Immune profile changes induced by extracorporeal photopheresis as prophylactic therapy in lung transplanted cystic fibrosis patients

Abstract Chronic rejection (CR) is the leading cause of late morbidity and mortality upon lung transplantation (LuTx). Extracorporeal photopheresis (ECP) has emerged as a promising immunomodulatory prophylactic induction treatment against rejection. We performed in-depth investigation immunological effects ECP in LuTx recipients with diagnosis cystic fibrosis (CF). A pilot clinical trial enrolled 20 CF patients who were randomly allocated 2 arms: standard immunosuppressive therapy alone vs. plus for 3 months, beginning within 72h from LuTx. Functional activation T NK subpopulations well mRNA expression cytokine secretion profiling evaluated peripheral blood bronchoalveolar lavage (BAL) up to 12 months after Clinical parameters, including respiratory volumes (e.g. FEV1), episodes infections, analyzed well. was tolerated no complications nor opportunistic infections. Rejection rate comparable two groups Notably, significantly better FEV1 observed group overtime. Treg lymphocytes IL10-producing NKs increased, while Th17 cells reduced compared control. Cytokine profile showed that pro-inflammatory cytokines IL1b, IL6) production, increasing anti-inflammatory IL10, IL1RA) both plasma BAL associated immune modulation resulting improved patients’ performance. More extensive studies longer follow-up are needed verify if ECP-induced will have beneficial effect organ Supported by grants Cystic Fibrosis Foundation