[Extracorporeal photochemotherapy].
Photopheresis or extracorporeal photochemotherapy (ECP) is a cellular therapy which combines a leukapheresis followed by ex vivo treatment using psoralen and ultraviolet A irradiation before reinfusion into the patient. Its mechanisms of action remain unclear and selective photodestruction of leukocytes cannot explain the long-lasting immunomodulatory effects. Recent studies demonstrated that ECP down regulates the immune response and induces tolerance through the maturation of dendritic cells and the production of regulatory T cells. Based on these effects, ECP is mainly used for treatment of Sezary syndrome, graft-versus-host disease, organ graft rejection and autoimmune diseases. However, it is still not clear how ECP both activates tumor immunity against cutaneous T-cell lymphoma and induces tolerance in autoreactive disorders. In addition, the use of adjuvant therapies, the long-term effects and various treatment protocols remain to be investigated along with the specific indications.
Viguier
M
M
Université Paris VII, Paris, France.
Pouthier
F
F
Tiberghien
P
P
Aubin
F
F
D001327:Autoimmune Diseases / Q000188:drug therapy; D003713:Dendritic Cells / Q000187:drug effects / Q000276:immunology; D005334:Fever / Q000209:etiology; D006084:Graft Rejection / Q000517:prevention & control; D006086:Graft vs Host Disease / Q000188:drug therapy; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007108:Immune Tolerance / Q000276:immunology; D007165:Immunosuppression Therapy / Q000379:methods*; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy; D017893:Photopheresis / Q000009:adverse effects / Q000379:methods; D012926:Social Control, Formal; D050378:T-Lymphocytes, Regulatory / Q000276:immunology