Department of Transfusion Medicine and Transplantation Biology, University Hospital Center Zagreb, Zagreb, Croatia.
School of Medicine, University of Zagreb, Zagreb, Croatia.
Front Immunol. 2023 Feb 17;14:1086006. doi: 10.3389/fimmu.2023.1086006. eCollection 2023.
Haematopoietic stem cell transplantation (HSCT) is the treatment of choice for malignant haematological diseases. Despite continuous improvements in pre- and post-transplantation procedures, the applicability of allo-HSCT is limited by life-threatening complications such as graft-versus-host disease (GvHD), engraftment failure, and opportunistic infections. Extracorporeal photopheresis (ECP) is used to treat steroid resistant GvHD with significant success. However, the molecular mechanisms driving its immunomodulatory action, whilst preserving immune function, require further understanding. As ECP is safe to administer with few significant adverse effects, it has the potential for earlier use in the post-HSCT treatment of GvHD. Thus, further understanding the immunomodulatory mechanisms of ECP action may justify more timely use in clinical practice, as well as identify biomarkers for using ECP as first line or pre-emptive GvHD therapy. This review aims to discuss technical aspects and response to ECP, review ECP as an immunomodulatory treatment modality for chronic GvHD including the effect on regulatory T cells and circulating vs. tissue-resident immune cells and consider the importance of emerging biomarkers for ECP response.
造血干细胞移植（HSCT）是治疗恶性血液病的首选方法。尽管在移植前和移植后程序方面不断取得进展，但同种异体 HSCT 的适用性受到危及生命的并发症的限制，例如移植物抗宿主病（GvHD）、植入失败和机会性感染。体外光化学疗法（ECP）已成功用于治疗皮质类固醇耐药性 GvHD。然而，驱动其免疫调节作用的分子机制，同时保留免疫功能，需要进一步理解。由于 ECP 给药安全，副作用很少，因此有可能在 HSCT 后 GvHD 的治疗中更早使用。因此，进一步了解 ECP 作用的免疫调节机制可能 justifies 在临床实践中更及时地使用，以及确定 ECP 作为一线或预防性 GvHD 治疗的生物标志物。本综述旨在讨论 ECP 的技术方面和反应，综述 ECP 作为慢性 GvHD 的免疫调节治疗方式，包括对调节性 T 细胞和循环与组织驻留免疫细胞的影响，并考虑 ECP 反应的新兴生物标志物的重要性。
