Immunological monitoring of extracorporeal photopheresis after heart transplantation Article

International Collaboration

cited authors

  • Dieterlen, M. -T., Bittner, H. B., Pierzchalski, A., Dhein, S., Mohr, F. W., Barten, M. J.

funding text

  • The work presented in this paper was made possible by a funding from the Heart Center Leipzig GmbH. Personnel expenses for M. T. D. were funded by the Heart Center Leipzig GmbH and the University of Leipzig within the scope of the endowed professorship of H. B. B. and to A. P. from the German Federal Ministry of Education and Research (BMBF 1315883).

abstract

  • Extracorporeal photopheresis (ECP) has been used as a prophylactic and therapeutic option to avoid and treat rejection after heart transplantation (HTx). Tolerance-inducing effects of ECP such as up-regulation of regulatory T cells (T-regs) are known, but specific effects of ECP on regulatory T cell (T-reg) subsets and dendritic cells (DCs) are lacking. We analysed different subsets of T-regs and DCs as well as the immune balance status during ECP treatment after HTx. Blood samples were collected from HTx patients treated with ECP for prophylaxis (n = 9) or from patients with histologically proven acute cellular rejection (ACR) of grade >= 1B (n = 9), as well as from control HTx patients without ECP (HTxC; n = 7). Subsets of T-regs and DCs as well as different cytokine levels were analysed. Almost 80% of the HTx patients showed an effect to ECP treatment with an increase of T-regs and plasmacytoid DCs (pDCs). The percentage of pDCs before ECP treatment was significantly higher in patients with no ECP effect (26 center dot 3% +/- 5 center dot 6%) compared to patients who showed an effect to ECP (9 center dot 8% +/- 10 center dot 2%; P = 0 center dot 011). Analysis of functional subsets of CD4(+)CD25(high)CD127(low) T-regs showed that CD62L-, CD120b- and CD147-positive T-regs did not differ between the groups. CD39-positive T-regs increased during ECP treatment compared to HTxC. ECP-treated patients showed higher levels for T helper type 1 (Th1), Th2 and Th17 cytokines. Cytokine levels were higher in HTx patients with rejection before ECP treatment compared to patients with prophylactic ECP treatment. We recommend a monitoring strategy that includes the quantification and analysis of T-regs, pDCs and the immune balance status before and up to 12 months after starting ECP.

Publication Date

  • April 1, 2014

webpage

published in

category

start page

  • 120

end page

  • 128

volume

  • 176

issue

  • 1

WoS Citations

  • 8

WoS References

  • 31