Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2009 Aug;14(4):338-43.
doi: 10.1097/MOT.0b013e32832ce943.

Extracorporeal photopheresis-induced immune tolerance: a focus on modulation of antigen-presenting cells and induction of regulatory T cells by apoptotic cells

Chang-Qing Xia  1 , Kim A Campbell, Michael J Clare-Salzler
Affiliations
Review

Extracorporeal photopheresis-induced immune tolerance: a focus on modulation of antigen-presenting cells and induction of regulatory T cells by apoptotic cells

Chang-Qing Xia et al. Curr Opin Organ Transplant. 2009 Aug.

Abstract

Purpose of review: This review is intended to introduce recent advances in the research surrounding extracorporeal photopheresis (ECP) with a focus on how apoptotic cells modulate antigen-presenting cells and induce regulatory T cells, given that ECP therapy induces apoptosis of leukocytes collected through leukapheresis.

Recent findings: It has been suggested that ECP therapy, unlike other immunosuppressive regimens, does not cause global immunosuppression, but induces immune tolerance. Recent clinical and animal studies demonstrate that ECP therapy induces antigen-specific regulatory T cells, including CD4+CD25+FoxP3+ T cells and IL-10-producing Tr1 cells, that may arise secondarily to the induction of tolerogenic antigen-presenting cells (APCs) by infusion of apoptotic cells. It has also been suggested that ECP therapy may induce IL-10-producing regulatory B cells and regulatory CD8+ T cells. Finally, several recent studies, which examined the cellular elements involved in the uptake of apoptotic cells, demonstrated that apoptotic cells modulate APCs through binding to specific receptors, particularly TAM receptors that provide inhibitory signals that block APC activation.

Summary: ECP therapy induces immune tolerance through modulation of antigen-presenting cells as well as induction of regulatory T cells. ECP therapy has great potential in the management of allogeneic transplantation and autoimmune diseases.

PubMed Disclaimer

Figures

Figure 1
Figure 1. ECP therapy modulates APCs and induces regulatory T cells through apoptotic cells
Leukocytes undergo apoptosis after ECP treatment and the apoptotic leukocytes phagocytosed by APCs, including macrophages and dendritic cells, lead to downregulation of costimulatory molecules and proinflammatory cytokines and upregulation of anti-inflammatory cytokines by APCs to create a tolerogenic environment that facilitates the generation of regulatory T cells.
See this image and copyright information in PMC

References

    1. Edelson R, Berger C, Gasparro F, et al. Treatment of cutaneous T-cell lymphoma by extracorporeal photochemotherapy. Preliminary results. N Engl J Med. 1987;316:297–303. - PubMed
    1. McKenna KE, Whittaker S, Rhodes LE, et al. Evidence-based practice of photopheresis 1987–2001: a report of a workshop of the British Photodermatology Group and the U.K. Skin Lymphoma Group. Br J Dermatol. 2006;154:7–20. - PubMed
    1. Marshall SR. Technology insight: ECP for the treatment of GvHD: can we offer selective immune control without generalized immunosuppression? Nat Clin Pract Oncol. 2006;3:302–314. - PubMed
    1. Flowers ME, Apperley JF, van Besien K, et al. A multicenter prospective phase 2 randomized study of extracorporeal photopheresis for treatment of chronic graft-versus-host disease. Blood. 2008;112:2667–2674. - PubMed
    1. Greinix HT, Socie G, Bacigalupo A, et al. Assessing the potential role of photopheresis in hematopoietic stem cell transplant. Bone Marrow Transplant. 2006;38:265–273. - PubMed

Publication types

Substances