Cutaneous T cell lymphoma and graft-versus-host disease: A comparison of in vivo effects of extracorporeal photochemotherapy on Foxp3+ regulatory T cells

• Published in: Clinical immunology (Orlando, Fla.) Vol. 133; no. 3; pp. 303 - 313
• Main Authors: Rao, Vidar, Saunes, Marit, Jørstad, Størker, Moen, Torolf
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01-12-2009; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Allergy and Immunology; Biological and medical sciences; Cutaneous T cell lymphoma; Cytokines - blood; Cytokines - immunology; Extracorporeal photochemotherapy; Female; Flow Cytometry; Forkhead box p3; Forkhead Transcription Factors - immunology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft vs Host Disease - immunology; Graft vs Host Disease - therapy; Graft-versus-host disease; Hematologic and hematopoietic diseases; Humans; Immunophenotyping; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, T-Cell, Cutaneous - immunology; Lymphoma, T-Cell, Cutaneous - therapy; Male; Medical sciences; Middle Aged; Mycosis fungoides; Photopheresis - methods; Regulatory T cells; Statistics, Nonparametric; T-Lymphocytes, Regulatory - immunology; Young Adult; Graft-versus-host disease; Mycosis fungoides; Cutaneous T cell lymphoma; Forkhead box p3; Extracorporeal photochemotherapy; Regulatory T cells; Skin disease; Stem cell; Hematopoietic cell; Homograft; Peripheral T cell lymphoma; Immunology; Lymphoproliferative syndrome; T-Lymphocyte; Graft; Photopheresis; Regulatory cell; Transcription factor FOXP3; Immunopathology; Graft versus host disease; Malignant hemopathy; Lymphoid neoplasm; Non Hodgkin lymphoma; Phototherapy; In vivo; Cutaneous hematologic disease; Treatment; Extracorporeat photochemotherapy; Comparative study; Cancer
• ISSN: 1521-6616; 1521-7035
• DOI: 10.1016/j.clim.2009.08.016

Abstract Extracorporeal photochemotherapy (ECP) is a well established treatment for both cutaneous T cell lymphoma (CTCL) and graft-versus-host disease (GVHD). However, the general effector mechanism is not fully settled. Twenty-four patients with CTCL and 14 patients with GVHD were included to assess the relative numbers of regulatory T cells (Treg) and any change in the serum cytokine profile during 6 months of ECP therapy. The relative amount of Treg cells was twice as high in CTCL compared to GVHD and healthy controls. TGF-β was on average three times higher in GVHD than in CTCL. Both patient groups had a small but significant increase in TGF-β after treatment. Our results indicate a strengthened Treg function as a result of ECP. Elevated TGF-β may indicate high Treg activation in GVHD, whereas an increased number of Treg cells in CTCL could be interpreted as a response that is involved in down-regulating the lymphoma cells.