Viguier M, Pouthier F, Tiberghien P, Aubin F
Université Paris VII, Paris, France.
Transfus Clin Biol. 2010 Feb;17(1):28-33. doi: 10.1016/j.tracli.2009.10.005. Epub 2009 Dec 29.
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.
光分离置换法或体外光化学疗法（ECP）是一种细胞疗法，它先进行白细胞单采，然后在将血液回输给患者之前，使用补骨脂素和紫外线A照射进行体外处理。其作用机制尚不清楚，白细胞的选择性光破坏无法解释其持久的免疫调节作用。最近的研究表明，ECP通过树突状细胞的成熟和调节性T细胞的产生来下调免疫反应并诱导耐受。基于这些作用，ECP主要用于治疗蕈样肉芽肿综合征、移植物抗宿主病、器官移植排斥反应和自身免疫性疾病。然而，目前仍不清楚ECP如何既能激活针对皮肤T细胞淋巴瘤的肿瘤免疫，又能在自身反应性疾病中诱导耐受。此外，辅助治疗的使用、长期效果和各种治疗方案以及具体适应症仍有待研究。
