Mechanisms of depressed reactivity to dinitrochlorobenzene and ultraviolet-induced tumors during ultraviolet carcinogenesis in BALB/c mice

Final Report on the Safety Assessment of Urocanic Acid

Urocanic Acid is a naturally occurring metabolite of histidine. The trans-Urocanic Acid isomer is found as a normal constituent of the epidermis, where it accumulates because there are only very low levels of the enzyme urocanase available to break it down; the accumulation causes trans-Urocanic Acid excretion in sweat. On exposure to UV radiation present in sunlight, the trans-Urocanic Acid isomer converts to the cis-Urocanic Acid isomer. In cosmetic formulations, Urocanic Acid is used as a skin-conditioning agent and as a sunscreen. Several questions were specifically considered in this safety assessment, including the extent to which applied Urocanic Acid is absorbed by the skin and, if absorbed, what the effect is on endogenous levels. Recognizing that photoisomerization is likely to occur in the skin, what is the resultant ability of cis-Urocanic Acid to act as an immunosuppressant? If the ingredient does cause immunosuppression, is there concomitant enhancement of photo-carcinogenesis? The available data indicate that Urocanic Acid is absorbed in mouse and human skin, although at a faster rate in mouse skin. Limited human data suggest that there is no increase in the total level (endogenous + applied) of Urocanic Acid in the skin over a 16-week period. Extensive animal data indicate that cis-Urocanic Acid is an immunosuppressant, but the clinical data are inconclusive as to the immunosuppressant effect of Urocanic Acid in humans (it may be problematic that Urocanic Acid was not exposed to UV radiation in the clinical tests). To directly assess the question of enhanced photocarcinogenesis, the results of two studies were considered. In one study of hairless mice, no neoplasms were found in the group exposed only to trans-Urocanic Acid, carcinomas were found in the group that received UV exposure and no trans-Urocanic Acid, and a significantly greater number of carcinomas was found in the group exposed to trans-Urocanic Acid followed by UV exposure. In a second study, using three similar groups of hairless mice (Urocanic Acid alone, UV alone, and UV plus varying concentrations of Urocanic Acid), all groups showed comparable numbers of carcinomas, papillomas, and other tumors. While there was concern about the influence of the methodologies on the interpretation of results in these two studies, the results from neither study could be discounted. Only further study, therefore, can resolve the questions of the immunosuppressive effect of Urocanic Acid in humans and whether the immunosuppressive effect in animals is linked to the incidence of cancer in those animals. The additional information needed includes human photoimmunosuppression data, data on the modulation of photocarcinogenicity using specified procedures, and a DNA adduct study in vivo and in vitro. Until these data are available, it cannot be concluded that Urocanic Acid is safe for use in cosmetic formulations.

Nutritional abrogation of photoimmunosuppression: in vivo investigations

Skin cancer is a major public health concern, and the primary aetiological factor in the majority of skin cancers is ultraviolet radiation (UVR) exposure. UVR not only induces potentially mutagenic DNA damage but also suppresses cell-mediated immunity (CMI), allowing cancerous cells to escape destruction and progress to tumours. A considerable proportion of an individual's annual sun exposure is obtained outside the vacation period when topical and physical measures for photoprotection are irregularly used. Certain nutrients could provide an adjunctive protective role, and evidence is accruing from experimental studies to support their use in abrogation of photoimmunosuppression. Moreover, developments in clinical research methods to evaluate impact of solar-simulated radiation on cutaneous CMI allow the immune protective potential of nutritional agents to be examined in humans in vivo. This article summarises the mediation of CMI and its suppression by UVR, evaluates the methodology for quantitative assessment in vivo, reviews the human studies reported on nutritional abrogation of photoimmunosuppression including recent randomized controlled trials and discusses the mechanisms of photoprotection by the nutrients. This includes, in addition to antioxidants, novel studies of omega-3 polyunsaturated fatty acids and nicotinamide.

Genetic determinants of UV-susceptibility in non-melanoma skin cancer

A milieu of cytokines and signaling molecules are involved in the induction of UV-induced immune suppression and thus the etiology of non-melanoma skin cancer (NMSC). Targeting the UV-induced immunosuppression pathway, and using a large population based study of NMSC, we have investigated the risk associated with functional variants in 10 genes (IL10, IL4, IL4R, TNF, TNFR2, HTR2A, HRH2, IL12B, PTGS2, and HAL). The most prominent single genetic effect was observed for IL10. There was increasing risk for both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) with increasing number of variant IL10 haplotypes (BCC: p_trend = 0.0048; SCC: p_trend = 0.031). Having two IL10 GC haplotypes was associated with increased odds ratios of BCC and SCC (OR_BCC = 1.5, 95% CI 1.1–1.9; OR_SCC = 1.4, 95% CI 1.0–1.9), and these associations were largely confined to women (OR_BCC = 2.2, 95% CI 1.4–3.4; SCC: OR_SCC = 1.8, 95% CI 1.1–3.0). To examine how combinations of these variants contribute to risk of BCC and SCC, we used multifactor dimensionality reduction (MDR) and classification and regression trees (CART). Results from both of these methods found that in men, a combination of skin type, burns, IL10, IL4R, and possibly TNFR2 were important in both BCC and SCC. In women, skin type, burns, and IL10 were the most critical risk factors in SCC, with risk of BCC involving these same factors plus genetic variants in HTR2A, IL12B and IL4R. These data suggest differential genetic susceptibility to UV-induced immune suppression and skin cancer risk by gender.

Natural agents: cellular and molecular mechanisms of photoprotection

The skin is the largest organ of the body that produces a flexible and self-repairing barrier and protects the body from most common potentially harmful physical, environmental, and biological insults. Solar ultraviolet (UV) radiation is one of the major environmental insults to the skin and causes multi-tiered cellular and molecular events eventually leading to skin cancer. The past decade has seen a surge in the incidence of skin cancer due to changes in life style patterns that have led to a significant increase in the amount of UV radiation that people receive. Reducing excessive exposure to UV radiation is desirable; nevertheless this approach is not easy to implement. Therefore, there is an urgent need to develop novel strategies to reduce the adverse biological effects of UV radiation on the skin. A wide variety of natural agents have been reported to possess substantial skin photoprotective effects. Numerous preclinical and clinical studies have elucidated that natural agents act by several cellular and molecular mechanisms to delay or prevent skin cancer. In this review article, we have summarized and discussed some of the selected natural agents for skin photoprotection.

CTLA4 variants, UV-induced tolerance, and risk of non-melanoma skin cancer

Although skin tumors are highly immunogenic, exposure to UV radiation is known to suppress immune responses via regulatory T cells. Specifically, the activity of cytotoxic lymphocyte-associated antigen-4 (CTLA-4) is integral in regulating the development of UV-induced tolerance and, concomitantly, skin cancers. Due to the inverse relationship between tumor surveillance and autoimmunity, we hypothesize that the same genetic variant in the CTLA4 locus that increases risk for autoimmune diseases is associated with decreased risk of non-melanoma skin cancer (NMSC). We analyzed whether the polymorphism CT60 or haplotypes of CTLA4 influence odds of developing the major types of NMSC, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), in a population-based case-control study of Caucasians in New Hampshire (849 controls, 930 BCC, and 713 SCC). The CTLA4 CT60 GG genotype was associated with decreased odds for BCC and SCC, controlling for age, sex, lifetime number of severe sunburns, and skin type [BCC: odds ratio (OR), 0.7; 95% confidence interval (95% CI), 0.5-0.9; SCC: OR, 0.7; 95% CI, 0.5-1.0]. For BCC, this decrease was apparent largely among those with a higher lifetime number of severe sunburns (P(interaction) = 0.0074). There were significantly decreased odds of disease associated with two haplotypes, which possess the CT60 G allele. Additionally, lifetime number of severe sunburns modestly altered the effects of the CTLA4 haplotypes in BCC, and the association seemed driven by the CT60 single nucleotide polymorphism. In conclusion, genetic variation at the CTLA4 locus may be etiologically important in NMSC, the most prevalent malignancy in the United States.

DNA damage, apoptosis and langerhans cells--Activators of UV-induced immune tolerance

Solar UVR is highly mutagenic but is only partially absorbed by the outer stratum corneum of the epidermis. UVR can penetrate into the deeper layers of the epidermis, depending on melanin content, where it induces DNA damage and apoptosis in epidermal cells, including those in the germinative basal layer. The cellular decision to initiate either cellular repair or undergo apoptosis has evolved to balance the acute need to maintain skin barrier function with the long-term risk of retaining precancerous cells. Langerhans cells (LCs) are positioned suprabasally, where they may sense UV damage directly, or indirectly through recognition of apoptotic vesicles and soluble mediators derived from surrounding keratinocytes. Apoptotic vesicles will contain UV-induced altered proteins that may be presented to the immune system as foreign. The observation that UVR induces immune tolerance to skin-associated antigens suggests that this photodamage response has evolved to preserve the skin barrier by protecting it from autoimmune attack. LC involvement in this process is not clear and controversial. We will highlight some basic concepts of photobiology and review recent advances pertaining to UV-induced DNA damage, apoptosis regulation, novel immunomodulatory mechanisms and the role of LCs in generating antigen-specific regulatory T cells.

Photoimmunology--illuminating the immune system through photobiology

We review the field of photoimmunology with emphasis on immunosuppression induced by ultraviolet B radiation. Recent studies have focused on UVB-induced alterations in epidermal Langerhans cell function, resulting in a shift from Th1 to Th2 phenotype and the activation of regulatory T cells as the source of IL-10 that is central to this form of immunosuppression.

UV-induced immune suppression and photocarcinogenesis: chemoprevention by dietary botanical agents

Studies of immune-suppressed transplant recipients and patients with biopsy-proven skin cancer have confirmed that ultraviolet (UV) radiation-induced immune suppression is a risk factor for the development of skin cancer in humans. UV radiation suppresses the immune system in several ways. The UVB spectrum inhibits antigen presentation, induces the release of immunosuppressive cytokines, and elicits DNA damage that is a molecular trigger of UV-mediated immunosuppression. It is therefore important to elucidate the mechanisms underlying UV-induced immunosuppression as a basis for developing strategies to protect individuals from this effect and subsequent development of skin cancer. Dietary botanicals are of particular interest as they have been shown to inhibit UV-induced immune suppression and photocarcinogenesis. In this review, we summarize the most recent investigations and mechanistic studies regarding the photoprotective efficacy of selected dietary agents, including, green tea polyphenols, grape seed proanthocyanidins and silymarin. We present evidence that these chemopreventive agents prevent UVB-induced immunosuppression and photocarcinogenesis through: (i) the induction of immunoregulatory cytokine interleukin (IL)-12; (ii) IL-12-dependent DNA repair; and (iii) stimulation of cytotoxic T cells in the tumor microenvironment. The new information regarding the mechanisms of action of these agents supports their potential use as adjuncts in the prevention of photocarcinogenesis.

Thymidine dinucleotides inhibit contact hypersensitivity and activate the gene for tumor necrosis factor alpha1

DNA is a target for ultraviolet-B-induced inhibition of contact hypersensitivity, and small DNA fragments such as thymidine dinucleotides (pTpT) can simulate several ultraviolet-induced effects. To determine whether pTpT mimics the suppressive influence of ultraviolet-B on contact hypersensitivity, we compared the effects of topical application of pTpT with those of ultraviolet-B irradiation on C57BL/6 mice sensitized to dinitrofluorobenzene. Mice pretreated with pTpT or ultraviolet-B irradiation showed markedly suppressed ear swelling responses to dinitrofluorobenzene challenge. Because tumor necrosis factor alpha mediates ultraviolet-B-induced suppression of contact hypersensitivity, and because pTpT exerts many ultraviolet-mimetic effects by augmenting mRNA and protein levels of effector molecules, we asked if pTpT mimics ultraviolet-B's upregulatory influence on tumor necrosis factor alpha expression. Using transgenic mice carrying a chloramphenicol acetyl transferase reporter linked to the tumor necrosis factor alpha promoter, we examined effects of ultraviolet-B irradiation versus intradermal injection of pTpT on tumor necrosis factor alpha gene transcription. Both treatments induced cutaneous chloramphenicol acetyl transferase activity. Ultra- violet-B or pTpT treatment of cultured dermal fibroblasts from these mice also stimulated chloramphenicol acetyl transferase activity. To determine whether human cells responded similarly, a well- differentiated ultraviolet-responsive human squamous cell carcinoma line was treated with pTpT. pTpT increased tumor necrosis factor alpha mRNA expression and protein secretion in a dose-dependent manner. Our findings expand the spectrum of ultraviolet effects mimicked by pTpT to include inhibition of contact hypersensitivity and activation of the tumor necrosis factor alpha gene. These results support the hypothesis that DNA photoproducts and/or their repair intermediates trigger many of the biologic consequences of ultraviolet irradiation.

The effects of two UVB radiation-absorbing sunscreens on UV radiation-induced carcinogenesis, suppression of the contact hypersensitivity response and histological changes in the hairless mouse

The research summarised in this report suggests that the two UVB-absorbers, o-PABA and 2-EHMC, have different modes of protection against UV radiation-induced immunosuppression, carcinogenesis and histological alterations, that appear to be independent of their SPF values, within experimental limits. The UVB-absorber o-PABA appears offer a valuable level of protection against photocarcinogenesis.

Interleukin 12 breaks ultraviolet light induced immunosuppression by affecting CD8+ rather than CD4+ T cells

Recent studies showed that injection of interleukin (IL)-12 prevents ultraviolet (UV) light mediated suppression of contact hypersensitivity and breaks UV-induced hapten specific tolerance. UV-mediated suppression can be adoptively transferred by injecting splenocytes from UV-irradiated mice; however, suppression is not transferable when donor mice are treated with IL-12 after UV-irradiation. This study was performed to elucidate the mechanisms by which IL-12 counteracts this immunosuppression. To characterize the cells transferring suppression, depletion studies were performed revealing that UV-induced suppression is transferred via CD8+ T cells. To investigate whether IL-12 counteracts UV-induced suppression by either inhibiting the development of CD8+ suppressor T cells or inducing CD4+ effector T cells, splenocytes from mice, which were IL-12 treated and sensitized through UV-exposed skin, were depleted from CD4+ T cells and transferred into naive mice that were subsequently sensitized. Whereas transfer of splenocytes from UV-irradiated mice inhibited sensitization of recipients, no inhibition was observed after transfer of splenocytes from UV-exposed and IL-12 treated mice. Recipients that received CD4 depleted spleen cells from UV-exposed and IL-12 treated donors, were still fully sensitizable. IL-12 also blocked transfer of UV-induced suppression when it was injected into UV-exposed donor animals at a time point when suppressor cells had already developed. CD4 depletion of such splenocytes did not result in a loss of the reconstitutive effect of IL-12. This suggests that IL-12 may break UV-induced tolerance not by inducing CD4+ effector T cells, but rather by inhibiting or inactivating suppressor T cells belonging to the CD8 subtype.

Suppressive effect of ultraviolet B radiation on contact sensitization in mice. II. Systemic immunosuppression is modulated by ultraviolet irradiation and hapten application

Irradiation of mice with ultraviolet-B (UVB) can suppress contact hypersensitivity "systemically", even if hapten is applied to the non-irradiated skin site. We previously reported the factors influencing UVB-induced "local" immunosuppression. To obtain the most effective systemic immunosuppression, we further investigated the effect of the following factors on contact hypersensitivity to dinitrofluorobenzene (DNFB): UVB dose, dividing exposure, timing of sensitization after irradiation, area of exposure, hapten concentration, age, and genetic basis. The suppression was enhanced by increasing UVB dose. When 1 J/cm2 of UVB was exposed, 4 daily divided exposures (0.25 J/cm2 x 4) was more suppressive than a single (1 J/cm2 x 1) or double divided (0.5 J/cm2 x 2) exposure. Five or 10 day intervals between irradiation and sensitization induced stronger suppression than 1 or 3 day intervals. When the total energy (Joule, J) was kept constant, the exposure of low dose-UVB to a large area (0.5 J/ cm2 x 16.45 cm2) suppressed contact hypersensitivity more strongly than did high dose-UVB to a small area (2 J/cm2 x 4.11 cm2). When 25 ml of DNFB solution was applied, high concentration induced lower suppression. The stronger suppression was most prominent in the young (7 week) than in the old (22 week) mice. No difference was found in the systemic immunosuppression between C3H/HeN and Balb/c mice. These results suggest that not only UVB dose but also various factors should be taken into consideration to effectively induce systemic immunosuppression.

Interleukin-12 prevents ultraviolet B-induced local immunosuppression and overcomes UVB-induced tolerance

Ultraviolet (UV) light abrogates contact hypersensitivity (CHS) responses and induces hapten-specific tolerance. Because Th-1 cells are critically involved in CHS and are induced to develop by the cytokine interleukin (IL)-12, we asked whether IL-12 might overcome UV-induced local immunosuppression. C3H/HeN mice exposed to low doses of UV light over 4 d and hapten sensitized through the irradiated skin area with dinitrofluorobenzene showed profound inhibition of the CHS response, which was completely prevented upon intraperitoneal injection of murine recombinant IL-12 (rIL-12) after the last UV exposure. UV-treated mice resensitized 14 d after the first challenge displayed hapten-specific tolerance, whereas UV-exposed mice injected with rIL-12 before the first sensitization exhibited a vigorous CHS response. Furthermore, mice that were initially sensitized through UV-exposed skin also produced a significant CHS reaction when they received rIL-12 before resensitization. Adoptive transfer of spleen and lymph node cells from UV-irradiated mice treated with rIL-12 had no effect on the CHS response in recipient mice, whereas transfer of cells from UV-treated mice inhibited the immune response. These findings demonstrate that rIL-12 can prevent UV-induced local immunosuppression and overcome UV-induced hapten-specific tolerance.

Dietary fat modulates immunoresponsiveness in UV-irradiated mice

Previous studies have shown that a high level of dietary lipid (corn oil) exacerbates UV-carcinogenic expression in hairless mice. Furthermore, it was demonstrated that this effect occurs at the postinitiation, or promotion, stage of UV-carcinogenesis--a stage believed to be modulated immunologically. Thus, we sought to examine the influence of dietary lipid on specific immune parameters at various times within a UV-carcinogenic protocol, with the purpose of detecting potential relationships to UV carcinogenesis. Hairless mice were fed either a high- (12%, wt/wt, corn oil) or low-fat (0.75%, wt/wt, corn oil) diet for 2 weeks prior to start of the UV or experimental protocols. Animals were sensitized to dinitrochlorobenzene (DNCB) hapten and delayed-type hypersensitivity (DTH) was assessed. Delayed-type hypersensitivity was significantly suppressed (P = 0.01) in the high-fat group, even before UV irradiation. Although both groups exhibited UV-induced suppression of this response, the high-fat group was totally suppressed after 3 weeks of UV, whereas the low-fat group exhibited reactivity through week 8. The splenic T-lymphocyte (Thy 1.2+) population had declined by about 50% at the time of UV termination (11 weeks). Dietary lipid exerted no apparent influence upon this T-cell population. However, after 6 weeks of UV, I-J+ cells (a marker shown to be acquired adaptively by suppressor T lymphocytes) began to increase. By week 15 (4 weeks post-UV) I-J+ cells had increased by about 65% in the high-fat group, twice the % increase that occurred in the low-fat group. When UV-induced tumors were transplanted to recipient animals receiving various periods (0, 6, 11 weeks) of UV irradiation, no significant differences in median tumor rejection times between the two dietary groups occurred at 0 or 6 weeks. After 11 weeks of UV, the low-fat group exhibited a tumor rejection time that was comparable to that of nonirradiated animals, i.e. 21 days. However, median tumor rejection time for the high-fat group was greater than 63 days, significantly (P = 0.01) longer than that of the low-fat group. Thus, suppression of tumor rejection by high fat occurred at a time when high fat had been shown to exacerbate carcinogenic expression and when I-J+ cells had markedly increased. These data demonstrate that level of dietary lipid modulates immunoresponsiveness in UV-irradiated animals and is compatible with the thesis that immune suppression may account for the exacerbation of carcinogenic expression elicited by high dietary fat.

Proopiomelanocortin production by epidermal cells: evidence for an immune neuroendocrine network in the epidermis

Proopiomelanocortin (POMC) is known to be synthesized in the pituitary gland and is subsequently cleaved by specific prohormone convertases into biologically active peptide hormones such as melanocyte stimulating hormones (MSH), adrenocorticotropin (ACTH) and endorphins (EP). Guanine nucleotide-binding protein (G-protein)-coupled receptors, which have only recently been discovered, are involved in the transmission of their message. There is also evidence indicating that POMC is not only produced by pituitary cells but is an ubiquitous molecule, that is cleaved cell- and tissue-specific. It has also been shown that the epidermis keratinocytes as well as melanocytes express POMC upon stimulation and release alpha MSH and ACTH. In addition to their function as hormones, POMC peptides have been shown to exert a variety of immunoregulatory effects by modulating the function of immunocompetent cells as well as cytokines. These findings provide further evidence for the immunoneuroendocrine network playing a crucial role during the pathogenesis of immune and inflammatory skin disease.

Proopiomelanocortin-derived peptides are synthesized and released by human keratinocytes

Proopiomelanocortin (POMC), the precursor for melanotropic, corticotropic, and opioid peptides such as alpha-melanocyte-stimulating hormone (alpha MSH), ACTH, and other related peptides, was originally identified as a product of the pituitary gland. However, recent evidence shows that POMC products can also be produced by nonpituitary tissues. Because keratinocytes, the major constituent of the epidermis exhibit the capacity to release a variety of proinflammatory and immunomodulatory mediators, the present study was performed to investigate whether human keratinocytes are able to produce POMC-derived peptides. Supernatants of human normal keratinocytes and an epidermal carcinoma cell line (A431) contained significant levels of immunoreactive alpha MSH and ACTH. Upon immuneprecipitation and size-exclusion chromatography, keratinocyte-derived alpha MSH exhibited a molecular mass of approximately 1 kD and was biologically active as demonstrated in a tyrosinase bioassay. Northern blot analysis revealed the expression of POMC-specific transcripts (1.3 kb) in both normal keratinocytes and A431 cells. The production of alpha MSH and ACTH could be significantly upregulated both at the protein and mRNA level upon treatment with phorbol myristate acetate, ultraviolet light, or interleukin 1. These data provide first evidence that human keratinocytes produce POMC-derived peptides such as alpha MSH and ACTH. Because POMC-derived peptides recently have been recognized as potent immunomodulatory mediators, their presence in the epidermis may have a major impact on the skin immune system.

Effect of UV irradiation on lethal infection of mice with Candida albicans

Exposure of mice to UV radiation inhibits the induction and elicitation of the delayed-type hypersensitivity (DTH) response to Candida albicans. To determine whether UV irradiation also affects the pathogenesis of systemic C. albicans infection, C3H mice were exposed to a single dose of 48 kJ/m2 UV-B radiation from FS40 sunlamps 5 days before or 5 days after sensitization with formalin-fixed C. albicans and challenged intravenously (i.v.) with a lethal dose of viable fungi 6 days after sensitization (11 or 1 days after UV irradiation). Exposing unsensitized mice to UV radiation 11 days before lethal challenge had no effect on survival, but the survival time of mice exposed to UV radiation 1 day before challenge was reduced by more than 50%. In the latter group, decreased survival time correlated with persistence of C. albicans in the brain and progressive growth of C. albicans in the kidneys. Sensitization of unirradiated mice with formalin-fixed C. albicans extended their survival time following lethal i.v. challenge with viable C. albicans. Exposing the mice to UV radiation 5 days before sensitization did not abrogate this beneficial effect of sensitization on survival, even though it significantly reduced the DTH response. Thus, immunity to systemic infection did not depend on the ability of the mice to exhibit a DTH response to C. albicans. The beneficial effect of sensitization on survival after lethal infection was abrogated, however, in mice exposed to UV radiation 1 day before lethal challenge with C. albicans. Furthermore, these mice were unable to contain the progressive growth of C. albicans in the kidneys, in contrast to sensitized, unirradiated mice.

Effects of ultraviolet radiation on the pathogenesis of Mycobacterium lepraemurium infection in mice

The purpose of this study was to determine whether exposing mice to ultraviolet radiation (UVR) would alter the pathogenesis of infection with Mycobacterium lepraemurium (MLM), which causes a chronic, progressive, lethal disease in susceptible mouse strains. BALB/c mice were irradiated on dorsal skin with various doses of UVR from FS40 sunlamps 3 days before infection with MLM in the hind footpad. The course of disease was followed by assessing the number of acid-fast bacteria in the footpad, regional lymph node and spleen, and measuring the size of the lesion at the site of MLM infection at various times after infection. Mice were also tested periodically for a delayed-type hypersensitivity (DTH) response by injecting MLM antigen into the uninfected footpad and measuring footpad swelling 24 hours later. Mice treated with a single high dose of UVR (45 kJ/m2) had significantly more bacteria in the infected footpad, lymph node and spleen than unirradiated control animals. They also had larger lesions at the site of MLM infection and exhibited significant suppression of the DTH response at 3 and 6 months after infection. Injection of mice s.c. in the footpad with MLM 3d after 45 kJ/m2 UVR reduced the median survival time from 391 to 305 d and after i.v. infection from 171 to 139 d. Dose-response studies indicated that exposing mice to 2.3 kJ/m2 of UVR, which is approximately 1 minimal erythemal dose for this strain, suppressed the DTH response by 50% at 3 months after infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Alteration of the immune response to Mycobacterium bovis BCG in mice exposed chronically to low doses of UV radiation

BALB/c mice were exposed on shaved dorsal skin to 1 minimal erythemal dose (MED) of UVB radiation (2.25 kJ/m2) from a bank of six FS-40 sunlamps three times per week. The total number of irradiations ranged from 1 to 27. At regular intervals, groups of mice were injected in the left hind foot pad with 1 x 10(6) live mycobacteria (Mycobacterium bovis BCG) 3 days after the last UVB exposure. The mice were tested 21 and 42 days after infection for a delayed type hypersensitivity (DTH) response to the purified protein derivative (PPD) of tubercle bacilli by injecting PPD into the right hind foot pad and measuring the foot pad swelling 24 hr later. The course of infection was followed by assessing the number of bacterial colony forming units in the lymph node draining the site of BCG infection and the spleen. Mice exposed from 1 to 15 times to 1 MED of UV radiation showed a significant suppression in their DTH response to PPD compared with the unirradiated mice. At the same time, the number of bacterial colony-forming units in the lymph node and spleen of the UV-irradiated mice was greater than in control mice. With continued exposure to UVB, however, the DTH response recovered to a normal level, and there was no longer an increase in the number of viable bacteria in the lymphoid organs. These results indicate that early in the course of chronic UV irradiation, mice were impaired in their ability to mount a DTH response to BCG and to clear these bacteria from their lymphoid organs; later the mice recovered from these effects of UV, with continued treatment. A dose-response study using single doses of UV radiation indicated that a dose of 2.7 kJ/m2 suppressed the DTH response by 50%. Thus, exposure of mice to a single or multiple low doses of UV radiation prior to infection can interfere with systemic immunity to mycobacteria.

Cell membrane is a major locus for ultraviolet B-induced alterations in accessory cells

In vitro ultraviolet B (UVB) irradiation of human blood monocytes inhibits their accessory cell function for antigen- and mitogen-induced T cell responses. These studies were designed to characterize the nature of the UVB-induced defect in human monocyte accessory cell function. Irradiated monocytes were deficient in their ability to serve as accessory cells for OKT3-induced T cell activation. In vitro exposure of monocytes to 100 J/m2 UVB completely inhibited the T cell proliferative response (51502 cpm, non-UVB-irradiated; 302 cpm, UVB-irradiated). Analysis of the accessory signals altered by UVB indicated that irradiated monocytes were incapable of binding to OKT3 molecules attached to the CD3 antigen on T cells. Provision of an alternative mechanism for binding of OKT3 molecules by attaching anti-mouse IgG to the bottom of microtiter wells completely restored accessory cell function. Further characterization of the defect demonstrated that UVB radiation did not deplete p72 Fc receptors from the surface of irradiated monocytes. However, UVB exposure did produce a dose-dependent decrease in monocyte membrane expression of ICAM-1. It is proposed that UVB radiation leads to changes within the cell membrane that inhibit the ability of monocytes to express selected molecules necessary for binding of T cells.

Effect of UV irradiation on epidermal cell cytokine production

Within the last decade it has been found that the keratinocyte is not only a mechanical barrier to the outside but is also a fully immunocompetent cell that can release immunomodulating cytokines such as interleukin (IL) 1, IL 3, IL 6 and colony-stimulating factors (CSF). The constitutive production of these mediators by keratinocytes both in vivo and in vitro is very low; however, it can be dramatically enhanced by various stimuli such as tumour promotors or endotoxin. In addition, UV light is one of the most potent inducers of cytokine release. Accordingly, UV exposure results in increased production of IL 1, IL 3, IL 6, tumour necrosis factor and granulocyte/macrophage-CSF by epidermal cells. The secretion of these cytokines causes local immunologic and inflammatory reactions following UV irradiation. These factors, however, may also enter the circulation and thus may be responsible for systemic effects. In addition, UV light causes keratinocytes to release immunosuppressive factors which block contact hypersensitivity reaction and IL 1 activity. The production of such immunoinhibitors may play an essential pathogenic role during systemic UV-induced immunosuppression. This review will focus on the biological effects of epidermal-cell-derived cytokines, whose release is induced by UV light, and their role in immunologic and inflammatory reactions following UV exposure will be discussed.

Resistance of human and mouse myeloid leukemia cells to UV radiation

Sensitivity of mouse bone marrow and myeloid leukemia cells as well as the sensitivity of human myeloid leukemia cells to UV light was tested. Criteria were the in vivo colony-forming ability of UV exposed cells and the inhibition of DNA synthesis during post-irradiation incubation for 24 h in vitro. Mouse bone marrow cells irradiated with a small dose of UV light (5 J/m2) and injected into x-irradiated animals did not form hemopoietic colonies on the recipients' spleens, and the recipients died. However, mouse leukemia cells, after irradiation with higher doses of UV light, retained the ability to form colonies on the spleens, and all recipient mice died with typical symptoms of leukemia. In vitro, mouse bone marrow cells exhibited high sensitivity to UV light as compared to mouse myeloid leukemia cells. Human leukemia cells were also resistant to UV light, but more sensitive than mouse leukemia cells. These results indicate that myeloid leukemia cells are resistant to UV light as compared with normal bone marrow cells.

UV sunlight and patch test reactions in humans

No seasonal influence of UV sunlight on patch test reactions in humans over a period of 9 years of clinical practice was found in this retrospective study of almost 8000 patients. Although the mean UV monthly dose varies seasonally, up in the summer and down in the winter, no significant differences could be identified for patch test reactions, either for the mean number of positive test reactions or for the intensity of the skin reaction or for the id-like spread reactions seen in summer or winter. Furthermore, no short-term influences of UV exposure during the weekend preceding patch testing could be demonstrated. Therefore, reliable patch-test results can be expected at any season of the year from a general population, at least in Belgian-type climates.

Analysis of the effect of a sunscreen agent on the suppression of natural killer cell activity induced in human subjects by radiation from solarium lamps

Previous studies in rodents have shown that ultraviolet radiation (UVR) may have direct effects on the immune system in the skin and at higher doses may induce systemic suppression of immune responses. We have previously shown that UVR from sun or solarium beds may induce systemic effects in human subjects. The purpose of the present study was to examine whether these systemic effects in human subjects could be prevented by use of commercially available sunscreen agents. Groups of 12 normal subjects were exposed to radiation from solarium lamps after application of a sunscreen agent or the base used in its preparation. Twelve half-hourly exposures induced a depression of natural killer (NK) cell activity against a melanoma and the K562 target cell which was not prevented by use of the sunscreen agent. Changes in functional activity were accompanied by a reduction in NK cell numbers assessed by Leu-11 monoclonal antibodies against the labile Fc receptor. Application of the sunscreen agent also did not protect against effects of solarium exposure on recall antigen skin tests and immunoglobulin production in vitro in pokeweed mitogen-stimulated cultures of B and T cells. These results suggest that further evaluation of the wave-length spectrum of UVR and the effectiveness of sunscreen agents in prevention of UVR-induced effects on the immune system is needed.

Inhibition of the induction of contact hypersensitivity by a UV-mediated epidermal cytokine

UVB exposure (290-320 nm) of mice has been shown to cause systemic suppression of contact hypersensitivity (CHS). Because UVB radiation hardly penetrates the epidermis, epidermal cells have been anticipated to be the site of the initiation of immunosuppression. Supernatants derived from UV-irradiated BALB/c epidermal cell cultures and a keratinocyte cell line (Pam 212) were evaluated for the ability to induce suppression of CHS after i.v. injection to BALB/c mice. Injection of supernatants derived from UV-treated epidermal cells and Pam 212 cells significantly blocked induction but not elicitation of CHS. In contrast, i.v. application of supernatants derived from unirradiated cells did not inhibit CHS. Using high-performance liquid chromatography gel filtration this mediator was shown to be a low-molecular-weight protein (15-50 kD). Moreover UV-mediated inhibitor production seems to be confined to epidermal cells since neither P 388 macrophages nor L 929 fibroblasts released this inhibitory cytokine. Therefore UV radiation may induce epidermal cells to produce an inhibitor of CHS which is distinct from prostaglandins and leukotrienes and may participate in the regulation of UV-mediated local as well as systemic immunosuppression.

Studies on the mechanism of systemic suppression of contact hypersensitivity by UVB radiation. II. Differences in the suppression of delayed and contact hypersensitivity in mice

Exposing mice to UV radiation in the UVB range (280-320 nm) causes a selective immune suppression that contributes to the development of UVB-induced skin cancers. Among the immune responses suppressed by UVB irradiation are contact and delayed hypersensitivity reactions to haptens administered at unexposed sites. In these studies we provide evidence that delayed and contact hypersensitivity to the same hapten are not equivalent reactions and that they are suppressed in UVB-irradiated mice by 2 different mechanisms. This conclusion is based on the findings that: suppression of contact hypersensitivity could not be overcome by immunizing UVB-irradiated mice with hapten-coupled antigen-presenting cells derived from normal donors; and treatment of UVB-irradiated mice with methylprednisolone before immunization prevented the suppression of delayed hypersensitivity but had no effect on the suppression of contact hypersensitivity. The decreased ability to induce contact hypersensitivity in UVB-irradiated mice could be transferred to x-irradiated mice by reconstituting them with spleen cells from UVB-irradiated donors. The induction of hapten-specific suppressor cells, however, required both UVB irradiation and priming with hapten. Based on these results, we postulate that UVB irradiation induces a population of suppressor-inducer cells with specificity for a modified skin antigen and that this antigen serves as a carrier molecule for haptens that induce contact hypersensitivity and for tumor-specific transplantation antigens on UVB-induced tumors.

Advances in the immunobiology of the skin. Implications for cutaneous malignancies

Recent advances in cutaneous immunobiology have led to the realization that skin is an important and unique immunologic organ. Studies on the immunobiology of skin cancers induced by ultraviolet radiation indicate that immune mechanisms can play a crucial role in the development of cutaneous tumors. This paper summarizes the evidence linking skin and the immune system and discusses current hypotheses concerning the mechanisms by which UV radiation interferes with cutaneous immunity. The significance of these findings for cutaneous carcinogenesis is discussed.

Modulation of immune function by UV radiation

In addition to its carcinogenic activity, ultraviolet (UV) radiation is capable of modifying certain immunologic reactions. Immunologic alterations induced in mice by UV radiation include both local and distant effects. Local alterations result from a direct effect of UV radiation on an immune reaction that takes place at the site of irradiation. Distant alterations are those in which exposure of skin to UV radiation at one site modifies an immune reaction occurring at a distant, unexposed site. Based on recent studies, we propose that there may be two types of distant alterations. One is nonspecific, may be due to accumulation of leukocytes at the site of UV-induced inflammation, and is exemplified by the suppression of delayed hypersensitivity and local graft-versus-host (GVH) reactions. The second may result from DNA damage, may involve a soluble mediator, and is manifested by the systemic suppression of contact hypersensitivity and the formation of antigen-specific suppressor T lymphocytes. These immunologic effects of exposure to UV radiation may be important in the pathogenesis of skin cancer and other cutaneous diseases.

Seasonal variations in UVR-induced DNA synthesis and in UVR inhibition of phytohaemagglutinin-stimulated proliferation of human lymphocytes

Two years of sequential studies of the UVR (254 nm) response in normal human lymphocytes showed pronounced seasonal variations. In the winters of 1981-82 and 1982-83 the UVR-induced DNA synthesis in the lymphocytes in vitro (the DNA-repair synthesis) was very stable with inter- and intra-individual variations below 14 and 10%, respectively (15 individuals). In the summers 1982 and 1983 the inter-individual variations was 2-3-fold higher. Closer analysis revealed that this was due to a pronounced intra-individual variation with sharp fluctuations in the single individual. Also the UVR tolerance of the lymphocytes estimated by alterations of the phytohaemagglutinin (PHA) stimulated lymphocyte proliferation showed seasonal variations, being 1.5-fold higher in the winter than in the summer (P less than 0.0001, 12 individuals). The observed seasonal variations emphasize the importance of considering chronobiological variations when working with long term projects. The UVR-induced DNA synthesis was determined as the increase in incorporation of [3H]-thymidine in irradiated cells compared to non-irradiated cells after incubation for 2 h at 37 degrees C in phosphate buffered saline. The UVR tolerance was measured by the UV dose necessary for 50% reduction in PHA stimulated lymphocyte proliferation assessed after 7 days of growth.

Role of UVB-induced serum factor(s) in suppression of contact hypersensitivity in mice

Ultraviolet, 280-320 nm (UVB), irradiation of the shaved dorsal skin of mice results in suppression of the development of contact hypersensitivity (CHS) to antigens applied subsequently to a distant nonirradiated skin site. Serum from BALB/cAnNCr mice exposed to a single dose of UVB radiation (8.6 X 10(4) J/m2) was evaluated for its ability to induce suppression of CHS to 2-chloro-1,3,5-trinitrobenzene (TNCB), a contact allergen, after transfer to normal recipients. Serum from UVB-irradiated donors was capable of inducing immunosuppression only when collected and transferred within a restricted time period, i.e., approximately 2-6 h post irradiation, and at least 400 microliters of serum per recipient was required. Serum from UVB-irradiated donors was sufficient to induce splenic suppressor cells in recipient mice.

Immunological unresponsiveness induced by ultraviolet radiation

Immunological unresponsiveness can be initiated by exposure of mice to UV radiation, followed by the introduction of certain antigens. These antigens include epicutaneously applied chemicals that induce contact hypersensitivity (CHS), and antigens that occur on skin cancers induced by UV radiation. Mice exposed repeatedly to high doses of UV radiation during UV carcinogenesis develop immunological unresponsiveness to UV radiation-induced skin cancers, which are highly antigenic. This unresponsiveness is associated with the appearance of suppressor T lymphocytes that are specific for tumors induced by UV radiation, even though these tumors express individually specific transplantation rejection antigens. Thus, the occurrence of suppressor cells with specificity for a set of non-cross-reacting tumors suggests that a common, UV-associated regulatory antigen or determinant may be present on UV-induced skin cancers. Suppression of CHS in mice by UV radiation can be induced by two different procedures. One involves applying the sensitizer directly on skin exposed to low doses of UV-B radiation and is thought to result from a direct effect of UV radiation on cutaneous Langerhans cells. The second involves application of the sensitizer to the unirradiated skin of mice or guinea pigs exposed several days earlier to a higher dose of UV-B radiation. The mechanism of the latter phenomenon is not well understood, but there is evidence that it results from an alteration of antigen presentation by splenic macrophages. Both forms of suppression are associated with the appearance of antigen-specific suppressor lymphocytes in the animals' spleens, which prevent the induction of CHS upon transfer to a normal recipient. Either or both of these pathways could be responsible for the formation of the suppressor cells involved in UV carcinogenesis. Recent studies suggest that UV radiation may also affect immunological responsiveness in humans as well as in animals. However, the extent of such alterations and the mechanisms by which they occur are still unknown.

Malignant melanoma in situ in two patients treated with psoralens and ultraviolet A

Two patients are reported who were treated with 8-methoxypsoralen and ultraviolet A (PUVA) for psoriasis and developed cutaneous lesions of malignant melanoma in situ (atypical melanocytic hyperplasia). One patient received 324.5 joules/cm2 of UVA. Seven months after discontinuing therapy, he developed a superficial spreading melanoma in situ in association with an intradermal nevus on the left posterior thoracic area. The second patient received 2,802 joules/cm of UVA. While on PUVA therapy she developed an in situ lentigo melanoma on her lower lip. To our knowledge only one other psoriatic patient and one patient with vitiligo have developed malignant melanomas after PUVA therapy, so that an increased incidence of malignant melanomas after PUVA therapy, so that an increased incidence of malignant melanoma following PUVA is not documented.

Systemic suppression of contact hypersensitivity in mice by psoralen plus UVA radiation (PUVA)

Treatment of mice with 8-methoxypsoralen plus longwave UV radiation (UVA, 320-400 nm) decreased their response to contact sensitizers applied subsequently to unirradiated skin. This decreased reactivity exhibited a delayed time course, it affected the afferent but not the efferent phase of the reaction, and it was associated with the development of splenic suppressor cells. These suppressor cells were antigen-specific T lymphocytes, and they prevented the induction, but not the elicitation, of contact hypersensitivity in recipient mice. In all of these characteristics, the decreased reactivity induced by treatment with psoralen plus UVA radiation (PUVA) resembled that produced by UV radiation of shorter wavelengths (less than 320 nm). These studies suggest that PUVA treatment may initiate the same sequence of cellular events as does exposure to sunlamp (UVB, 280-320 nm) radiation, leading to preferential activation of the suppressor cell pathway.

Suppressor substance produced by the K562 cell line in vitro

Supernatant fluids from three human cultured cell lines, K562, NALM-1, and Daudi, all isolated from patients with lymphoreticular malignancies, were tested for suppressive activity toward normal lymphocytes in vitro. It was found that the K562 line elaborated material which effectively suppressed the response of normal human blood lymphocytes to the T-cell mitogens phytohemagglutinin and concanaval in A as well as the mixed lymphocyte reaction. Little or no suppressive activity was evident when supernatants from Daudi or NALM-1 were used. In contrast, a recent report [29] indicates that K562 does not inhibit the induction of immunoglobulin synthesis of B lymphocytes by pokeweed mitogen. The findings are discussed in the context of the immunosuppression associated with cancer and the apparent selective inhibition of different lymphocyte functions by material elaborated by different neoplasms.

Influence of PUVA and UVB radiation on delayed hypersensitivity in the guinea pig

Exposure of guinea pigs to UVA (320--400 nm) radiation following administration of 8-methoxypsoralen by gavage (referred to by the acronym, PUVA) or exposure to UVB (290--320 nm) radiation, produced suppression of the cutaneous delayed hypersensitivity reaction at the site of exposure to radiation and at distant nonexposed sites. In these experiments, the animals were immunized by injection of dinitrophenyl-bovine gamma-globulin (DNP-BGG) in complete Freund's adjuvant and delayed hypersensitivity responses were provoked by intradermal injections of DNP-BGG, DNP and BGG on the flanks. Exposure to erythemogenic doses of either PUVA or UVB radiation for 7 days prior to immunization and for the 7 days between immunization and challenge (total period of radiation: 14 days) produced inhibiton of responses to each of the test substances. In addition, treatment with erythemogenic doses of PUVA either for 7 days prior to immunization or during the interval between immunization and challenge with DNP-BGG, inhibited the delayed hypersensitivity responses at the site of irradiation and at a nonexposed site. These findings suggest that in vivo exposure to nonionizing radiation leads to both local and systemic alteration of certain immune responses.

The influence of ultraviolet radiation on allergic contact dermatitis in the guinea-pig. I. UVB radiation

Guniea-pigs were sensitized by percutaneous application of dinitrochlorobenzene and exposed to UVB (280-320 nm) radiation. The exposure to radiation diminished the response to an elicitation dose of the hapten administered 14 days later within the site of irradiation. The exposure dose of radiation required to produce this effect resulted in a marked erythemal response, but this response did not conceal the contact allergic reaction. The site of elicitation of the allergic response had to be included in the exposure field.