title: Narrowband ultraviolet B phototherapy ameliorates acute graft-versus-host disease by a mechanism involving in vivo expansion of CD4+CD25+Foxp3+ regulatory T cells.
abstract: Narrowband ultraviolet B phototherapy (NB-UVB) is a therapeutic alternative for haematopoietic stem cell transplantation-related skin graft-versus-host disease (GVHD). The beneficial effects of this intervention may be induced by direct irradiation of inflammatory cells in the skin; however, the putative involvement of indirect effects on systemic immunity has not been elucidated. To address this issue, 11 acute skin GVHD patients refractory to standard corticosteroid treatment and with no gut/liver involvement were treated with NB-UVB irradiation. The median number of treatments was 10 times, with a mean cumulative exposure of 6.36 J/cm(2). No other immunosuppressive therapy was initiated during irradiation. Eight patients achieved an objective complete response, two had a partial response, and one showed no change. None of the patients experienced progressive skin GVHD or newly diagnosed gut/liver GVHD. NB-UVB was well tolerated, with no patients discontinuing irradiation due to toxicity. We additionally demonstrated by flow cytometry that NB-UVB irradiation induces the increment of the proportion of regulatory T cell (Tregs) in patients' peripheral blood. These results suggest that NB-UVB may exert beneficial effects on steroid-refractory skin GVHD through the expansion of Tregs.
authors.affiliation: Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine, South-1 West-16, Chuo-ku, Sapporo, Japan, iyama@sapmed.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iyama
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Murase
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sato
authors.forename: Akari
authors.initials: A
authors.lastname: Hashimoto
authors.forename: Ayumi
authors.initials: A
authors.lastname: Tatekoshi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Horiguchi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kamihara
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ono
authors.forename: Shohei
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Kohichi
authors.initials: K
authors.lastname: Takada
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kawano
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Koji
authors.initials: K
authors.lastname: Miyanishi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sato
authors.forename: Rishu
authors.initials: R
authors.lastname: Takimoto
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kobune
authors.forename: Satoru
authors.initials: S
authors.lastname: Mori
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamashita
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism; D006086:Graft vs Host Disease / Q000209:etiology* / Q000532:radiotherapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D016130:Immunophenotyping; D053645:Interleukin-2 Receptor alpha Subunit / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012871:Skin Diseases / Q000209:etiology* / Q000532:radiotherapy*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology* / Q000378:metabolism; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000009:adverse effects; D055815:Young Adult
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D053645:Interleukin-2 Receptor alpha Subunit