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NBME Immunology Practice Test

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Which transcription factor is essential for regulatory T cell development?
Correct Answer:
FOXP3
Explanation:
FOXP3 is the master regulator that drives regulatory T cell development and their suppressive function. Regulatory T cells, which help maintain immune tolerance, express CD4, CD25, and FOXP3. FOXP3 controls a transcriptional program that enables these cells to dampen immune responses, partly by promoting molecules like CTLA-4, IL-10, and TGF-β. When FOXP3 is absent or defective, regulatory T cells fail to develop properly or lose their suppressive activity, leading to severe autoimmunity such as IPEX syndrome. Other transcription factors—GATA3 for Th2, T-bet for Th1, and RORγt for Th17—define other helper T cell lineages and are not essential for regulatory T cell development. Thus, FOXP3 is the essential transcription factor for regulatory T cell development.

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