Extracorporeal photochemotherapy does not suppress T- or B-cell responses to novel or recall antigens

Background: Extracorporeal photopheresis (ExP) is an effective therapy for several conditions including cutaneous T-cell lymphoma, scleroderma, and allograft rejection. Experimental animal models suggest that ExP may induce antigen-specific immunosuppression. Objective: Our purpose was to determine...

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Published in:Journal of the American Academy of Dermatology 1999-12, Vol.41 (6), p.980-986
Main Authors: Suchin, Karen Rebecca, Cassin, Maureen, Washko, Rita, Nahass, George, Berkson, Michael, Stouch, Bruce, Vowels, Benjamin R., Rook, Alain H.
Format: Article
Language:English
Subjects:
Antibody Formation
B-Lymphocytes - immunology
Biological and medical sciences
Humans
Immunity, Cellular
Medical sciences
Photopheresis
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Scleroderma, Systemic - immunology
Scleroderma, Systemic - therapy
Skin Tests
T-Lymphocytes - immunology
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Summary:Background: Extracorporeal photopheresis (ExP) is an effective therapy for several conditions including cutaneous T-cell lymphoma, scleroderma, and allograft rejection. Experimental animal models suggest that ExP may induce antigen-specific immunosuppression. Objective: Our purpose was to determine the effect of photopheresis on humoral and cell-mediated immunity in human subjects. Methods: Recall and primary immune responses of patients with scleroderma receiving monthly ExP treatments were assessed by delayed type hypersensitivity skin tests, T-cell proliferative responses after immunizations with tetanus toxoid and keyhole limpet hemocyanin, and serum antibody titers against common viral pathogens. Results: After 6 months of ExP, viral antibody titers and delayed type hypersensitivity responses were not significantly different from baseline values in all 7 patients tested. T-cell responses to tetanus toxoid remained normal in 3 of 3 patients tested for a minimum of 6 months after booster immunization. Immunization with the protein antigen keyhole limpet hemocyanin after initiation of ExP therapy resulted in sustained T-cell proliferative responses up to 6 months in 3 of 3 patients. Conclusion: These results, along with the observation of no increased incidence of opportunistic infections or neoplasms, suggest that ExP is not broadly immunosuppressive and does not prevent primary responses to vaccination or other antigenic challenges. (J Am Acad Dermatol 1999;41:980-6.)
ISSN:0190-9622
1097-6787
DOI:10.1016/S0190-9622(99)70257-4