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occurring Tregs may degrade ATP and catalyze the generation of adenosine that acts
via the adenosine A2a receptor on activated effector T cells, thereby suppressing
their function by intracellular production of cAMP (Deaglio et al. 2007 ). In
addition, continuous antigen exposure to T cells leads to generation of adaptive
Tregs (Aandahl et al. 2004 ). Adaptive Tregs express cyclooxygenase 2 (COX-2),
leading to secretion of PGE 2 . PGE 2 stimulates FOXP3 expression in Tregs in
addition to inhibit effector T-cell function through activation of the cAMP-P-
KA-Csk signaling pathway (Mahic et al. 2006 ). The different mechanisms affect-
ing effector T cells described above are schematically summarized in Fig. 1 .
The spatiotemporal regulation of cAMP levels within the cell is a result of the
combined action of ACs and phosphodiesterases (PDEs), which provide the only
mechanism for cAMP degradation (Conti and Jin 1999 ; Houslay and Adams 2003 ).
Specifically, compartmentalization of receptors, cyclases, and PKA by A-kinase-
anchoring proteins (AKAPs) (Michel and Scott 2002 ) in addition to generation of
local pools of cAMP within the cell by the action of PDEs (Zaccolo and Pozzan
2002 ) results in a high degree of specificity in PKA-mediated signaling, although
there are multiple receptors and targets all using cAMP as a second messenger.
PGE 2
[ cAMP ]
EP2/EP4
[ cAMP ]
COX-2
Continuous antigen
exposure
[ cAMP ]
FOXP3
A2a-receptor
Naive T cell
Effector T cell
Adaptive Treg
PGE 2
Adenosine
ATP/ADP
CD39/CD73
CD14/TLR4
LPS
Gap junction
FOXP3
Natural occuring
Treg
Monocyte
Fig. 1 Schematic model of cAMP-mediated induction of Treg cells and suppression of effector
T cells. Naturally occurring Tregs have high cAMP levels and mediate their suppressive function
by transferring cAMP to responder T cells through gap junctions. In addition, the ecto-enzymes
CD39 and CD73 expressed on naturally occurring Tregs degrade ATP/ADP and catalyze the
generation of adenosine, acting via the adenosine A2a receptor on activated effector T cells and
thereby suppressing their function by intracellular production of cAMP. Furthermore, continuous
activation of T cells results in generation of adaptive Tregs that express COX-2, leading to PGE 2
production. Increased PGE 2 levels stimulate further FOXP3 expression in Treg cells in addition to
inhibiting effector T-cell function. Finally, T-cell inhibiton and induction of FOXP3 due to PGE 2
secretion can also be a result of LPS-activated monocytes
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