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Extracorporeal photochemotherapy--present and future.

¹Division of Special and Environmental Dermatology, Vienna General Hospital, University of Vienna, Austria.

|August 12, 2000

Summary

Extracorporeal photochemotherapy (ECP) is a widely accepted treatment for various T-cell mediated diseases, including cutaneous T-cell lymphoma and graft-versus-host disease. ECP demonstrates a low side-effect profile and is increasingly used for transplant rejection and inflammatory bowel disease.

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Area of Science:

Immunology
Dermatology
Transplantation Medicine

Background:

Extracorporeal photochemotherapy (ECP) was developed in 1985 and is now used in over 160 centers.
ECP has gained acceptance for dermatological and non-dermatological conditions despite some controversy.
Recent data highlight ECP's favorable side-effect profile.

Purpose of the Study:

To review the current applications and proposed mechanisms of Extracorporeal Photochemotherapy (ECP).
To highlight ECP's role in managing T-cell mediated diseases and transplant-related complications.

Main Methods:

Review of existing literature and clinical data on ECP.
Analysis of ECP's efficacy in various dermatological and non-dermatological indications.
Exploration of proposed immunological mechanisms underlying ECP's therapeutic effects.

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Main Results:

ECP is effective in treating cutaneous T-cell lymphoma, acute and chronic graft-versus-host disease (GvHD).
ECP plays a significant role in managing allograft rejection (renal, lung, cardiac) and steroid-refractory inflammatory bowel disease.
Proposed mechanisms include induction of anticlonotypic immunity, T-cell apoptosis, and antigen-presenting cell activation.

Conclusions:

ECP is a valuable therapeutic option for a range of T-cell mediated conditions.
Its efficacy is supported by a low side-effect profile and plausible immunological mechanisms.
Further research into ECP's mechanisms may optimize its clinical application.