CD4 ؉ CD25 ؉ Foxp3 ؉ regulatory T cells (T regs) are important for preventing autoimmune diabetes and are either thymic-derived (natural) or differentiated in the periphery outside the thymus (induced). Here we show that -cell peptide-pulsed dendritic cells (DCs) from nonobese diabetic (NOD) mice can effectively induce CD4 ؉ CD25 ؉ Foxp3 ؉ T cells from naïve islet-specific CD4 ؉ CD25 ؊ T cells in the presence of TGF-1. These induced, antigen-specific T regs maintain high levels of clonotype-specific T cell receptor expression and exert islet-specific suppression in vitro. When cotransferred with diabetogenic cells into NOD scid recipients, T regs induced with DCs and TGF-1 prevent the development of diabetes. Furthermore, in overtly NOD mice, these cells are able to significantly protect syngeneic islet grafts from established destructive autoimmunity. These results indicate a role for DCs in the induction of antigen-specific CD4 ؉ CD25 ؉ Foxp3 ؉ T cells that can inhibit fully developed autoimmunity in a nonlymphopoenic host, providing an important potential strategy for immunotherapy in patients with autoimmune diabetes.antigen-presenting cells ͉ autoimmunity ͉ type 1 diabetes ͉ nonobese diabetic (NOD) mice T he nonobese diabetic (NOD) mouse models the pathogenesis of human type 1 diabetes and allows the study of potential therapeutics (1). In NOD mice, the thymic-derived CD4 ϩ CD25 ϩ regulatory T cells (T regs) expressing the transcription factor Foxp3 suppress autoimmunity and delay the development of diabetes (2). Considerable effort has focused on expanding the small numbers of these so-called ''natural'' CD4 ϩ CD25 ϩ T regs in the NOD and other models (3-6). Dendritic cells (DCs) are specialized antigen-presenting cells (APCs) that can effectively expand and sustain antigen-specific CD4 ϩ CD25 ϩ T regs (3, 4). However, in humans, only the infrequent cells with high CD25 expression have regulatory function (7). Alternatively, the more abundant CD4 ϩ CD25 Ϫ T cells can be differentiated into CD4 ϩ CD25 ϩ T regs that express Foxp3 by stimulation with mitogenic antibodies in the presence of TGF-1, although it is not known whether these induced cells are functionally identical to T regs that develop in the thymus (8). Such ''induced T regs'' with islet specificity can prevent diabetes in lymphopoenic models (9), but their ability to induce tolerance at late pathogenic stages of autoimmunity, such as in already-diabetic NOD mice, has not been fully addressed.A separate issue that remains to be addressed is the requirement for APCs in the induction of T regs with TGF-1. The use of DCs instead of mitogenic stimuli to differentiate T regs de novo from CD4 ϩ CD25 Ϫ T cells has numerous potential advantages, including selection and maintenance of antigen specificity (10, 11); provision of paracrine TGF-1 (12-14), which is known to play an important role in T reg homeostasis by its ability to induce Foxp3 (8, 15); and/or provision of costimulatory signals such as CD80/86 for CTLA-4 ligation, which is necessary f...