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The 2025 Nobel Prize in Physiology or Medicine: The Guardians of Tolerance

December 30, 2025 by
The 2025 Nobel Prize in Physiology or Medicine: The Guardians of Tolerance
Lieven Gentaur

The 2025 Nobel Prize has been awarded to Shimon Sakaguchi, Mary Brunkow, and Fred Ramsdell for their discovery of Regulatory T cells (Tregs) and the FOXP3 gene. This work solved a decades-old mystery in immunology: how does the body stop its own "attack" cells from destroying healthy tissue?

1. The Discovery: From Suppressor Cells to Tregs

For years, the concept of "suppressor cells" was controversial. It wasn't until Shimon Sakaguchi’s 1995 breakthrough that the field found its footing.

  • The Marker: Sakaguchi identified CD25 as a specific marker that distinguished a small population of T cells (Tregs) that actively suppress immune responses rather than promoting them.

  • The Genetic Key: In 2001, Mary Brunkow and Fred Ramsdell identified the FOXP3 gene. They discovered that mutations in this gene led to the fatal "scurfy" mouse model and the rare human disease IPEX syndrome, both characterized by massive, uncontrolled autoimmunity.

For years, the concept of "suppressor cells" was controversial. It wasn't until Shimon Sakaguchi’s 1995 breakthrough that the field found its footing.  The Marker: Sakaguchi identified CD25 as a specific marker that distinguished a small population of T cells (Tregs) that actively suppress immune responses rather than promoting them.  The Genetic Key: In 2001, Mary Brunkow and Fred Ramsdell identified the FOXP3 gene. They discovered that mutations in this gene led to the fatal "scurfy" mouse model and the rare human disease IPEX syndrome, both characterized by massive, uncontrolled autoimmunity.

2. Mechanism: How the "Brakes" Work

Tregs are not just passive; they are active peacekeepers. They use a "multi-tool" approach to maintain peripheral tolerance:

  • Cytokine Secretion: They release anti-inflammatory signals like IL-10 and TGF-β to dampen nearby inflammation.

  • Metabolic Disruption: They express high levels of CD25, allowing them to "soak up" IL-2 (the fuel for effector T cells), essentially starving the "attacker" cells.

  • Direct Contact: Through molecules like CTLA-4, they can tell Antigen-Presenting Cells (APCs) to stop activating new T cells.

3. Clinical Value: A Blueprint for New Medicine

This discovery has shifted the treatment paradigm from "broad immunosuppression" (which weakens the whole body) to "precision tolerance."

  • Autoimmunity (Lupus & Type 1 Diabetes): Researchers are now developing CAR-Treg therapies—engineering a patient's own Tregs to specifically protect the pancreas or kidneys from immune attack.

  • Cancer Immunotherapy: In oncology, the goal is reversed. Tumors often "recruit" Tregs to hide from the immune system. New drugs are being tested to temporarily disable Tregs only within the tumor microenvironment to let the "killer" T cells through.

  • Organ Transplantation: By boosting Treg levels, doctors hope to induce "graft tolerance," allowing patients to keep their new organs without needing lifelong, heavy medication.

4. Recommended Reading & References

For researchers looking for the foundational data, we recommend these primary sources:

  • Sakaguchi, S., et al. (1995). "Immunologic self-tolerance maintained by activated T cells expressing IL-2 receptor alpha-chains (CD25)." Journal of Immunology.

  • Brunkow, M. E., et al. (2001). "Disruption of a new forkhead/winged-helix protein, scurfin, results in the fatal lymphoproliferative disorder of the scurfy mouse." Nature Genetics.

  • Nobel Assembly at Karolinska Institutet (2025). "The Nobel Prize in Physiology or Medicine 2025: Regulatory T cells and the Prevention of Autoimmunity." NobelPrize.org.

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The 2025 Nobel Prize in Physiology or Medicine: The Guardians of Tolerance
Lieven Gentaur December 30, 2025
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