direct effect of Tregs on acinar cell proliferation. Finally, we show that transient Treg depletion in established orthotopic pancreatic tumours leads to tumour rejection yet provokes long-lasting dysplasia of the surrounding exocrine parenchyma. Conclusion Exocrine pancreas-resident Tregs regulate tissue-repair and homeostasis after injury; these roles are perturbed in cancer or cancer therapy.