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Extracorporeal photopheresis (photochemotherapy) in the treatment of acute and chronic graft versus host disease: immunological mechanisms and the results from clinical studies

机译：体外光透疗法（光化学疗法）在治疗急性和慢性移植物抗宿主疾病中的作用：免疫机制和临床研究结果

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摘要

Extracorporeal photopheresis (ECP) is an immunomodulatory alternative for treatment of graft versus host disease (GVHD). The blood is then separated into its various components through apheresis; buffy coat cells are thereafter treated with 8-methoxypsoralen before exposure to ultraviolet light and finally reinfused into the patient. There is a general agreement that this treatment has an anti-GVHD effect, but the mechanisms of action behind this effect are only partly understood. However, altered maturation of dendritic cells (DC) and thereby indirect modulation of T-cell reactivity seems to be one important mechanism together with DC-presentation of antigens derived from apoptotic donor T cells and induction of regulatory T cells. The treatment has been best studied in patients with chronic GVHD (both pediatric and adult patients), but most studies are not randomized and it is difficult to know whether the treatment is more effective than the alternatives.
机译：体外光透疗法（ECP）是用于治疗移植物抗宿主病（GVHD）的一种免疫调节替代品。然后通过单采血液将血液分离成各种成分。之后，在暴露于紫外线之前，用8-甲氧基补骨脂素处理血沉棕黄层细胞，最后重新注入患者体内。人们普遍同意这种治疗方法具有抗GVHD的作用，但对该作用背后的作用机理仅部分了解。然而，改变树突状细胞（DC）的成熟度，从而间接调节T细胞反应性，似乎是一种重要的机制，与DC呈递来自凋亡供体T细胞的抗原和诱导调节性T细胞一起。对于患有慢性GVHD的患者（儿童患者和成年患者），最好的研究方法是治疗，但是大多数研究不是随机的，因此很难知道该治疗方法是否比其他方法更有效。

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