Immunomodulatory effects of extracorporeal photochemotherapy in patients with extensive chronic graft-versus-host disease
Immunomodulatory effects of extracorporeal photochemotherapy in patients with extensive chronic graft-versus-host disease
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DOI：
10.1182/blood.v98.5.1622
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发表时间：
2001-09-01
期刊：
影响因子：
20.3
通讯作者：
Foss, FM
中科院分区：
文献类型：
--
作者：
Alcindor, T;Gorgun, G;Foss, FM
体外光化学疗法(ECP)可改善异基因骨髓移植后急、慢性移植物抗宿主病(CGVHD)患者的临床症状，但其作用机制尚不清楚。这项研究验证了一种假设，即在cGVHD患者中，ECP通过影响激活的淋巴细胞群体或通过改变效应淋巴细胞和抗原提呈细胞(APC)之间的相互作用来调节同种异体反应。对10例难治性慢性移植物抗宿主病(CGVHD)患者进行体外反搏治疗，评价其临床疗效和免疫学效果。7例cGVHD有反应，3例临床表现无变化。1例患者死于TRAM导管相关的脓毒症。ECP后观察到的免疫效应包括CD4/CD8细胞倒置比值正常化，CD3-CD56(+)自然杀伤(NK)细胞数量增加，CD80(+)和CD123(+)树突状细胞减少。结果提示ECP对慢性移植物抗宿主病患者的NK细胞和APC细胞均有调节作用。(C)2001年，由美国血液病学会提供。
Extracorporeal photochemotherapy (ECP) has been associated with clinical improvement in several patients with acute and chronic graft-versus-host disease (cGVHD) after allogeneic bone marrow transplantation, but the mechanism of action Is unknown. This study tested the hypothesis that in patients with cGVHD, ECP modulates alloreactivity by affecting activated lymphocyte populations or by altering the interaction between effector lymphocytes and antigen-presenting cells (APCs). Ten patients who had refractory cGVHD were treated with ECP, and the clinical response to and immunologic effects of this therapy were assessed. Seven patients had a response and 3 had no change in clinical manifestations of cGVHD. One patient died tram catheter-related sepsis. Immunologic effects observed after ECP included normalization of inverted ratios of CD4 to CD8 cells, an increase in the number of CD3-CD56(+) natural killer (NK) cells, and a decrease in CD80(+) and CD123(+) circulating dendritic cells. The results suggest that ECP modulates both NK cells and APC populations in patients with cGVHD. (C) 2001 by The American Society of Hematology.