Photopheresis: a new therapeutic concept.

摘要: Photopheresis, the process by which peripheral blood is exposed in an extracorporeal flow system to photoactivated 8-methoxypsoralen (8-MOP), a new treatment for disorders caused aberrant T lymphocytes. It now standard therapy advanced cutaneous T-cell lymphoma and shows promise of two autoimmune disorders, pemphigus vulgaris progressive systemic sclerosis (scleroderma). Additional diseases clinical trials are progress include multiple sclerosis, organ transplant rejection, rheumatoid arthritis, AIDS. The mechanism action appears involve "vaccination" against pathogenic cells, clone-specific manner. Photoactivated 8-MOP initiates cascade immunologic events forming covalent photoadducts with nuclear cell surface-adherent DNA possibly other cellular molecules. For reasons not yet fully clarified, but probably related enhanced cycling receptor antigen, photopheresis increases immunogenicity irradiated cells so that their reinfusion induces therapeutically significant reaction targets unirradiated clone(s). specificity induced results from extremely disproportionate expansion clone(s), relative several million clones normal cells.