Ischemic stroke is a leading cause of mortality worldwide, with an excessive immune response playing a major role in exacerbating post-stroke pathogenesis. Regulatory T (Treg) cells, known for their immunosuppressive properties, are believed to be crucial in mitigating post-stroke inflammation. Moreover, emerging evidence suggests that Treg cells contribute to ischemic stroke recovery by suppressing neurotoxic astrogliosis and by promoting myelination regeneration. However, significant challenges remain before the clinical translation of Treg cell-based therapies can be realized. In this review, we summarize recent advances in understanding the role of Treg cells in ischemic stroke, with a particular emphasis on CD8+ Treg cells, a subset that has been largely overlooked. We comprehensively explore the activation, expansion, recruitment, and functional mechanisms of Treg cells during both the acute and chronic phases of stroke. Additionally, we highlight unresolved challenges and discuss potential strategies for translating Treg-based therapies into clinical application. The development of Treg cell-based treatments holds promise for revolutionizing ischemic stroke therapy, opening new avenues for patient treatment and recovery.
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