Induction of regulatory T cells after prophylactic treatment with photopheresis in renal transplant recipients.
Extracorporeal photopheresis (ECP), originally used to treat cutaneous T-cell lymphoma, also has been applied to the therapy of transplant rejection. Our aim was to investigate the biologic response in two children who underwent kidney transplantation with ECP as prophylactic treatment. They received conventional immunosuppressive therapy and ECP immediately after transplantation: six applications over the course of 3 weeks. During a 12-month follow-up, the clinical course was favorable in both patients; renal histology was normal 6 months after transplantation. When compared with four transplanted controls, the ECP-treated patients showed lower tumor necrosis factor-alpha serum levels in the short-term and a marked increase of Foxp3-positive T-regulatory cells. T-regulatory cells were still higher than in the controls 1 year after transplantation. These preliminary results suggest that the addition of ECP to standard immunosuppressive therapy induces a tolerogenic shift in the immune system of kidney transplanted patients and may pave the way to preventing chronic rejection.
Lamioni
Andrea
A
Research Center, Bambino Gesu Children's Research Hospital, Rome, Italy.
Carsetti
Rita
R
Legato
Antonia
A
Landolfo
Attilio
A
Isacchi
Giancarlo
G
Emma
Francesco
F
Bottazzo
Gian Franco
GF
Dello Strologo
Luca
L
D015703:Antigens, CD / Q000276:immunology; D002648:Child; D003404:Creatinine / Q000097:blood; D006801:Humans; D007674:Kidney Diseases / Q000145:classification / Q000601:surgery; D016030:Kidney Transplantation / Q000276:immunology*; D008212:Lymphocyte Depletion; D008730:Methoxsalen / Q000627:therapeutic use; D017893:Photopheresis; D011184:Postoperative Period; D050378:T-Lymphocytes, Regulatory / Q000187:drug effects / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015703:Antigens, CD; D014409:Tumor Necrosis Factor-alpha; D003404:Creatinine; D008730:Methoxsalen