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2014 ; 124
(11
): 1832-42
Nephropedia Template TP
Florek M
; Sega EI
; Leveson-Gower DB
; Baker J
; Müller AM
; Schneidawind D
; Meyer E
; Negrin RS
Blood
2014[Sep]; 124
(11
): 1832-42
PMID25030062
show ga
Acute graft-versus-host disease (GVHD) is induced by alloreactivity of donor T
cells toward host antigens presented on antigen-presenting cells (APCs).
Apoptotic cells are capable of inducing tolerance by altering APC maturation.
Apoptosis can be induced by extracorporeal photopheresis (ECP). We demonstrate
that the use of ECP as a prophylaxis prior to conditioning significantly improves
survival (P < .0001) after bone marrow transplantation (BMT) by inhibiting the
initiation phase of acute GVHD in a murine BMT model. ECP-treated autologous
splenocytes resulted in immune tolerance in the host, including reduced dendritic
cell activation with decreased nuclear factor-?B engagement, increased regulatory
T-cell (Treg) numbers with enhanced expression of cytolytic T
lymphocyte-associated antigen 4, potentiating their suppressive function. The
protective effect required host production of interleukin-10 and host Tregs.
Conventional T cells that entered this tolerant environment experienced reduced
proliferation, as well as a reduction of tissue homing and expression of
activation markers. The induction of this tolerant state by ECP was obviated by
cotreatment with lipopolysaccharide, suggesting that the inflammatory state of
the recipient prior to treatment would play a role in potential clinical
translation. The use of prophylactic ECP may provide an alternative and safe
method for immunosuppression in the bone marrow transplant setting.