title: Modified extracorporeal photopheresis with cells from a healthy donor for acute graft-versus-host disease in a mouse model.
abstract: BACKGROUND
  Graft-versus-host disease (GvHD) is a major challenge after hematopoietic stem cell transplantation but treatment options for patients are still limited. In many cases first-line treatment with glucocorticoids is not successful. Among second-line therapies the extracorporeal photopheresis (ECP) is frequently performed, due to induction of selective tolerance instead of general immunosuppression. However, for some patients with severe acute GvHD the leukapheresis step of the ECP procedure is physically exhausting and limits the number of ECP cycles.
  
  
  METHODS
  We hypothesized that leukocytes from healthy cell donors could be used as a replacement for ECP leukocytes gained from the GvHD patient. For this purpose we used a well established mouse model of acute GvHD. The ECP therapy was based on cells with the genetic background of the initial donor of the stem cell transplantation. As a precondition we developed a protocol representing conventional ECP in mice equivalent to clinical used ECP setup.
  
  
  RESULTS
  We could demonstrate that conventional, clinically derived ECP setup is able to alleviate acute GvHD. By using leukocytes obtained from healthy mice with the bone marrow donor's genetic background we could not observe a statistically significant therapeutic effect.
  
  
  CONCLUSIONS
  Conventional human ECP setup is effective in the mouse model of severe acute GvHD. In addition we could not prove that ECP cells from healthy mice with bone marrow donor's genetic background are as effective as ECP cells derived from GvHD mice. Based on our findings, new questions arise for further studies, in which the cellular characteristics for ECP mediated immune tolerance are a matter of investigation.
authors.affiliation: Department of Transfusion Medicine, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Budde
authors.affiliation: Department of Transfusion Medicine, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Kolb
authors.affiliation: Department of Transfusion Medicine, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Salinas Tejedor
authors.affiliation: Department of Hematology and Oncology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Wulf
authors.affiliation: Institute for Cellular and Molecular Immunology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Holger M
authors.initials: HM
authors.lastname: Reichardt
authors.affiliation: Department of Transfusion Medicine, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Riggert
authors.affiliation: Department of Transfusion Medicine, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Tobias J
authors.initials: TJ
authors.lastname: Legler
mesh_terms: D064591:Allografts; D000818:Animals; D001782:Blood Donors; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods; D004195:Disease Models, Animal; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D007108:Immune Tolerance; D008297:Male; D008807:Mice, Inbred BALB C; D017893:Photopheresis / Q000379:methods*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology / Q000473:pathology