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Because of its dampening effect, CTLA-4 is an essential regulator of T-cell homeostasis and self-tolerance. The systems through which CTLA-4 exerts its inhibitory function may be classified as either cell-intrinsic (affects the CTLA-4 expressing T-cell) or cell-extrinsic (impacts additional cells). Research through the last ten years has shown that CTLA-4 mainly acts in a cell-extrinsic manner via its competitors with CD28, CTLA-4-mediated trans-endocytosis of CD80 and CD8