Control of Foxp3 induction and maintenance by sequential histone acetylation and DNA demethylation

Regulatory T (T(reg)) cells play crucial roles in suppressing deleterious immune response. Here, we investigate how T(reg) cells are mechanistically induced in vitro (iT(reg)) and stabilized via transcriptional regulation of T(reg) lineage-specifying factor Foxp3. We find that acetylation of histone tails at the Foxp3 promoter is required for inducing Foxp3 transcription. Upon induction, histone acetylation signals via bromodomain-containing proteins, particularly targets of inhibitor JQ1, and sustains Foxp3 transcription via a global or trans effect. Subsequently, Tet-mediated DNA demethylation of Foxp3 cis-regulatory elements, mainly enhancer CNS2, increases chromatin accessibility and protein binding, stabilizing Foxp3 transcription and obviating the need for the histone acetylation signal. These processes transform stochastic iT(reg) induction into a stable cell fate, with the former sensitive and the latter resistant to genetic and environmental perturbations. Thus, sequential histone acetylation and DNA demethylation in Foxp3 induction and maintenance reflect stepwise mechanical switches governing iT(reg) cell lineage specification.