Extracorporeal photochemotherapy does not suppress T- or B-cell responses to novel or recall antigens

Suchin, Karen Rebecca; Cassin, Maureen; Washko, Rita; Nahass, George T.; Berkson, Michael; Stouch, Bruce C.; Vowels, Benjamin R.; Rook, Alain H.

doi:10.1016/s0190-9622(99)70257-4

Cited by 77 publications

(59 citation statements)

References 15 publications

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“…Although these diseases are extremely heterogeneous clinically, they share similar underlying pathophysiological mechanisms and response to immunosuppressive therapies. It is unlikely that ECP induces a generalized immunosuppression because patients, including those undergoing long-term ECP therapy, have no reported higher risk of developing infections or malignancies (9) and respond normally to both novel and recall Ag (10). More recently, it has been suggested that ECP may induce Ag-specific immunomodulation, possibly via regulatory T cells (Tr) (11).…”

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confidence: 99%

Intravenous Infusion of Syngeneic Apoptotic Cells by Photopheresis Induces Antigen-Specific Regulatory T Cells

Maeda¹,

Schwarz²,

Kernebeck³

et al. 2005

The Journal of Immunology

209

200

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The basis of extracorporeal photopheresis is the reinfusion of leukocytes previously exposed to 8-methoxypsoralen (8-MOP) and UVA radiation. It has been approved for the palliative treatment of cutaneous T cell lymphoma and has reported benefits in autoimmune diseases, transplant rejection, and graft-vs-host disease. However, the underlying mechanism of photopheresis remains unresolved. Because UVB radiation can cause immune tolerance via induction of regulatory T cells, we studied whether photopheresis exerts a similar effect extracorporeally. Therefore, we established a model of photopheresis using a murine model of contact hypersensitivity. Splenocytes and lymph node cells of mice that were sensitized with dinitrofluorobenzene were exposed to 8-MOP plus UVA in vitro. Intravenous injection of these cells into naive mice caused inhibition of a hapten immune response, which was lost upon depletion of CD11c+ cells but not T cells. Mice that received untreated cells or cells exposed to UVA or 8-MOP alone were not affected. Inhibition was cell-mediated and Ag-specific as demonstrated by transfer of tolerance from the primary recipients into naive animals, which could, however, properly respond to the unrelated hapten oxazolone. Transfer activity was lost when cells were depleted of CD4+ or CD25+ subpopulations. These data suggest that photopheresis exerts its immunomodulatory effects via the induction of Ag-specific regulatory T cells.

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mentioning

confidence: 99%

Intravenous Infusion of Syngeneic Apoptotic Cells by Photopheresis Induces Antigen-Specific Regulatory T Cells

Maeda¹,

Schwarz²,

Kernebeck³

et al. 2005

The Journal of Immunology

209

200

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“…In fact, patients receiving ECP respond normally to new immune challenges such as exposure to pathogens or vaccines. 61 ECP in patients with GVHD does not result in an increased incidence of malignant relapse, and patients undergoing long-term ECP therapy for CTCL and scleroderma do not develop the infections or secondary malignancies that are associated with conventional immunosuppressants. 62,63 Because intravenous access is required to perform ECP, patients are at risk for catheter-related complications including infection and thrombosis.…”

Section: Discussionmentioning

confidence: 99%

An update on the clinical utility of extracorporeal photopheresis in the treatment of graft-versus-host disease

Salem¹,

Webb²,

Jacobsohn³

2017

IJCTM

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Graft-versus-host disease (GVHD) continues to be a major complication following allogeneic hematopoietic cell transplantation (allo-HCT) with high morbidity and mortality. Corticosteroids are the first-line treatment for GVHD; however, a substantial number of patients go on to require second-line treatment where no single therapeutic modality has been proven to be the most effective. Extracorporeal photopheresis (ECP) is an efficient and established therapy for cutaneous T-cell lymphoma, GVHD, rejection after solid organ transplantation and various autoimmune diseases. Although large randomized trials are limited, there is compelling cumulative data on the efficacy of ECP for GVHD, and the response rates, especially for cutaneous involvement, are encouraging. ECP has an excellent safety profile, a well-documented steroid-sparing effect, proven survival benefit and overall quality-of-life improvement. In many institutions, ECP is commonly regarded as the preferred second-line treatment for GVHD.

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“…Considering the delayed clinical responses observed, mechanisms other than the central role of depleting pathogenic T-cell clones may exist. In light of the facts that the standard schedule involves one to two courses weekly for few weeks [5], and that GVHD-treated patients are still able to respond to immune challenges from pathogens or vaccines [6], the key mechanism appears to be an immunomodulation rather than an immunodepletion. made in humans because these studies do not reflect the pathological history of patients, or immune dysregulation during reconstitution, or chronic immunosuppressive drugs for GVHD prevention, or microbial pressure.…”

Section: Mechanisms Of Action For Ecp: From T Lymphocytes Apoptosis Tmentioning

confidence: 99%

Extracorporeal Photopheresis: Scientific and Technical Considerations for Improving Clinical Management of Patients

Garban¹,

Makowski

Carras

et al. 2014

J Stem Cell Res Ther

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Extracorporeal photochemotherapy does not suppress T- or B-cell responses to novel or recall antigens

Cited by 77 publications

References 15 publications

Intravenous Infusion of Syngeneic Apoptotic Cells by Photopheresis Induces Antigen-Specific Regulatory T Cells

Intravenous Infusion of Syngeneic Apoptotic Cells by Photopheresis Induces Antigen-Specific Regulatory T Cells

An update on the clinical utility of extracorporeal photopheresis in the treatment of graft-versus-host disease

Extracorporeal Photopheresis: Scientific and Technical Considerations for Improving Clinical Management of Patients

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