Extracorporeal photopheresis and its role in heart transplant rejection: prophylaxis and treatment.

Autor: Slomovich S; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Bell J; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Clerkin KJ; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Habal MV; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Griffin JM; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Raikhelkar JK; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Fried JA; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Vossoughi SR; Department of Pathology & Cell Biology, Columbia University, New York, NY, USA., Finnigan K; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Latif F; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Farr MA; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Sayer GT; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA., Uriel N; Division of Cardiology, Department of Medicine, Columbia University, New York, NY, USA.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2021 Jul; Vol. 35 (7), pp. e14333. Date of Electronic Publication: 2021 May 27.
DOI: 10.1111/ctr.14333
Abstrakt: Heart transplantation is the gold standard therapeutic option for select patients with end-stage heart failure. Unfortunately, successful long-term outcomes of heart transplantation can be hindered by immune-mediated rejection of the cardiac allograft, specifically acute cellular rejection, antibody-mediated rejection, and cardiac allograft vasculopathy. Extracorporeal photopheresis is a cellular immunotherapy that involves the collection and treatment of white blood cells contained in the buffy coat with a photoactive psoralen compound, 8-methoxy psoralen, and subsequent irradiation with ultraviolet A light. This process is thought to cause DNA and RNA crosslinking, ultimately leading to cell destruction. The true mechanism of therapeutic action remains unknown. In the last three decades, extracorporeal photopheresis has shown promising results and is indicated for a variety of conditions. The American Society for Apheresis currently recommends the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma, scleroderma, psoriasis, pemphigus vulgaris, atopic dermatitis, graft-versus-host disease, Crohn's disease, nephrogenic systemic fibrosis, and solid organ rejection in heart, lung, and liver transplantation. In this review, we aim to explore the proposed effects of extracorporeal photopheresis and to summarize published data on its use as a prophylactic and therapy in heart transplant rejection.
(© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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