Abstract
Narrowband ultraviolet B phototherapy (NB-UVB) is a therapeutic alternative for haematopoietic stem cell transplantation-related skin graft-versus-host disease (GVHD). The beneficial effects of this intervention may be induced by direct irradiation of inflammatory cells in the skin; however, the putative involvement of indirect effects on systemic immunity has not been elucidated. To address this issue, 11 acute skin GVHD patients refractory to standard corticosteroid treatment and with no gut/liver involvement were treated with NB-UVB irradiation. The median number of treatments was 10 times, with a mean cumulative exposure of 6.36 J/cm2. No other immunosuppressive therapy was initiated during irradiation. Eight patients achieved an objective complete response, two had a partial response, and one showed no change. None of the patients experienced progressive skin GVHD or newly diagnosed gut/liver GVHD. NB-UVB was well tolerated, with no patients discontinuing irradiation due to toxicity. We additionally demonstrated by flow cytometry that NB-UVB irradiation induces the increment of the proportion of regulatory T cell (Tregs) in patients’ peripheral blood. These results suggest that NB-UVB may exert beneficial effects on steroid-refractory skin GVHD through the expansion of Tregs.
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Acknowledgments
We appreciate the assistance of the physicians, physician assistants, nurses, and support staff on the transplantation units.
Conflict of interest
This manuscript has not been published or submitted for publication elsewhere. All authors have contributed significantly and are in agreement with the content of the manuscript. We declare that there are no financial support or relationships that may pose conflict of interest.
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12185_2014_1530_MOESM1_ESM.pptx
Supplemental Figure 1. The flowcytometric panels (case #1122) to show changes before and after treatment of the NB-UVB (PPTX 2053 kb)
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Supplemental Figure 2. Serum TGF-β levels monitoring in five patients with aGVHD. Statistical comparisons were made using the paired t test (p = 0.0390) (PPTX 55 kb)
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Supplemental Figure 3. Immunohistochemical staining using anti-CD1a antibodies. Complete depletion of the LCs was observed after treatment in two patients (PPTX 12747 kb)
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Iyama, S., Murase, K., Sato, T. et al. Narrowband ultraviolet B phototherapy ameliorates acute graft-versus-host disease by a mechanism involving in vivo expansion of CD4+CD25+Foxp3+ regulatory T cells. Int J Hematol 99, 471–476 (2014). https://doi.org/10.1007/s12185-014-1530-1
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DOI: https://doi.org/10.1007/s12185-014-1530-1