e Hypertension-associated cardiorenal diseases represent one of the heaviest burdens for current health systems. In addition to hemodynamic damage, recent results have revealed that hematopoietic cells contribute to the development of these diseases by generating proinflammatory and profibrotic environments in the heart and kidney. However, the cell subtypes involved remain poorly characterized. Here we report that CD39 ؉ regulatory T (T REG ) cells utilize an immunosuppression-independent mechanism to counteract renal and possibly cardiac damage during angiotensin II (AngII)-dependent hypertension. This mechanism relies on the direct apoptosis of tissue-resident neutrophils by the ecto-ATP diphosphohydrolase activity of CD39. In agreement with this, experimental and genetic alterations in T REG /T H cell ratios have a direct impact on tissue-resident neutrophil numbers, cardiomyocyte hypertrophy, cardiorenal fibrosis, and, to a lesser extent, arterial pressure elevation during AngII-driven hypertension. These results indicate that T REG cells constitute a first protective barrier against hypertension-driven tissue fibrosis and, in addition, suggest new therapeutic avenues to prevent hypertension-linked cardiorenal diseases.
F oxp3ϩ CD4 ϩ regulatory T (T REG ) cells are primarily involved in the negative control of conventional T-cell-dependent immune processes. To this end, they utilize a number of effector mechanisms, including cytokine-dependent paracrine signaling events, interleukin 2 consumption, presentation of immunosuppressive ligands, cytolysis of target cells, and modification of cell responses through the degradation of extracellular ATP. The latter regulatory mechanism is mediated by CD39, an ectoenzyme that displays ATP diphosphohydrolase activity (1, 2). In addition, T REG cells can promote immunomodulation through the regulation of other hematopoietic cells, such as B lymphocytes, dendritic cells, and macrophages (1, 2). Recent observations have revealed that tissue-specific T REG subtypes can also perform immunosuppression-independent functions. The best-characterized examples are the T REG cells present in adipose tissue and injured skeletal muscles, which control metabolic indexes and muscle repair, respectively. These T REG subsets are distinct from those involved in immunosuppression in terms of their T cell receptor repertoires and transcriptomal features (3, 4).At present, hypertension and associated cardiovascular diseases represent one of the heaviest burdens for our health systems (5, 6). In addition to the hemodynamic damage inflicted by hypertension itself, a number of pathophysiological circuits that change the inflammatory, fibrotic, and functional status of peripheral tissues also influence the progression of these dysfunctions. If untreated, these processes eventually lead to end-organ disease and failure (7,8). Extensive data indicate that T REG cells play protective roles against high arterial pressure, cardiovascular remodeling, and heart damage (9-11). The exact nature of such...