Nicoli Michael, Rovira Jordi, Diekmann Fritz
Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain.
Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
Transplant Direct. 2025 Sep 2;11(9):e1809. doi: 10.1097/TXD.0000000000001809. eCollection 2025 Sep.
Extracorporeal photopheresis (ECP) is emerging as an apoptotic cell-based therapy that suppresses alloimmunity, promotes donor-specific regulation, and reduces the need for conventional maintenance immunosuppression. ECP therapy is associated with regulatory T-cell proliferation, anti-inflammatory effects, and reduction of anti-HLA antibodies, making ECP a possible alternative or adjunct treatment for preventing and treating transplant rejection. Presently, we have a limited understanding of the mechanisms of ECP action, and clinical evidence for efficacy in kidney transplantation is sparse. Promising results in acute cellular or antibody-mediated rejection were reported, but beneficial effects in chronic settings are less evident. The absence of reliable markers for patient stratification and therapeutic monitoring further complicates its application. Working with the European Union-funded exTra network, our group is studying the therapeutic action of ECP in kidney transplantation with the ultimate goal of conducting a large multicenter study to standardize and harmonize treatment indications and approaches.
体外光化学疗法（ECP）正在成为一种基于凋亡细胞的疗法，它可抑制同种免疫、促进供体特异性调节并减少常规维持性免疫抑制的需求。ECP疗法与调节性T细胞增殖、抗炎作用以及抗HLA抗体的减少有关，这使得ECP成为预防和治疗移植排斥反应的一种可能的替代或辅助治疗方法。目前，我们对ECP作用机制的了解有限，且肾移植疗效的临床证据稀少。有报道称在急性细胞性或抗体介导的排斥反应中取得了有前景的结果，但在慢性情况下的有益效果则不太明显。缺乏用于患者分层和治疗监测的可靠标志物进一步使其应用复杂化。我们团队与欧盟资助的exTra网络合作，正在研究ECP在肾移植中的治疗作用，最终目标是开展一项大型多中心研究，以规范和统一治疗适应症及方法。
