Narrowband ultraviolet B phototherapy ameliorates acute graft-versus-host disease by a mechanism involving in vivo expansion of CD4+CD25+Foxp3+ regulatory T cells
Narrowband ultraviolet B phototherapy ameliorates acute graft-versus-host disease by a mechanism involving in vivo expansion of CD4+CD25+Foxp3+ regulatory T cells
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DOI：
10.1007/s12185-014-1530-1
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发表时间：
2014-02
影响因子：
2.1
通讯作者：
S. Iyama;K. Murase;Tsutomu Sato;A. Hashimoto;A. Tatekoshi;H. Horiguchi;Y. Kamihara;K. Ono;S. Kikuchi;K. Takada;Y. Kawano;Tsuyoshi Hayashi;K. Miyanishi;Y. Sato;R. Takimoto;M. Kobune;Satoru Mori;J. Kato;T. Yamashita
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文献类型：
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作者：
S. Iyama;K. Murase;Tsutomu Sato;A. Hashimoto;A. Tatekoshi;H. Horiguchi;Y. Kamihara;K. Ono;S. Kikuchi;K. Takada;Y. Kawano;Tsuyoshi Hayashi;K. Miyanishi;Y. Sato;R. Takimoto;M. Kobune;Satoru Mori;J. Kato;T. Yamashita
窄带紫外线B光疗法（NB-UVB）是造血干细胞移植相关的皮肤移植物抗宿主病（GVHD）的治疗替代方案。这种干预的有益效果可能是通过直接照射皮肤中的炎性细胞诱导的;然而，尚未阐明对全身免疫的间接影响的假定参与。为了解决这个问题，11例标准皮质类固醇治疗难治性且无肠道/肝脏受累的急性皮肤GVHD患者接受NB-UVB照射治疗。中位治疗次数为10次，平均累积暴露量为6.36 J/cm 2。照射期间未开始其他免疫抑制治疗。8例患者达到了客观完全缓解，2例部分缓解，1例无变化。没有患者经历进行性皮肤GVHD或新诊断的肠道/肝脏GVHD。NB-UVB耐受性良好，没有患者因毒性而停止照射。我们还通过流式细胞术证实了NB-UVB照射诱导患者外周血中调节性T细胞（Tcells）比例的增加。这些结果表明，NB-UVB可能通过调节性T细胞的扩增对类固醇难治性皮肤GVHD产生有益影响。
Narrowband ultraviolet B phototherapy (NB-UVB) is a therapeutic alternative for haematopoietic stem cell transplantation-related skin graft-versus-host disease (GVHD). The beneficial effects of this intervention may be induced by direct irradiation of inflammatory cells in the skin; however, the putative involvement of indirect effects on systemic immunity has not been elucidated. To address this issue, 11 acute skin GVHD patients refractory to standard corticosteroid treatment and with no gut/liver involvement were treated with NB-UVB irradiation. The median number of treatments was 10 times, with a mean cumulative exposure of 6.36 J/cm2. No other immunosuppressive therapy was initiated during irradiation. Eight patients achieved an objective complete response, two had a partial response, and one showed no change. None of the patients experienced progressive skin GVHD or newly diagnosed gut/liver GVHD. NB-UVB was well tolerated, with no patients discontinuing irradiation due to toxicity. We additionally demonstrated by flow cytometry that NB-UVB irradiation induces the increment of the proportion of regulatory T cell (Tregs) in patients’ peripheral blood. These results suggest that NB-UVB may exert beneficial effects on steroid-refractory skin GVHD through the expansion of Tregs.