title: The immunological effect of photopheresis in children with newly diagnosed type 1 diabetes.
abstract: Photopheresis has been claimed to have immune-modulating effects, but the mechanisms of action are unknown. This study investigated the immune effect of photopheresis in children with type 1 diabetes, with a focus on the balance of Th1- and Th2-like cytokines. Ten children with newly diagnosed type 1 diabetes (10-17 y) were treated with five double treatments of photopheresis and 10 children matched for disease, age, and gender were given placebo tablets and sham pheresis. Expression of IFN-gamma and IL-4 mRNA was determined by real-time reverse-transcriptase polymerase chain reaction (RT-PCR) and secretion of IFN-gamma, IL-10, and IL-13 in cell-culture supernatants by ELISA after stimulation with glutamic acid decarboxylase (GAD65) (a.a. 247-279), the ABBOS peptide (a.a. 152-169), insulin, phytohemagglutinin (PHA), and keyhole limpet hemocyanin (KLH). Photopheresis changed antigen-stimulated immune balance in line with a Th2-like shift. Thus, the ratio of IFN-gamma/IL-4 mRNA expression after in vitro stimulation with a peptide of the autoantigen GAD65 was reduced after treatment in the photopheresis group. The IFN-gamma/IL-4 mRNA expression ratio after in vitro stimulation with insulin was also lower in children treated with photopheresis compared with the placebo group. Photopheresis has an immune-modulating effect in children with type 1 diabetes, causing a Th2-like deviation.
authors.affiliation: Division of Pediatrics and Diabetes Research Centre, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden. maria.faresjo@imk.liu.se
authors.forename: Maria Karlsson
authors.initials: MK
authors.lastname: Faresjö
authors.forename: Jan
authors.initials: J
authors.lastname: Ernerudh
authors.forename: Gösta
authors.initials: G
authors.lastname: Berlin
authors.forename: Jorge
authors.initials: J
authors.lastname: Garcia
authors.forename: Johnny
authors.initials: J
authors.lastname: Ludvigsson
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood; D002096:C-Peptide / Q000097:blood; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000628:therapy*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology; D017893:Photopheresis
chemical_list: D001323:Autoantibodies; D002096:C-Peptide