Zouboulis C C, Schmuth M, Doepfmer S, Dippel E, Orfanos C E
Department of Dermatology, University Medical Center Benjamin Franklin, Free University of Berlin, Germany.
Dermatology. 1998;196(3):305-8. doi: 10.1159/000017926.
Extracorporeal photopheresis (ECP) has been successfully introduced for the treatment of cutaneous T-cell lymphoma; however, the mechanism(s) of its action is (are) unknown.
To investigate the effects of ECP on the immune system of patients with cutaneous T-cell lymphoma.
Clinical response and changes of lymphocyte subpopulations in 20 patients with cutaneous T-cell lymphoma under ECP monotherapy or combined regimens were evaluated and compared after 3, 6 and 12 ECP cycles.
Thirteen of 20 patients showed a > or = 50% reduction of skin lesions after 6-12 ECP cycles. An overall T-lymphocyte reduction was assessed with a balanced CD4+ T-helper and CD8+ T-suppressor cell decrease in responders. In contrast, there was a trend of CD4+ T-helper cell increase in nonresponders which could result from the failure of treatment to control the natural course of the disease. The CD4+/CD8+ ratios were 1.6 at baseline and 1.4 after 12 cycles in responders, while they increased from 1.7 to 4.1 in nonresponders, respectively (p = 0.47). In addition, there was an overall decrease in the CD57+/CD8+ T-cell subpopulation mostly due to a reduction in the responder group.
The marked differences detected in certain T-cell subpopulations suggest an effect of ECP on peripheral T lymphocytes and, especially, on CD4+ cells.
体外光化学疗法（ECP）已成功应用于皮肤T细胞淋巴瘤的治疗；然而，其作用机制尚不清楚。
研究ECP对皮肤T细胞淋巴瘤患者免疫系统的影响。
对20例接受ECP单一疗法或联合治疗方案的皮肤T细胞淋巴瘤患者，在进行3、6和12个ECP疗程后，评估并比较其临床反应及淋巴细胞亚群的变化。
20例患者中有13例在接受6 - 12个ECP疗程后皮肤病变减少≥50%。应答者的总T淋巴细胞减少，同时CD4 +辅助性T细胞和CD8 +抑制性T细胞均有平衡减少。相比之下，无应答者中CD4 +辅助性T细胞有增加趋势，这可能是由于治疗未能控制疾病自然进程所致。应答者的CD4 + / CD8 +比值在基线时为1.6，12个疗程后为1.4，而无应答者的该比值分别从1.7增至4.1（p = 0.47）。此外，CD57 + / CD8 + T细胞亚群总体减少，主要是由于应答者组减少。
在某些T细胞亚群中检测到的显著差异表明ECP对外周T淋巴细胞，尤其是对CD4 +细胞有影响。
