Ultraviolet-induced alloantigen-specific immunosuppression in transplant immunity
Open accessAbstract
After the first observation of the immunosuppressive effects of ultraviolet (UV) irradiation was reported in 1974, therapeutic modification of immune responses by UV irradiation began to be investigated in the context immunization. UV-induced immunosuppression is via the action of regulatory T cells (Tregs). Antigen-specific Tregs were induced by high-dose UV-B irradiation before antigen immunization in many studies, as it was considered that functional alteration and/or modulation of antigen-presenting cells by UV irradiation was required for the induction of antigen-specific immunosuppression. However, it is also reported that UV irradiation after immunization induces antigen-specific Tregs. UV-induced Tregs are also dominantly transferable, with interleukin-10 being important for UV-induced immunosuppression. Currently, various possible mechanisms involving Treg phenotype and cytokine profile have been suggested. UV irradiation accompanied by alloantigen immunization induces alloantigen-specific transferable Tregs, which have potential therapeutic applications in the transplantation field. Here we review the current status of UV-induced antigen-specific immunosuppression on the 40(th) anniversary of its discovery.
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CPDs remaining in the genome function as one of the main causes of UV-induced immune suppression.
“CPDs remaining in the genome also function as one of the main causes of UV-induced immune suppression25,26.”
From Modulation of UVB-induced Carcinogenesis by Activation of Alternative DNA Repair Pathways (2018) · cites this paper as [26]
Cites
A CD4+T-cell subset inhibits antigen-specific T-cell responses and prevents colitis
Groux, H., O’Garra, A., Bigler, M., Rouleau, M., Antonenko, S. V., de Vries, J. E., & Roncarolo, M. G. (1997) · Nature · doi:10.1038/39614 · Cited by 3,588 · see citing works
REGULATION OF IMMUNE RESPONSES BY TGF-β
Letterio, J. J., & Roberts, A. B. (1998) · Annual Review of Immunology · doi:10.1146/annurev.immunol.16.1.137 · Cited by 1,894 · see citing works
Toews, G., Bergstresser, P., & Streilein, J. (1980) · Journal of Immunology · doi:10.4049/jimmunol.124.1.445 · Cited by 963 · see citing works
Interleukin-10 induces a long-term antigen-specific anergic state in human CD4+ T cells
Groux, H., Bigler, M., de Vries, J. D., & Roncarolo, M. (1996) · Journal of Experimental Medicine · doi:10.1084/jem.184.1.19 · Cited by 876 · see citing works
Origin, homeostasis and function of Langerhans cells and other langerin-expressing dendritic cells
Merad, M., Ginhoux, F., & Collin, M. (2008) · Nature Reviews Immunology · doi:10.1038/nri2455 · Cited by 850 · see citing works
Ultraviolet-radiation-induced inflammation promotes angiotropism and metastasis in melanoma
Bald, T., Quast, T., Landsberg, J., Rogava, M., Glodde, N., Lopez-Ramos, D., Kohlmeyer, J., Riesenberg, S., van den Boorn-Konijnenberg, D., Hömig-Hölzel, C., et al. (2014) · Nature · doi:10.1038/nature13111 · Cited by 623 · see citing works
Antigenicity of Murine Skin Tumors Induced by Ultraviolet Light2
Kripke, M. L. (1974) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/53.5.1333 · Cited by 481 · see citing works
Inflammatory Skin Diseases, T Cells, and Immune Surveillance
Robert, C., & Kupper, T. S. (1999) · New England Journal of Medicine · doi:10.1056/nejm199912093412407 · Cited by 474 · see citing works
Mast Cells Are Key Promoters of Contact Allergy that Mediate the Adjuvant Effects of Haptens
Dudeck, A., Dudeck, J., Scholten, J., Petzold, A., Surianarayanan, S., Köhler, A., Peschke, K., Voehringer, D., Waskow, C., Krieg, T. M., et al. (2011) · Immunity · doi:10.1016/j.immuni.2011.03.028 · Cited by 455 · see citing works
Rivas, J. M., & Ullrich, S. E. (1992) · Journal of Immunology · doi:10.4049/jimmunol.149.12.3865 · Cited by 436 · see citing works
Yoshikawa, T., Rae, V., Bruins-Slot, W., van den Berg, J.-W., Taylor, J. R., & Streilein, J. W. (1990) · Journal of Investigative Dermatology · doi:10.1111/1523-1747.ep12504877 · Cited by 427 · see citing works
FISHER, M. S., & Kripke, M. L. (1977) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.74.4.1688 · Cited by 400 · see citing works
Elmets, C. A., Bergstresser, P. R., Tigelaar, R. E., Wood, P. J., & Streilein, J. W. (1983) · The Journal of experimental medicine · doi:10.1084/jem.158.3.781 · Cited by 392 · see citing works
FISHER, M. S., & Kripke, M. L. (1982) · Science · doi:10.1126/science.6210958 · Cited by 384 · see citing works
Cooper, K. D., Oberhelman, L., HAMILTON, T. A., Baadsgaard, O., Terhune, M. H., LeVee, G. J., Anderson, T. J., & Koren, H. S. (1992) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.89.18.8497 · Cited by 368 · see citing works
Identification of committed NK cell progenitors in adult murine bone marrow
Rosmaraki, E. E., Douagi, I., Roth, C., Colucci, F., Cumano, A., & Santo, J. P. D. (2001) · European Journal of Immunology · doi:10.1002/1521-4141(200106)31:6 · Cited by 361 · see citing works
Calcineurin inhibitors: 40 years later, can’t live without
Azzi, J. R., Sayegh, M. H., & Mallat, S. G. (2013) · The Journal of Immunology · doi:10.4049/jimmunol.1390055 · Cited by 337 · see citing works
Mechanisms underlying UV-induced immune suppression.
Ullrich, S. (2005) · Mutation research · doi:10.1016/j.mrfmmm.2004.06.059 · Cited by 332 · see citing works
Immune suppression and skin cancer development: regulation by NKT cells
Moodycliffe, A. M., Nghiem, D. X., Clydesdale, G. J., & Ullrich, S. E. (2000) · Nature Immunology · doi:10.1038/82782 · Cited by 318 · see citing works
Interleukin-12 suppresses ultraviolet radiation-induced apoptosis by inducing DNA repair
Schwarz, A., Ständer, S., Berneburg, M., Böhm, M., Kulms, D., van Steeg, H., Grosse-Heitmeyer, K., Krutmann, J., & Schwarz, T. (2002) · Nature Cell Biology · doi:10.1038/ncb717 · Cited by 276 · see citing works
Regulatory T cells and inflammatory bowel disease
Groux, H., & Powrie, F. M. (1999) · Immunology Today · doi:10.1016/s0167-5699(99)01510-8 · Cited by 257 · see citing works
Beissert, S., Schwarz, A., & Schwarz, T. (2005) · Journal of Investigative Dermatology · doi:10.1038/sj.jid.5700004 · Cited by 256 · see citing works
Impairment of antigen-presenting cell function by ultraviolet radiation.
Greene, M. I., Sy, M. S., Kripke, M., & D, B. B. M. (1979) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.76.12.6591 · Cited by 252 · see citing works
Prevention of UV radiation–induced immunosuppression by IL-12 is dependent on DNA repair
Schwarz, A., Maeda, A., Kernebeck, K., van Steeg, H., Beissert, S., & Schwarz, T. (2005) · Journal of Experimental Medicine · doi:10.1084/jem.20041212 · Cited by 202 · see citing works
Mechanisms of UV-induced immunosuppression
Schwarz, T. (2005) · The Keio Journal of Medicine · doi:10.2302/kjm.54.165 · Cited by 200 · see citing works
Schwarz, T. (2007) · Photochemistry and Photobiology · doi:10.1111/j.1751-1097.2007.00223.x · Cited by 197 · see citing works
Schwarz, A., Maeda, A., Wild, M. K., Kernebeck, K., Gross, N., Aragane, Y., Beissert, S., Vestweber, D., & Schwarz, T. (2004) · The Journal of Immunology · doi:10.4049/jimmunol.172.2.1036 · Cited by 192 · see citing works
Kang, K., Hammerberg, C., Meunier, L., et al. (1994) · The Journal of Immunology · doi:10.4049/jimmunol.153.11.5256 · Cited by 191 · see citing works
Further Studies on the Tumor-Specific Suppressor Cells Induced by Ultraviolet Radiation
FISHER, M. S., & Kripke, M. L. (1978) · The Journal of Immunology · doi:10.4049/jimmunol.121.3.1139 · Cited by 186 · see citing works
DC ablation in mice: promises, pitfalls, and challenges
Bennett, C. L., & Clausen, B. E. (2007) · Trends in Immunology · doi:10.1016/j.it.2007.08.011 · Cited by 181 · see citing works
Regulation of TGF-β Response During T Cell Activation Is Modulated by IL-10
Cottrez, F., & Groux, H. (2001) · The Journal of Immunology · doi:10.4049/jimmunol.167.2.773 · Cited by 178 · see citing works
Bromley, S. K., Yan, S., Tomura, M., Kanagawa, O., & Luster, A. D. (2012) · The Journal of Immunology · doi:10.4049/jimmunol.1202805 · Cited by 168 · see citing works
IL-10 Controls Ultraviolet-Induced Carcinogenesis in Mice
Loser, K., Apelt, J., Voskort, M., Mohaupt, M., Balkow, S., Schwarz, T., Grabbe, S., & Beissert, S. (2007) · The Journal of Immunology · doi:10.4049/jimmunol.179.1.365 · Cited by 160 · see citing works
Evidence for Functional Relevance of CTLA-4 in Ultraviolet-Radiation-Induced Tolerance
Schwarz, A., Beissert, S., Grosse-Heitmeyer, K., Gunzer, M., Bluestone, J. A., Grabbe, S., & Schwarz, T. (2000) · The Journal of Immunology · doi:10.4049/jimmunol.165.4.1824 · Cited by 160 · see citing works
Byrne, S. N., Limón-Flores, A. Y., & Ullrich, S. E. (2008) · The Journal of Immunology · doi:10.4049/jimmunol.180.7.4648 · Cited by 157 · see citing works
The Consequences of UV‐Induced Immunosuppression for Human Health
Norval, M., & Halliday, G. M. (2011) · Photochemistry and Photobiology · doi:10.1111/j.1751-1097.2011.00969.x · Cited by 155 · see citing works
Th1/Th2 lymphocyte polarization in asthma
Mazzarella, G., Bianco, A., Catena, E., et al. (2000) · Allergy · doi:10.1034/j.1398-9995.2000.00511.x · Cited by 153 · see citing works
Langerhans Cells Are Required for UVR-Induced Immunosuppression
Schwarz, A., Noordegraaf, M., Maeda, A., Torii, K., Clausen, B. E., & Schwarz, T. (2010) · Journal of Investigative Dermatology · doi:10.1038/jid.2009.429 · Cited by 152 · see citing works
Infections in immunocompromised hosts and organ transplant recipients: Essentials
Fishman, J. A. (2011) · Liver Transplantation · doi:10.1002/lt.22378 · Cited by 151 · see citing works
Changing Views of the Role of Langerhans Cells
Romani, N., Brunner, P. M., & Stingl, G. (2012) · Journal of Investigative Dermatology · doi:10.1038/jid.2011.437 · Cited by 141 · see citing works
UVB exposure-induced systemic modulation of Th1- and Th2-mediated immune responses
Garssen, Vandebriel, Gruijl, D., Wolvers, Dijk, V., Fluitman, & Loveren, V. (1999) · Immunology · doi:10.1046/j.1365-2567.1999.00801.x · Cited by 119 · see citing works
Fukunaga, A., Khaskhely, N. M., Sreevidya, C. S., Byrne, S. N., & Ullrich, S. E. (2008) · The Journal of Immunology · doi:10.4049/jimmunol.180.5.3057 · Cited by 107 · see citing works
The Immunologic Revolution: Photoimmunology
Ullrich, S. E., & Byrne, S. N. (2012) · Journal of Investigative Dermatology · doi:10.1038/jid.2011.405 · Cited by 103 · see citing works
Origin and Characteristics of Ultraviolet-B Radiation-Induced Suppressor T Lymphocytes
Shreedhar, V. K., Pride, M. W., Sun, Y. K., Kripke, M. L., & Strickland, F. M. (1998) · The Journal of Immunology · doi:10.4049/jimmunol.161.3.1327 · Cited by 102 · see citing works
Chacón‐Salinas, R., Limón-Flores, A. Y., Chávez-Blanco, A. D., Gonzalez‐Estrada, A., & Ullrich, S. E. (2010) · The Journal of Immunology · doi:10.4049/jimmunol.1001657 · Cited by 102 · see citing works
Impaired immunosuppressive response to ultraviolet radiation in interleukin-10-deficient mice.
Beissert, S., Hosoi, J., Kühn, R., Rajewsky, K., Müller, W., & Granstein, R. (1996) · Journal of Investigative Dermatology · doi:10.1111/1523-1747.ep12582809 · Cited by 100 · see citing works
Maeda, A., Schwarz, A., Bullinger, A., et al. (2008) · The Journal of Immunology · doi:10.4049/jimmunol.181.9.5956 · Cited by 98 · see citing works
Does Exposure to UV Radiation Induce a Shift to a Th‐2‐like Immune Reaction?
Ullrich, S. E. (1996) · Photochemistry and Photobiology · doi:10.1111/j.1751-1097.1996.tb02454.x · Cited by 98 · see citing works
Ghoreishi, M., & Dutz, J. (2006) · Journal of Immunology · doi:10.4049/jimmunol.176.4.2635 · Cited by 90 · see citing works
Streilein, J. W., Toews, G., Gilliam, J. N., & Bergstresser, P. R. (1980) · Journal of Investigative Dermatology · doi:10.1111/1523-1747.ep12543557 · Cited by 89 · see citing works
Langerhans Cells Serve as Immunoregulatory Cells by Activating NKT Cells
Fukunaga, A., Khaskhely, N. M., Ma, Y., Sreevidya, C. S., Taguchi, K., Nishigori, C., & Ullrich, S. E. (2010) · The Journal of Immunology · doi:10.4049/jimmunol.1000246 · Cited by 81 · see citing works
Mechanisms Underlying the Suppression of Established Immune Responses by Ultraviolet Radiation
Nghiem, D. X., Kazimi, N., Mitchell, D. L., Vink, A. A., Ananthaswamy, H. N., Kripke, M. L., & Ullrich, S. E. (2002) · Journal of Investigative Dermatology · doi:10.1046/j.1523-1747.2002.01845.x · Cited by 81 · see citing works
Phenotypic and Functional Characterization of Ultraviolet Radiation-Induced Regulatory T Cells
Maeda, A., Beissert, S., Schwarz, T., & Schwarz, A. (2008) · The Journal of Immunology · doi:10.4049/jimmunol.180.5.3065 · Cited by 77 · see citing works
SOLAR ULTRAVIOLET RADIATION AND THE RISK OF INFECTIOUS DISEASE: SUMMARY OF A WORKSHOP*†
Chapman, R. S., Cooper, K. D., Fabo, E. C. D., et al. (1995) · Photochemistry and Photobiology · doi:10.1111/j.1751-1097.1995.tb03966.x · Cited by 77 · see citing works
Plasmacytoid Dendritic Cells: No Longer an Enigma and Now Key to Transplant Tolerance?
Rogers, N. M., Isenberg, J. S., & Thomson, A. W. (2013) · American Journal of Transplantation · doi:10.1111/ajt.12229 · Cited by 66 · see citing works
Regulatory T Cells: Banned Cells for Decades
Loser, K., & Beissert, S. (2011) · Journal of Investigative Dermatology · doi:10.1038/jid.2011.375 · Cited by 59 · see citing works
Schwarz, A., & Schwarz, T. (2010) · Journal of Investigative Dermatology · doi:10.1038/jid.2010.59 · Cited by 55 · see citing works
Aubin, F., & Mousson, C. (2004) · Transplantation · doi:10.1097/01.tp.0000112969.24120.64 · Cited by 55 · see citing works
Ullrich, S. E. (1986) · Transplantation · doi:10.1097/00007890-198609000-00012 · Cited by 52 · see citing works
Schwarz, T., & Beissert, S. (2013) · Journal of Investigative Dermatology · doi:10.1038/skinbio.2013.177 · Cited by 43 · see citing works
UV-induced immunosuppression and the efficacy of vaccination
Norval, M., & Woods, G. M. (2011) · Photochemical & Photobiological Sciences · doi:10.1039/c1pp05105a · Cited by 40 · see citing works
Ultraviolet-irradiated apoptotic lymphocytes produce interleukin-10 by themselves
Tomimori, Y., Ikawa, Y., & Oyaizu, N. (2000) · Immunology Letters · doi:10.1016/s0165-2478(99)00163-7 · Cited by 36 · see citing works
Liver Transplant Tolerance and Its Application to the Clinic: Can We Exploit the High Dose Effect?
Cunningham, E. C., Sharland, A. F., & Bishop, G. A. (2013) · Clinical and Developmental Immunology · doi:10.1155/2013/419692 · Cited by 35 · see citing works
Determining the role of cytokines in UV-induced immunomodulation
Walterscheid, J. P., Nghiem, D. X., & Ullrich, S. E. (2002) · Methods · doi:10.1016/s1046-2023(02)00212-8 · Cited by 35 · see citing works
Early Inflammatory Processes in the Skin
Stamatas, G. N., Morello, A., & Mays, D. (2013) · Current Molecular Medicine · doi:10.2174/15665240113139990047 · Cited by 33 · see citing works
Photoimmunology—illuminating the immune system through photobiology
Leitenberger, J. J., Jacobe, H. T., & Cruz, P. D. (2007) · Seminars in Immunopathology · doi:10.1007/s00281-007-0063-6 · Cited by 27 · see citing works
Stein, P., Rechtsteiner, G., Warger, T., Bopp, T., Fuhr, T., Prüfer, S., Probst, H. C., Stassen, M., Langguth, P., Schild, H., et al. (2010) · Journal of Investigative Dermatology · doi:10.1038/jid.2010.254 · Cited by 25 · see citing works
Osmola-Mańkowska, A. J., Silny, W., Dańczak‐Pazdrowska, A., et al. (2012) · PubMed · Cited by 25 · see citing works
Mottram, P., Mirisklavos, A., Clunie, G. J. A., et al. (1988) · Immunology and Cell Biology · doi:10.1038/icb.1988.49 · Cited by 25 · see citing works
Wang, L., Toda, M., Saito, K., et al. (2007) · International Immunology · doi:10.1093/intimm/dxm124 · Cited by 25 · see citing works
Self-citationUllrich, S. E., & Magee, M. J. (1988) · Transplantation · doi:10.1097/00007890-198807000-00021 · Cited by 22 · see citing works
Ultraviolet radiation-induced immunosuppression of delayed-type hypersensitivity in mice
Nghiem, D. X., Walterscheid, J. P., Kazimi, N., & Ullrich, S. E. (2002) · Methods · doi:10.1016/s1046-2023(02)00207-4 · Cited by 22 · see citing works
The challenges of UV-induced immunomodulation for children’s health
Norval, M. (2011) · Progress in Biophysics and Molecular Biology · doi:10.1016/j.pbiomolbio.2011.07.014 · Cited by 21 · see citing works
Toda, M., Wang, L., Ogura, S., et al. (2010) · International Journal of Cancer · doi:10.1002/ijc.25775 · Cited by 20 · see citing works
Self-citationSUPPRESSION OF THE ELICITATION OF THE IMMUNE RESPONSE TO ALLOANTIGEN BY ULTRAVIOLET RADIATION
Magee, M. J., Kripke, M. L., & Ullrich, S. E. (1989) · Transplantation · doi:10.1097/00007890-198906000-00018 · Cited by 20 · see citing works
Smith, K. C., Wood, S. C., Lu, G., et al. (2005) · European Journal of Immunology · doi:10.1002/eji.200425685 · Cited by 20 · see citing works
MHC class II-KO mice are resistant to the immunosuppressive effects of UV light.
Krasteva, M., Aubin, F., Laventurier, S., et al. (2002) · PubMed · Cited by 18 · see citing works
Plain, K. M., Verma, N. D., Tran, G. T., Nomura, M., Boyd, R. A., Robinson, C. M., Hodgkinson, S. J., & Hall, B. M. (2013) · Transplant Immunology · doi:10.1016/j.trim.2013.10.003 · Cited by 17 · see citing works
Wang, L., Saito, K., Toda, M., et al. (2009) · Immunobiology · doi:10.1016/j.imbio.2009.01.013 · Cited by 16 · see citing works
Self-citationUV-induced immunosuppressive and anti-inflammatory actions: mechanisms and clinical applications.
Dupont, E., & Craciun, L. (2009) · Immunotherapy · doi:10.2217/1750743x.1.2.205 · Cited by 15 · see citing works
Blom, L. H., & Poulsen, L. K. (2013) · Journal of Immunological Methods · doi:10.1016/j.jim.2013.08.008 · Cited by 9 · see citing works
Prolonged skin allograft survival by IL-10 gene-introduced CD4 T cell administration
Miyamoto, T. K., Kaneko, T., Yamashita, M., et al. (2005) · International Immunology · doi:10.1093/intimm/dxh256 · Cited by 9 · see citing works
Hori, T., Kuribayashi, K., Üemoto, S., et al. (2007) · Transplant Immunology · doi:10.1016/j.trim.2007.11.001 · Cited by 8 · see citing works
Self-citationKato, T. (2014) · Annals of Transplantation · doi:10.12659/aot.890890 · Cited by 2 · see citing works
Self-citationDonor chimera model for tolerance induction in transplantation
Rezaee, F., Peppelenbosch, M. P., & Dashty, M. (2013) · Human Immunology · doi:10.1016/j.humimm.2013.01.003 · Cited by 2 · see citing works
Brinkman, C. C., Burrell, B. E., Scalea, J. R., & Bromberg, J. S. (2013) · Methods in molecular biology · doi:10.1007/978-1-62703-493-7_4 · Cited by 1 · see citing works
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Modulation of UVB-induced Carcinogenesis by Activation of Alternative DNA Repair Pathways
Sha, Y., Vartanian, V., Owen, N., Mengden Koon, S. J., Calkins, M. J., Thompson, C. S., Mirafzali, Z., Mir, S., Goldsmith, L. E., He, H., et al. (2018) · Scientific Reports · doi:10.1038/s41598-017-17940-8 · Cited by 12 · see citing works
- Authors
- Hori, T., Kuribayashi, K., Saito, K., Wang, L., Torii, M., Uemoto, S., Iida, T., Yagi, S., & Kato, T.
- Affiliations
- Kyoto University (JP)
- Venue
- World Journal of Transplantation
- Publisher
- Baishideng Publishing Group Inc.
- Published
- 2015
- Volume
- 5
- Issue
- 1
- Pages
- 11
- ISSN
- 2220-3230 (ISSN-L)
- PMC
- PMC4371157
- OpenAlex
- W221224410
- Cited by
- 5
- References
- 86
- Citations by year
- 2026: 1 · 2024: 1 · 2020: 1 · 2018: 1 · 2017: 1
- FWCI
- 0.33
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- World Journal of Transplantation (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (25670553)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Keywords
- UV irradiation, UV-induced immunosuppression, regulatory T cells, IL-10, transplantation immunology, UVB irradiation, antigen-presenting cells
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