Fotofereza pozaustrojowa w leczeniu chorych na twardzinę układową
Abstract
Fotofereza pozaustrojowa (ECP) jest formą terapii komórkowej o działaniu immunomodulującym. Polega na separacji leukocytów z krwi obwodowej, ich aktywacja za pomocą metoksalenu, a następnie naświetleniu promieniowaniem UVA i reinfuzji do krwiobiegu. Fotofereza pozaustrojowa znajduje zastosowanie w leczeniu choroby przeszczep przeciw gospodarzowi po allogenicznej transplantacji komórek krwiotwórczych oraz w leczeniu chłoniaków skórnych. Jej skuteczność opisano też jednak w odniesieniu do wielu chorób autoimmunologicznych, w tym twardziny układowej (SSc). W niniejszej pracy przedstawiono metodologię ECP, mechanizmy działania, a także doświadczenia kliniczne u chorych na SSc, obejmujące
trzy prospektywne badania randomizowane oraz siedem prospektywnych lub retrospektywnych analiz bez grupy porównawczej. Wskazują one, że poprawę w zakresie zmian skórnych można uzyskać u ponad połowy chorych. Metoda cechuje się dobrą tolerancją i może stanowić opcję, zwłaszcza dla chorych bez zajęcia narządów wewnętrznych.
Forum Reumatol. 2019, tom 5, nr 1: 27–32
Keywords: fotofereza pozaustrojowatwardzina układowaskuteczność
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