{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:16:22Z","timestamp":1791994582098,"version":"4.4.0"},"reference-count":130,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Bullous pemphigoid (BP) is an autoimmune blistering disorder that predominantly affects the elderly. Its pathogenesis involves the disruption of the basement membrane zone (BMZ), driven by pathogenic autoantibodies and a pronounced inflammatory response. Current first-line therapies, primarily based on glucocorticoids and immunosuppressants, are limited by substantial side effects and frequent disease recurrence. Regulatory T cells (Tregs) play a central role in maintaining immune homeostasis and peripheral tolerance, exerting control over effector immune cells through transcriptional regulation, surface markers, and diverse immunosuppressive mechanisms. Accumulating evidence indicates that numerical reduction and functional impairment of Tregs are critical to the breakdown of immune tolerance in BP. Treg dysfunction leads to the aberrant activation of Th2, Th17, and follicular helper T (Tfh) cells, which in turn promotes the production of anti\u2212BP180\/BP230 autoantibodies and disrupts the regulation of inflammatory cells such as neutrophils and eosinophils. These events collectively result in BMZ degradation and blister formation. Multiple factors, including age\u2212related immunosenescence, genetic predisposition, pharmacological exposures, and environmental stimuli, can further compromise Treg function, thereby contributing to BP pathogenesis. A deeper understanding of Treg\u2212driven mechanisms in BP provides a rational basis for developing targeted therapeutic strategies.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1775932","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T04:22:00Z","timestamp":1776745320000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Regulatory T cells in bullous pemphigoid: biological characteristics, dysfunction, and pathogenic roles"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhimin","family":"Wang","sequence":"first","affiliation":[{"name":"First School of Clinic Medicine, Yunnan University of Traditional Chinese Medicine","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Kunming Municipal Hospital of Traditional Chinese Medicine","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Cui","sequence":"additional","affiliation":[{"name":"First School of Clinic Medicine, Yunnan University of Traditional Chinese Medicine","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiwen","family":"Zhang","sequence":"additional","affiliation":[{"name":"First School of Clinic Medicine, Yunnan University of Traditional Chinese Medicine","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingzhi","family":"Meng","sequence":"additional","affiliation":[{"name":"First School of Clinic Medicine, Yunnan University of Traditional Chinese Medicine","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyu","family":"Chang","sequence":"additional","affiliation":[{"name":"First School of Clinic Medicine, Yunnan University of Traditional Chinese Medicine","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuesong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, First Affiliated Hospital of Yunnan Traditional Chinese Medicine University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzhou","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Dermatology, First Affiliated Hospital of Yunnan Traditional Chinese Medicine University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61140-4","article-title":"Pemphigoid diseases","volume":"381","author":"Schmidt","year":"2013","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2025.102591","article-title":"Immunotherapy for pemphigus and bullous pemphigoid","volume":"95","author":"Xu","year":"2025","journal-title":"Curr Opin Immunol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.jid.2022.08.041","article-title":"Cxcl12\/Cxcr4 axis drives the chemotaxis and differentiation of B cells in bullous pemphigoid","volume":"143","author":"Fang","year":"2023","journal-title":"J Invest Dermatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.02.013","article-title":"Autoimmune bullous skin diseases, pemphigus and pemphigoid","volume":"145","author":"Egami","year":"2020","journal-title":"J Allergy Clin Immunol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.20593","article-title":"International multicentre observational study to assess the efficacy and safety of a 0.5 mg kg(-1) per day starting dose of oral corticosteroids to treat bullous pemphigoid","volume":"185","author":"Hebert","year":"2021","journal-title":"Br J Dermatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12041638","article-title":"Can methotrexate be employed as monotherapy for bullous pemphigoid? 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