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Journal of the American Academy of Dermatology
Volume 41, n° 6
pages 980-986 (décembre 1999)
Doi : 10.1016/S0190-9622(99)70257-4
accepted : 24 June 1999
Extracorporeal photochemotherapy does not suppress T- or B-cell responses to novel or recall antigens

Karen Rebecca Suchin, MD, Maureen Cassin, BS, Rita Washko, MD, George Nahass, MD, Michael Berkson, MD, Bruce Stouch, MS, Benjamin R. Vowels, PhD, Alain H. Rook, MD
Philadelphia, Pennsylvania 
From the Department of Dermatology, School of Medicine, University of Pennsylvania. Deceased 


Background: Extracorporeal photopheresis (ExP) is an effective therapy for several conditions including cutaneous T-cell lymphoma, scleroderma, and allograft rejection. Experimental animal models suggest that ExP may induce antigen-specific immunosuppression. Objective: Our purpose was to determine the effect of photopheresis on humoral and cell-mediated immunity in human subjects. Methods: Recall and primary immune responses of patients with scleroderma receiving monthly ExP treatments were assessed by delayed type hypersensitivity skin tests, T-cell proliferative responses after immunizations with tetanus toxoid and keyhole limpet hemocyanin, and serum antibody titers against common viral pathogens. Results: After 6 months of ExP, viral antibody titers and delayed type hypersensitivity responses were not significantly different from baseline values in all 7 patients tested. T-cell responses to tetanus toxoid remained normal in 3 of 3 patients tested for a minimum of 6 months after booster immunization. Immunization with the protein antigen keyhole limpet hemocyanin after initiation of ExP therapy resulted in sustained T-cell proliferative responses up to 6 months in 3 of 3 patients. Conclusion: These results, along with the observation of no increased incidence of opportunistic infections or neoplasms, suggest that ExP is not broadly immunosuppressive and does not prevent primary responses to vaccination or other antigenic challenges. (J Am Acad Dermatol 1999;41:980-6.)

The full text of this article is available in PDF format.

 Reprint requests: Alain Rook, MD, Department of Dermatology, Hospital of the University of Pennsylvania, 2 Rhoads Pavilion, 3600 Spruce St, Philadelphia, PA 19104-4283.
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