title: Induction of regulatory T cells after prophylactic treatment with photopheresis in renal transplant recipients.
abstract: 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.
authors.affiliation: Research Center, Bambino Gesu Children's Research Hospital, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lamioni
authors.forename: Rita
authors.initials: R
authors.lastname: Carsetti
authors.forename: Antonia
authors.initials: A
authors.lastname: Legato
authors.forename: Attilio
authors.initials: A
authors.lastname: Landolfo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Isacchi
authors.forename: Francesco
authors.initials: F
authors.lastname: Emma
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Bottazzo
authors.forename: Luca
authors.initials: L
authors.lastname: Dello Strologo
mesh_terms: 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
chemical_list: D015703:Antigens, CD; D014409:Tumor Necrosis Factor-alpha; D003404:Creatinine; D008730:Methoxsalen