Combined treatment with low dose IL-2 cplxs, rapamycin, and anti–IL-6 potentiates Treg function and prolongs skin allograft survival. Groups of mice were treated with IL-2 cplx-based tolerance regimens and grafted with fully mismatched BALB/c skin. Groups of mice received PBS (control; n = 17 [5]; MST = 10 d), IL-2 cplxs only (cplx; n = 5 [1]; MST = 11 d), IL-2 cplx combined with rapamycin (cplx/rapa; n = 10; MST = 13.5 d; low-dose (LD) cplx/rapa; n = 6 [1]; MST = 14 d) or prolonged treatment with cplx and rapamycin with (30 d LD cplx/rapa + a–IL-6 n = 31 [5]; MST = 76 d) and without anti–IL-6 (30 d LD cplx/rapa n = 10; MST = 22). (A) Survival curves of cumulative data of several independent experiments are shown (indicated in brackets), log-rank test. (B and C) Changes of leukocyte subsets were analyzed in the spleen on day 6 (d6) (*P < 0.05, **P < 0.005, ***P < 0.0005 2-tailed t test with unequal variances) and (D) in peripheral blood over time at indicated timepoints (two-way ANOVA *P < 0.05, **P < 0.01, ***P < 0.001). Mean percentages (B and D) and total cell numbers (C) are shown. Error bars indicate SD. (E) Mice were treated with IL-2 cplx-based tolerance protocol were grafted with 2 BALB/c grafts on contralateral sides of the back. Macroscopically intact grafts were harvested for analysis on d25 and d50. Graft-infiltrating T cells subsets were analyzed for percentage of CD25+FoxP3+ (Tregs; gated on CD45+CD4+). Mean percentages are shown, error bars indicate SD, groups were compared using a 2-tailed t test with unequal variances (**P < 0.01). (F) Mice were grafted with BALB/c (full mismatch) or B10.D2 (MHC mismatch, with minimal minor H antigen difference) skin, and groups were treated with IL-2 cplx-based tolerance regime. Naïve recipients uniformly rejected allografts within 10 d (BALB/c graft MST = 8 d; B10.D2 graft MST = 9 d; n = 5 per group), whereas graft survival was prolonged after IL-2 cplx-based treatment in all groups (BALB/c graft MST = 61.5 d; B10.D2 graft MST = 105 d, P = 0.0075 vs. BALB/c; n = 12 per group). Data were pooled from 2 independent experiments.