Tsirigotis Panagiotis, Kapsimalli Violetta, Baltadakis Ioannis, Kaloyannidis Panayotis, Karakasis Dimitrios, Papalexandri Apostolia, Psarra Ekaterini, Nosi Efi, Konsta Evi, Vikentiou Myrofora, Papageorgiou Sotirios, Sakellari Ioanna, Pappa Vassiliki, Harhalakis Nikolaos, Anagnostopoulos Achilles, Dervenoulas John
2nd Department of Internal Medicine, "ATTIKON" General University Hospital, Medical School, University of Athens, Greece.
Transfus Apher Sci. 2012 Apr;46(2):181-8. doi: 10.1016/j.transci.2011.10.028. Epub 2011 Nov 23.
Extracorporeal photopheresis (ECP) has been established as an effective treatment modality for patients with chronic extensive graft-versus host disease (GVHD). In the present study, we evaluated the influence of ECP on the numbers of CD4+, CD8+, CD20+, CD56+ cells, and on T-regulatory (Tregs), as well as on the numbers of naïve, central memory (CM), and effector memory (EM) T-cells in patients treated for refractory chronic GVHD. Flow cytometric analysis of peripheral blood lymphocytes was performed for the calculation of the different T-cell subsets. Patients with GVHD had a higher percentage of EM-CD4+ cells in comparison with healthy donors (p=0.046). The percentages of naïve-CD8+, naïve-CD4+, CM-CD8+, CM-CD4+, EM-CD8+, and Tregs were not different between patients with GVHD and healthy donors. Similarly there was no statistical difference in the percentages of naïve, CM, and EM CD4+ and CD8+ cells before and after 3 months of treatment with ECP. However, in the subset of Tregs a statistically significant increase was observed after 3 months of treatment with ECP (p=0.015). Responders to ECP had statistically significantly higher absolute numbers of CD4+, and CD8+ cells, in comparison with non-responders. These data further support the concept that ECP does not cause immune-suppression, but should be better considered as an immune-modulating treatment.
体外光化学疗法（ECP）已被确立为治疗慢性广泛性移植物抗宿主病（GVHD）患者的一种有效治疗方式。在本研究中，我们评估了ECP对难治性慢性GVHD患者CD4 +、CD8 +、CD20 +、CD56 +细胞数量以及对调节性T细胞（Tregs）的影响，同时也评估了其对初始、中枢记忆（CM）和效应记忆（EM）T细胞数量的影响。通过对外周血淋巴细胞进行流式细胞术分析来计算不同的T细胞亚群。与健康供体相比，GVHD患者的EM - CD4 +细胞百分比更高（p = 0.046）。GVHD患者与健康供体之间，初始 - CD8 +、初始 - CD4 +、CM - CD8 +、CM - CD4 +、EM - CD8 +和Tregs的百分比没有差异。同样，在接受ECP治疗3个月前后，初始、CM和EM CD4 +和CD8 +细胞的百分比也没有统计学差异。然而，在Tregs亚群中，接受ECP治疗3个月后观察到有统计学意义的增加（p = 0.015）。与无反应者相比，ECP反应者的CD4 +和CD8 +细胞绝对数量在统计学上显著更高。这些数据进一步支持了ECP不会引起免疫抑制，而应更好地被视为一种免疫调节治疗的概念。
