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Methoxsalen is a naturally occurring photoactive psoralen compound that serves as a photosensitizing agent. In the clinical context of the COPAVEHDI trial conducted by Central Hospital, Nancy, France, it is utilized in extracorporeal photopheresis (ECP) for the treatment of Grade II acute graft-versus-host disease (aGVHD) with skin involvement. The drug works by intercalating into the DNA of T-lymphocytes. When these cells are subsequently exposed to ultraviolet A (UVA) radiation during the ECP procedure, methoxsalen forms covalent cross-links with pyrimidine bases, leading to the induction of apoptosis in the treated cells and a subsequent modulation of the immune response.
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