Recurrent acute rejection (RR) which is defined as three or more consecutive episodes of moderate/severe rejection, remains a major challenge after heart transplantation (HTX). Treatment for RR are sometimes unsuccessful and the adjunctive course of steroids or polymonoclonal antibodies increase the risk for infections primarily when infections are concurrent. Extracorporeal photopheresis (PP), already used to treat cutaneous T-cell lymphoma and autoimmune diseases, has been proposed as a valid adjuvant treatment for RR.1, 2, 3, 4, 5, 6 The mechanism of action of PP is based on the clinical and experimental evidence3, 7 of an immunomodulation, many aspects of which still need to be better understood. It is well known that substances such as psoralens bind to leucocyte DNA after photoactivation, thereby inhibiting DNA synthesis.8 DNA inhibition does not necessarily cause immediate cell death, but can induce a “stress” response, thus releasing IL-1, IL-6, and TNFα.9 As described in numerous arms of immunologic response, the release of IL1 and IL6 could initiate apoptosis of inflammatory cells. Apoptosis is a phenomenon involving, among other types of cell regulation, lymphocytic cell regulation, which occurs not only during the developmental phase but also in the removal of B and T cells activated in the immune response.10, 11, 12 However, apoptotic cells have been identified both in peripheral blood and lesional infiltrates of mycosis fungoides and systemic sclerosis following PP treatment.13, 14 Our study evaluates PP capability of inducing apoptosis in lymphocytic cells of rejection infiltrates obtained from endomyocradial biopsies (EMB) following HTX.

Schürfeld, K., Giunti, G., Maccherini, M., Rubegni, P., D'Ascenzo, G., Diciolla, F., et al. (1999). Photopheresis after cardiac transplantation induces apoptosis. TRANSPLANTATION PROCEEDINGS, 31(1-2), 125-127 [10.1016/S0041-1345(98)01470-5].

Photopheresis after cardiac transplantation induces apoptosis

Rubegni, P.;Tanganelli, P.;Fimiani, M.;
1999-01-01

Abstract

Recurrent acute rejection (RR) which is defined as three or more consecutive episodes of moderate/severe rejection, remains a major challenge after heart transplantation (HTX). Treatment for RR are sometimes unsuccessful and the adjunctive course of steroids or polymonoclonal antibodies increase the risk for infections primarily when infections are concurrent. Extracorporeal photopheresis (PP), already used to treat cutaneous T-cell lymphoma and autoimmune diseases, has been proposed as a valid adjuvant treatment for RR.1, 2, 3, 4, 5, 6 The mechanism of action of PP is based on the clinical and experimental evidence3, 7 of an immunomodulation, many aspects of which still need to be better understood. It is well known that substances such as psoralens bind to leucocyte DNA after photoactivation, thereby inhibiting DNA synthesis.8 DNA inhibition does not necessarily cause immediate cell death, but can induce a “stress” response, thus releasing IL-1, IL-6, and TNFα.9 As described in numerous arms of immunologic response, the release of IL1 and IL6 could initiate apoptosis of inflammatory cells. Apoptosis is a phenomenon involving, among other types of cell regulation, lymphocytic cell regulation, which occurs not only during the developmental phase but also in the removal of B and T cells activated in the immune response.10, 11, 12 However, apoptotic cells have been identified both in peripheral blood and lesional infiltrates of mycosis fungoides and systemic sclerosis following PP treatment.13, 14 Our study evaluates PP capability of inducing apoptosis in lymphocytic cells of rejection infiltrates obtained from endomyocradial biopsies (EMB) following HTX.
1999
Schürfeld, K., Giunti, G., Maccherini, M., Rubegni, P., D'Ascenzo, G., Diciolla, F., et al. (1999). Photopheresis after cardiac transplantation induces apoptosis. TRANSPLANTATION PROCEEDINGS, 31(1-2), 125-127 [10.1016/S0041-1345(98)01470-5].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/27418
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