Advertisement

Immunomodulation with Photopheresis

  • M. L. Barr

Abstract

Modern immunosuppressive regimens utilizing cyclosporin or tacrolimus (FK506), azathioprine or mycophenolate mofetil, and corticosteroids, with or without induction protocols using monoclonal or polyclonal antibodies, have resulted in dramatically increased survival of transplanted organs. However, in addition to suppressing the immune response to the allograft, they impair immune function in a non-specific and often toxic fashion, leaving the host susceptible to increased risk of opportunistic infections, malignancy, and the direct side-effects of these drugs. Moreover, there remain significant morbidity and mortality from organ rejection in the form of acute episodes, as well as chronic forms as seen in late-onset progressive graft failure such as transplant coronary disease.

Keywords

Mycophenolate Mofetil Heart Transplant Recipient Acute Cellular Rejection Heart Lung Transplant Mixed Lymphocyte Culture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Gasparro F, Dall’Amico R, Goldminz D et al. Molecular aspects of extracorporeal photochemotherapy. Yale J Biol Med. 1989;62:579–94.PubMedGoogle Scholar
  2. 2.
    Edelson R, Berger C, Gasparro F et al. Treatment of cutaneous T cell lymphoma by extracorporcal photochemotherapy-preliminary results. N Engl J Med. 1987;316:297–303.PubMedCrossRefGoogle Scholar
  3. 3.
    Rook A, Cohen J, Lessin S et al. Therapeutic applications of photopheresis. Derm Clin. 1993;11:339–47.CrossRefGoogle Scholar
  4. 4.
    Lider O, Reshef T, Beraud E et al. Anti-idiotypic network induced by T cell vaccination against experimental autoimmune encephalomyelitis. Science. 1988;239:18l–3.CrossRefGoogle Scholar
  5. 5.
    Berger C, Perez M, Laroche L, Edelson R. Inhibition of autoimmune disease in a murine model of systemic lupus erythematosus induced by exposure to syngeneic photoinactivated lymphocytes. J Invest Dermatol. 1990;94:52–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Perez M, Edelson R, Laroche L, Berger C. Specific suppression of anti-allograft immunity by immunization with syngeneic photoinactivated effector lymphocytes. J Invest Dermatol. 1989;92:669–76.PubMedCrossRefGoogle Scholar
  7. 7.
    Pepino P, Berger C, Fuzesi L et al Primate cardiac allo and xeno transplantation: modulation of the immune response with photochemotherapy. Eur Surg Res. 1989;21:105–13.PubMedGoogle Scholar
  8. 8.
    Rose E, Barr M, Xu H et al. Photochemotherapy in human heart transplant recipients at high risk for fatal rejection. J Heart Lung Transplant. 1992;11:746–50.PubMedGoogle Scholar
  9. 9.
    Costanzo-Nordin M, Hubbell E, O’Sullivan EJ et al. Photopheresis versus corticosteroids in the therapy of heart transplant rejection. Circulation. 1992;86:242–50.Google Scholar
  10. 10.
    Rose E, Pepino P, Barr M et al. Relation of HI-A antibodies and graft atherosclerosis in human cardiac allongraft recipients. J Heart Lung Transplant. 1992;11:S120–3.PubMedGoogle Scholar
  11. 11.
    Barr M, McLaughlin S, Murphy M et al. Prophylactic photopheresis and effect on graft atherosclerosis in cardiac transplantation. Transplant Proc. 1995;27:1993–4.PubMedGoogle Scholar
  12. 12.
    Meiser B, Kur F, Reichenspurner H et al. Reduction of the incidence of rejection by adjunct immunosuppression with photochemotherapy after heart transplantation. Transplantation. 1994;57:563–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Knobler R, Trautinger F, Graninger W et al. Parenteral administration of 8-methoxypsoralen in photopheresis. J Am Acad Dermatol. 1993;28:580PubMedCrossRefGoogle Scholar
  14. 14.
    Dall’Amico R, Livi U, Milano A et al. Extracorporeal photochemotherapy as adjuvant treatment of heart transplant recipients with recurrent rejection. Transplantation. 1995;60:45–9.Google Scholar

Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • M. L. Barr

There are no affiliations available

Personalised recommendations