光量子血液疗法后的视网膜毒性反应。
Retinal toxic reactions following photopheresis.
作者信息
Vagace Jose Manuel, Gervasini Guillermo, Morais Fernando, Benitez Julio, Alonso Nieves, de Argila Diego, Arranz Isabel, Bajo Roberto
机构信息
Department of Hematology, University Hospital Infanta Cristina, Avda Elvas s/n, E-06080 Badajoz, Spain.
出版信息
Arch Dermatol. 2007 May;143(5):622-5. doi: 10.1001/archderm.143.5.622.
BACKGROUND
Extracorporeal photochemotherapy (ECP), also known as photopheresis, is a generally well-tolerated therapeutic, immunomodulatory approach successfully used in cutaneous T-cell lymphoma and other diseases produced by T-lymphocytes such as graft vs host disease.
OBSERVATIONS
On 2 separate occasions, a 54-year-old white man with Sézary syndrome developed cutaneous phototoxic reactions and chorioretinitis after being treated with ECP. A pharmacokinetic study showed therapeutic blood levels of 8-methoxypsoralen as long as 18 weeks after therapy had been terminated. However, the analysis of mutations in genes involved in the drug's disposition could not explain these abnormal levels.
CONCLUSIONS
To our knowledge, there has been no previous description of ECP-related retinal toxic effects. This adverse effect was probably linked to impaired drug elimination. Further studies would be needed to determine the underlying mechanism.
背景
体外光化学疗法（ECP），也称为光分离置换法，是一种耐受性良好的治疗性免疫调节方法，已成功应用于皮肤T细胞淋巴瘤及其他由T淋巴细胞引起的疾病，如移植物抗宿主病。
观察结果
在2个不同的时间点，一名患有塞扎里综合征的54岁白人男性在接受ECP治疗后出现皮肤光毒性反应和脉络膜视网膜炎。一项药代动力学研究显示，在治疗终止后长达18周的时间里，血液中8-甲氧基补骨脂素仍维持在治疗水平。然而，对参与药物代谢的基因突变分析无法解释这些异常水平。
结论
据我们所知，此前尚无关于ECP相关视网膜毒性作用的描述。这种不良反应可能与药物清除受损有关。需要进一步研究以确定其潜在机制。
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