Photopheresis immunomodulation after heart transplantation

Maccherini, Massimo; Diciolla, Francesco; Laghi-Pasini, Franco; Lisi, Gianfranco; Tanganelli, Piero; D'Ascenzo, G; Mondillo, Sergio; Carone, Enrico; Oricchio, Luca; Baraldi, Claudia; Capecchi, Pier Leopoldo; Lazzerini, Pietro Enea; Toscano, Thomas; Barretta, Antonio; Giunti, Guido; Schuerfeld, Karin; Fimiani, Michele; Papalia, Ugo

doi:10.1016/s0041-1345(00)02605-1

Cited by 18 publications

(15 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Because of its safety and efficacy in the treatment of cutaneous T cell lymphoma, ECP has been investigated in a variety of diseases that have a suspected involvement of pathogenic T cells, including rejection of organ transplants, graft-vs-host-disease (GvHD), and autoimmune disorders. In heart transplantation, ECP prevents chronic rejection (4) and reduces acute rejection episodes of cardiac transplants (5). In patients with GvHD.…”

Section: T He Basis Of Extracorporeal Photopheresis (Ecp)mentioning

confidence: 99%

Experimental Extracorporeal Photopheresis Inhibits the Sensitization and Effector Phases of Contact Hypersensitivity via Two Mechanisms: Generation of IL-10 and Induction of Regulatory T Cells

Maeda

Schwarz

Bullinger³

et al. 2008

The Journal of Immunology

View full text Add to dashboard Cite

Extracorporeal photopheresis (ECP) is used to treat immune-mediated diseases including transplant rejection and graft-vs-host-disease. An experimental murine model of ECP utilizing contact hypersensitivity (CHS) revealed that ECP inhibits the sensitization of CHS and induces regulatory T cells (Treg). In this study, we find that ECP inhibits not only the sensitization but also the effector phase of CHS, although Treg only inhibited sensitization. IL-10 was determined to be a critical component of the effector phase inhibition and also a driving force in developing Treg. Thus, we propose that the inhibition of the effector phase of CHS by ECP is a process that does not require Treg but may be mediated via enhanced IL-10 as suggested by the use of IL-10-deficient mice. This suggests that ECP has at least two mechanisms of action, one inhibiting the effector phase of CHS and one generating Treg, which in turn can inhibit CHS sensitization and is responsible for the transferable protection. Together, this may help explain the clinical benefits of ECP in prophylactic, acute, and therapeutic settings.

show abstract

Section: T He Basis Of Extracorporeal Photopheresis (Ecp)mentioning

confidence: 99%

Experimental Extracorporeal Photopheresis Inhibits the Sensitization and Effector Phases of Contact Hypersensitivity via Two Mechanisms: Generation of IL-10 and Induction of Regulatory T Cells

Maeda

Schwarz

Bullinger³

et al. 2008

The Journal of Immunology

View full text Add to dashboard Cite

show abstract

“…An intravenous formulation of 8-MOP, UVADEX, allows for direct addition of the photosensitizing agent to the collected plasma and buffy coat ex vivo prior to UVA exposure. ECP was originally introduced for the treatment of cutaneous T-cell lymphoma by Edelson et al [1]; thereafter it was shown that ECP reduces the incidence of acute and chronic heart rejection [2][3][4] and alloreactive T-cell responses in graft versus host diseases (GvHD) [5]. In heart transplant patients, ECP reduces cardiac rejection episodes, decreases the frequency of cytomegalovirus infections [2], and decreases coronary artery intimal thickness [6].…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal photochemotherapy

Maeda

2009

Journal of Dermatological Science

View full text Add to dashboard Cite

Although extracorporeal photochemotherapy (ECP) is reported to be effective for a wide variety of diseases, such as cutaneous T cell lymphoma, autoimmune diseases, organ graft rejection, and graft versus host disease, its mechanism of action remains unclear. The basis of extracorporeal photopheresis is the reinfusion of leukocytes previously exposed to 8-methoxypsoralen (8-MOP) and ultraviolet A radiation. Although only 5-10% of circulating mononuclear cells is treated during one ECP procedure, the treatment has long-lasting immunomodulatory effects. The advantage of photopheresis treatment is the low frequency of side effects related to treatment. The disadvantages, however, are the practical efforts required and the high treatment cost. Recent studies demonstrated that ECP downregulates the immune response and induces tolerance by regulatory T cells. Other studies suggest that the mechanism of ECP also involves the recruitment and involvement of additional immune cells. Although immune tolerance induced by ECP is the most likely mechanism of the clinical efficacy of ECP it is not clear how ECP, both activates tumor immunity against cutaneous T-cell lymphoma and induces tolerance in autoreactive disorders. Further studies are necessary to determine the details of the underlying mechanisms of action.

show abstract

“…In heart transplantation, ECP prevents chronic rejection (3,4), reduces acute rejection episodes (5), and is associated with an increased number of apoptotic cells infiltrating the transplanted heart (4). In patients with graft-versus-host-disease, ECP reduces alloreactive T-cell responses (6,7); a partial success has also been reported in type 1 diabetes (8) but ECP had no beneficial effect in multiple sclerosis (9).…”

mentioning

confidence: 99%

The Immunological Effects of Extracorporeal Photopheresis Unraveled: Induction of Tolerogenic Dendritic Cells In Vitro and Regulatory T Cells In Vivo

Parisi²,

et al. 2005

View full text Add to dashboard Cite

Extracorporeal photopheresis (ECP) may represent an alternative to immunosuppression, as a means of reducing rejection after thoracic organ transplantation. The mechanism by which ECP exerts its protective effects has, until now, remained elusive. We analyzed peripheral blood mononuclear cells of four children with chronic heart and lung transplant rejection, who received ECP in addition to conventional immunosuppressive treatment. The effects of ECP were evaluated at each cycle, comparing blood samples from the same patient collected before and after treatment. In vitro, peripheral blood mononuclear cells treated with ECP undergo apoptosis and are phagocytosed by immature dendritic cells, which, in turn, acquire a tolerogenic phenotype. The frequency of T cells, with a regulatory phenotype and strong suppressive activity, was significantly increased in the blood of ECP-treated patients. The immunomodulatory effects of ECP may be explained by its ability to increase the frequency of regulatory T cells with inhibitory action on transplant immune rejection.

show abstract

Photopheresis immunomodulation after heart transplantation

Cited by 18 publications

References 13 publications

Experimental Extracorporeal Photopheresis Inhibits the Sensitization and Effector Phases of Contact Hypersensitivity via Two Mechanisms: Generation of IL-10 and Induction of Regulatory T Cells

Experimental Extracorporeal Photopheresis Inhibits the Sensitization and Effector Phases of Contact Hypersensitivity via Two Mechanisms: Generation of IL-10 and Induction of Regulatory T Cells

Extracorporeal photochemotherapy

The Immunological Effects of Extracorporeal Photopheresis Unraveled: Induction of Tolerogenic Dendritic Cells In Vitro and Regulatory T Cells In Vivo

Contact Info

Product

Resources

About