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Kurz B, Klein B, Berneburg M, Meller S. [Ultraviolet radiation in the pathogenesis of lupus erythematosus]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:528-538. [PMID: 38916603 DOI: 10.1007/s00105-024-05369-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/26/2024]
Abstract
Photosensitivity represents an increased inflammatory reaction to sunlight, which can be observed particularly in the autoimmune disease lupus erythematosus. Cutaneous lupus erythematosus (CLE) can be provoked by ultraviolet (UV) radiation and can cause both acute, nonscarring and chronic, scarring skin changes. In systemic lupus erythematosus, on the other hand, provocation by UV radiation can lead to flare or progression of systemic involvement. The etiology of lupus erythematosus is multifactorial and includes genetic, epigenetic and immunologic mechanisms. In this review, we address the effect of UV radiation on healthy skin and photosensitive skin using the example of lupus erythematosus. We describe possible mechanisms of UV-triggered immune responses that could offer therapeutic approaches. Currently, photosensitivity can only be prevented by avoiding UV exposure itself. Therefore, it is important to better understand the underlying mechanisms in order to develop strategies to counteract the deleterious effects of photosensitivity.
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Affiliation(s)
- Bernadett Kurz
- Klinik und Poliklinik für Dermatologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | - Benjamin Klein
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, USA
| | - Mark Berneburg
- Klinik und Poliklinik für Dermatologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - Stephan Meller
- Klinik und Poliklinik für Dermatologie, Universität Düsseldorf, Düsseldorf, Deutschland
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2
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Morio KA, Sternowski RH, Zeng E, Brogden KA. Antimicrobial Peptides and Biomarkers Induced by Ultraviolet Irradiation Have the Potential to Reduce Endodontic Inflammation and Facilitate Tissue Healing. Pharmaceutics 2022; 14:pharmaceutics14091979. [PMID: 36145725 PMCID: PMC9503046 DOI: 10.3390/pharmaceutics14091979] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Ultraviolet (UV) irradiation can modulate host immune responses and this approach is a novel application for treating endodontic infections and inflammation in root canals. Methods: A dataset of UV-induced molecules was compiled from a literature search. A subset of this dataset was used to calculate expression log2 ratios of endodontic tissue molecules from HEPM cells and gingival fibroblasts after 255, 405, and 255/405 nm UV irradiation. Both datasets were analyzed using ingenuity pathway analysis (IPA, Qiagen, Germantown, MD, USA). Statistical significance was calculated using Fisher’s exact test and z-scores were calculated for IPA comparison analysis. Results: The dataset of 32 UV-induced molecules contained 9 antimicrobial peptides, 10 cytokines, 6 growth factors, 3 enzymes, 2 transmembrane receptors, and 2 transcription regulators. These molecules were in the IPA canonical pathway annotations for the wound healing signaling pathway (9/32, p = 3.22 × 10−11) and communication between immune cells (6/32, p = 8.74 × 10−11). In the IPA disease and function annotations, the 32 molecules were associated with an antimicrobial response, cell-to-cell signaling and interaction, cellular movement, hematological system development and function, immune cell trafficking, and inflammatory response. In IPA comparison analysis of the 13 molecules, the predicted activation or inhibition of pathways depended upon the cell type exposed, the wavelength of the UV irradiation used, and the time after exposure. Conclusions: UV irradiation activates and inhibits cellular pathways and immune functions. These results suggested that UV irradiation can activate innate and adaptive immune responses, which may supplement endodontic procedures to reduce infection, inflammation, and pain and assist tissues to heal.
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Affiliation(s)
| | | | - Erliang Zeng
- Division of Biostatistics and Computational Biology, College of Dentistry, The University of Iowa, Iowa City, IA 52242, USA
| | - Kim A. Brogden
- College of Dentistry, The University of Iowa, Iowa City, IA 52242, USA
- Correspondence:
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3
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Vogeley C, Rolfes KM, Krutmann J, Haarmann-Stemmann T. The Aryl Hydrocarbon Receptor in the Pathogenesis of Environmentally-Induced Squamous Cell Carcinomas of the Skin. Front Oncol 2022; 12:841721. [PMID: 35311158 PMCID: PMC8927079 DOI: 10.3389/fonc.2022.841721] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/09/2022] [Indexed: 01/05/2023] Open
Abstract
Cutaneous squamous cell carcinoma (SCC) is one of the most frequent malignancies in humans and academia as well as public authorities expect a further increase of its incidence in the next years. The major risk factor for the development of SCC of the general population is the repeated and unprotected exposure to ultraviolet (UV) radiation. Another important risk factor, in particular with regards to occupational settings, is the chronic exposure to polycyclic aromatic hydrocarbons (PAH) which are formed during incomplete combustion of organic material and thus can be found in coal tar, creosote, bitumen and related working materials. Importantly, both exposomal factors unleash their carcinogenic potential, at least to some extent, by activating the aryl hydrocarbon receptor (AHR). The AHR is a ligand-dependent transcription factor and key regulator in xenobiotic metabolism and immunity. The AHR is expressed in all cutaneous cell-types investigated so far and maintains skin integrity. We and others have reported that in response to a chronic exposure to environmental stressors, in particular UV radiation and PAHs, an activation of AHR and downstream signaling pathways critically contributes to the development of SCC. Here, we summarize the current knowledge about AHR's role in skin carcinogenesis and focus on its impact on defense mechanisms, such as DNA repair, apoptosis and anti-tumor immune responses. In addition, we discuss the possible consequences of a simultaneous exposure to different AHR-stimulating environmental factors for the development of cutaneous SCC.
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Affiliation(s)
- Christian Vogeley
- IUF - Leibniz-Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Katharina M Rolfes
- IUF - Leibniz-Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Jean Krutmann
- IUF - Leibniz-Research Institute for Environmental Medicine, Düsseldorf, Germany
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4
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Mehanna S, Mansour N, Daher CF, Elias MG, Dagher C, Khnayzer RS. Drug-free phototherapy of superficial tumors: White light at the end of the tunnel. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2021; 224:112324. [PMID: 34619435 DOI: 10.1016/j.jphotobiol.2021.112324] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/25/2021] [Accepted: 09/20/2021] [Indexed: 12/28/2022]
Abstract
Visible light has long been recognized as a treatment for many diseases and an essential component of photo-induced chemotherapy. While previous data proved its inherent cytotoxicity, this study is the first to explore the use of a commercially available, high-intensity white LED light (24.5 mW.cm-2) as a treatment for skin tumors. After a 9-h exposure in vitro, the viability of Human Malignant Melanoma cells (A375) decreased by around 70%. Western blot analysis suggested an apoptotic cell death confirmed by the upregulation of Bax, cleaved PARP/caspase-3/8, cytochrome c, and t-bid. Additionally, cellular ROS accumulation and DNA damage were induced upon irradiation with blue light. When tested on a DMBA/TPA skin carcinogenesis model, a 90-min exposure to white light thrice weekly resulted in a significant decrease in tumor volumes/incidence compared to control and cisplatin groups, and restored normal morphological features, as confirmed by histopathology. Toxicological evaluation of ight-treated animals indicated a 100% survival rate, no skin irritation, no signs of discomfort or changes in body weight/behavior, and no toxicities to vital organs. Although these results must be confirmed by further studies, this research showed that short-exposure by commercially available high-intensity white LED light irradiation may be a promising approach for the treatment of superficial malignancies.
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Affiliation(s)
- Stephanie Mehanna
- Department of Natural Sciences, Lebanese American University, Chouran, Beirut 1102-2801, Lebanon
| | - Najwa Mansour
- Department of Natural Sciences, Lebanese American University, Chouran, Beirut 1102-2801, Lebanon
| | - Costantine F Daher
- Department of Natural Sciences, Lebanese American University, Chouran, Beirut 1102-2801, Lebanon
| | - Maria George Elias
- Department of Natural Sciences, Lebanese American University, Chouran, Beirut 1102-2801, Lebanon
| | - Carole Dagher
- School of Medicine, Lebanese American University, Lebanon
| | - Rony S Khnayzer
- Department of Natural Sciences, Lebanese American University, Chouran, Beirut 1102-2801, Lebanon.
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5
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Hawkshaw NJ, Pilkington SM, Murphy SA, Al‐Gazaq N, Farrar MD, Watson REB, Nicolaou A, Rhodes LE. UV radiation recruits CD4 +GATA3 + and CD8 +GATA3 + T cells while altering the lipid microenvironment following inflammatory resolution in human skin in vivo. Clin Transl Immunology 2020; 9:e01104. [PMID: 32257209 PMCID: PMC7114692 DOI: 10.1002/cti2.1104] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/11/2019] [Accepted: 01/01/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Solar ultraviolet radiation (UVR) has major adverse effects on human health. While the mechanisms responsible for induction of UVR-induced inflammation are well-documented, the mediation of its resolution and longer-term adaptive homeostasis is unknown. Therefore, we examined the skin immune and lipid profile over time following UVR inflammation. METHODS To investigate the self-resolving events of UVR inflammation in vivo, human skin was exposed to a single pro-inflammatory dose of UVR. Skin biopsies and suction blister fluid were taken at intervals up to 2 weeks post-UVR. The immune infiltrate was quantified by immunohistochemistry, and lipid mediators were profiled by liquid chromatography/mass spectrometry. RESULTS We identified that cellular resolution events including switching of macrophage phenotype apply to human sunburn. However, UVR-induced inflammation in humans involves a post-resolution phase that differs from other experimental models. We demonstrate that 2 weeks after the initiating UVR stimulus, there is considerable immune activity with CD8+GATA3+ T cells maintained in human skin. Our results challenge the dogma of CD4+FOXP3+ T cells being the main effector CD4+ T-cell population following UVR, with CD4+GATA3+ T cells the dominant phenotype. Furthermore, lipid mediators are elevated 14 days post-UVR, demonstrating the skin lipid microenvironment does not revert to the tissue setting occurring prior to UVR exposure. CONCLUSION We have identified for the first time that CD4+GATA3+ and CD8+GATA3+ T-cell subpopulations are recruited to UVR-inflamed human skin, demonstrating discrepancies between the adaptive UVR response in mice and humans. Future strategies to abrogate UVR effects may target these T-cell subpopulations and also the persistent alteration of the lipid microenvironment post-UVR.
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Affiliation(s)
- Nathan J Hawkshaw
- Centre for Dermatology ResearchDivision of Musculoskeletal and Dermatological SciencesFaculty of Biology, Medicine and HealthSchool of Biological SciencesManchester Academic Health Science CentreThe University of Manchester and Salford Royal NHS Foundation TrustManchesterUK
| | - Suzanne M Pilkington
- Centre for Dermatology ResearchDivision of Musculoskeletal and Dermatological SciencesFaculty of Biology, Medicine and HealthSchool of Biological SciencesManchester Academic Health Science CentreThe University of Manchester and Salford Royal NHS Foundation TrustManchesterUK
| | - Sharon A Murphy
- Laboratory for Lipidomics and Lipid BiologyDivision of Pharmacy and OptometryFaculty of Biology Medicine and HealthSchool of Health SciencesThe University of ManchesterManchesterUK
| | - Norah Al‐Gazaq
- Laboratory for Lipidomics and Lipid BiologyDivision of Pharmacy and OptometryFaculty of Biology Medicine and HealthSchool of Health SciencesThe University of ManchesterManchesterUK
| | - Mark D Farrar
- Centre for Dermatology ResearchDivision of Musculoskeletal and Dermatological SciencesFaculty of Biology, Medicine and HealthSchool of Biological SciencesManchester Academic Health Science CentreThe University of Manchester and Salford Royal NHS Foundation TrustManchesterUK
| | - Rachel EB Watson
- Centre for Dermatology ResearchDivision of Musculoskeletal and Dermatological SciencesFaculty of Biology, Medicine and HealthSchool of Biological SciencesManchester Academic Health Science CentreThe University of Manchester and Salford Royal NHS Foundation TrustManchesterUK
| | - Anna Nicolaou
- Laboratory for Lipidomics and Lipid BiologyDivision of Pharmacy and OptometryFaculty of Biology Medicine and HealthSchool of Health SciencesThe University of ManchesterManchesterUK
| | - Lesley E Rhodes
- Centre for Dermatology ResearchDivision of Musculoskeletal and Dermatological SciencesFaculty of Biology, Medicine and HealthSchool of Biological SciencesManchester Academic Health Science CentreThe University of Manchester and Salford Royal NHS Foundation TrustManchesterUK
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6
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7
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Abstract
Ultraviolet (UV) radiation contributes to the development of skin cancer through direct and indirect DNA damage, production of reactive oxygen species, and local immunomodulation. The association between UV radiation and skin cancer has raised concern for the risk of carcinogenesis following phototherapy. The photocarcinogenic impact of psoralen and UVA radiation (PUVA) has been extensively studied, whereas limited safety studies exist for other phototherapy modalities, such as broadband and narrowband UVB and UVA1. Because of the as of yet unclear risk, patients who have undergone any type of phototherapy should be followed for age-appropriate skin cancer screening.
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8
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Bernard JJ, Gallo RL, Krutmann J. Photoimmunology: how ultraviolet radiation affects the immune system. Nat Rev Immunol 2019; 19:688-701. [PMID: 31213673 DOI: 10.1038/s41577-019-0185-9] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2019] [Indexed: 02/07/2023]
Abstract
Ultraviolet (UV) radiation is a ubiquitous component of the environment that has important effects on a wide range of cell functions. Short-wavelength UVB radiation induces sunburn and is a potent immunomodulator, yet longer-wavelength, lower-energy UVA radiation also has effects on mammalian immunity. This Review discusses current knowledge regarding the mechanisms by which UV radiation can modify innate and adaptive immune responses and how this immunomodulatory capacity can be both beneficial in the case of inflammatory and autoimmune diseases, and detrimental in the case of skin cancer and the response to several infectious agents.
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Affiliation(s)
- Jamie J Bernard
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, USA. .,Division of Dermatology, Department of Medicine, Michigan State University, East Lansing, MI, USA.
| | - Richard L Gallo
- Department of Dermatology, University of California, San Diego, La Jolla, CA, USA
| | - Jean Krutmann
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.,Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
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9
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Wang W, Chapman NM, Zhang B, Li M, Fan M, Laribee RN, Zaidi MR, Pfeffer LM, Chi H, Wu ZH. Upregulation of PD-L1 via HMGB1-Activated IRF3 and NF-κB Contributes to UV Radiation-Induced Immune Suppression. Cancer Res 2019; 79:2909-2922. [PMID: 30737234 DOI: 10.1158/0008-5472.can-18-3134] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/16/2019] [Accepted: 02/05/2019] [Indexed: 12/21/2022]
Abstract
Solar ultraviolet radiation (UVR) suppresses skin immunity, which facilitates initiation of skin lesions and establishment of tumors by promoting immune evasion. It is unclear whether immune checkpoints are involved in the modulation of skin immunity by UVR. Here, we report that UVR exposure significantly increased expression of immune checkpoint molecule PD-L1 in melanoma cells. The damage-associated molecular patterns molecule HMGB1 was secreted by melanocytes and keratinocytes upon UVR, which subsequently activated the receptor for advanced glycation endproducts (RAGE) receptor to promote NF-κB- and IRF3-dependent transcription of PD-L1 in melanocytes. UVR exposure significantly reduced the susceptibility of melanoma cells to CD8+ T-cell-dependent cytotoxicity, which was mitigated by inhibiting the HMGB1/TBK1/IRF3/NF-κB cascade or by blocking the PD-1/PD-L1 checkpoint. Taken together, our findings demonstrate that UVR-induced upregulation of PD-L1 contributes to immune suppression in the skin microenvironment, which may promote immune evasion of oncogenic cells and drive melanoma initiation and progression. SIGNIFICANCE: These findings identify PD-L1 as a critical component of UV-induced immune suppression in the skin, which facilitates immunoevasion of oncogenic melanocytes and development of melanoma.See related commentary by Sahu, p. 2805.
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Affiliation(s)
- Wei Wang
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.,Center for Cancer Research, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Nicole M Chapman
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Bo Zhang
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.,Center for Cancer Research, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Mingqi Li
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.,Center for Cancer Research, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Meiyun Fan
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.,Center for Cancer Research, University of Tennessee Health Science Center, Memphis, Tennessee
| | - R Nicholas Laribee
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.,Center for Cancer Research, University of Tennessee Health Science Center, Memphis, Tennessee
| | - M Raza Zaidi
- Fels Institute for Cancer Research and Molecular Biology, Temple University, Philadelphia, Pennsylvania.,Department of Medical Genetics and Molecular Biochemistry, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Lawrence M Pfeffer
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.,Center for Cancer Research, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Hongbo Chi
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Zhao-Hui Wu
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, Tennessee. .,Center for Cancer Research, University of Tennessee Health Science Center, Memphis, Tennessee
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10
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Abstract
Phototherapy is widely used to treat inflammatory skin diseases such as psoriasis and atopic dermatitis. Repeated suberythemogenic doses of UV-light reduce inflammation in these diseases and ultimately may lead to a complete disappearance of cutaneous symptoms for weeks or months. Chronic pruritus is an important and highly distressing symptom of many of these inflammatory skin diseases. Interestingly, pruritus is also reduced or completely abolished by UV-treatment of psoriasis and atopic dermatitis, and sometimes reduction of pruritus is the first indication for skin improvement by phototherapy. The cutaneous nervous system is an integral part of skin anatomy, and free nerve endings of sensory cutaneous nerve fibers reach up into the epidermis getting in close contact with epidermal cells and mediators from epidermal cells released into the intercellular space. Stimulation of “pruriceptors” within this group of sensory nerve fibers generates a neuronal signal eventually transmitted via the dorsal root and the spinal cord to the brain, where it is recognized as “itch”. UV-light may directly affect cutaneous sensory nerve fibers or, via the release of mediators from cells within the skin, indirectly modulate their function as well as the transmission of itch to the central nervous system inducing the clinically recognized antipruritic effect of phototherapy.
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Affiliation(s)
- Franz J Legat
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
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12
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Abstract
Preclinical infection model systems are extremely valuable tools to aid in our understanding of Human Papillomavirus (HPV) biology, disease progression, prevention, and treatments. In this context, rodent papillomaviruses and their respective infection models are useful tools but remain underutilized resources in the field of papillomavirus biology. Two rodent papillomaviruses, MnPV1, which infects the Mastomys species of multimammate rats, and MmuPV1, which infects laboratory mice, are currently the most studied rodent PVs. Both of these viruses cause malignancy in the skin and can provide attractive infection models to study the lesser understood cutaneous papillomaviruses that have been frequently associated with HPV-related skin cancers. Of these, MmuPV1 is the first reported rodent papillomavirus that can naturally infect the laboratory strain of mice. MmuPV1 is an attractive model virus to study papillomavirus pathogenesis because of the ubiquitous availability of lab mice and the fact that this mouse species is genetically modifiable. In this review, we have summarized the knowledge we have gained about PV biology from the study of rodent papillomaviruses and point out the remaining gaps that can provide new research opportunities.
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13
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Abstract
Light and optical techniques have made profound impacts on modern
medicine, with numerous lasers and optical devices being currently used in
clinical practice to assess health and treat disease. Recent advances in
biomedical optics have enabled increasingly sophisticated technologies —
in particular those that integrate photonics with nanotechnology, biomaterials
and genetic engineering. In this Review, we revisit the fundamentals of
light–matter interactions, describe the applications of light in
imaging, diagnosis, therapy and surgery, overview their clinical use, and
discuss the promise of emerging light-based technologies.
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Affiliation(s)
- Seok Hyun Yun
- Wellman Center for Photomedicine, Massachusetts General Hospital, 65 Landsdowne Street, Cambridge, MA 02139, USA.,Department of Dermatology, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115.,Harvard-MIT Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Sheldon J J Kwok
- Wellman Center for Photomedicine, Massachusetts General Hospital, 65 Landsdowne Street, Cambridge, MA 02139, USA.,Harvard-MIT Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
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15
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Goh G, Walradt T, Markarov V, Blom A, Riaz N, Doumani R, Stafstrom K, Moshiri A, Yelistratova L, Levinsohn J, Chan TA, Nghiem P, Lifton RP, Choi J. Mutational landscape of MCPyV-positive and MCPyV-negative Merkel cell carcinomas with implications for immunotherapy. Oncotarget 2016; 7:3403-15. [PMID: 26655088 PMCID: PMC4823115 DOI: 10.18632/oncotarget.6494] [Citation(s) in RCA: 262] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 11/20/2015] [Indexed: 12/17/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a rare but highly aggressive cutaneous neuroendocrine carcinoma, associated with the Merkel cell polyomavirus (MCPyV) in 80% of cases. To define the genetic basis of MCCs, we performed exome sequencing of 49 MCCs. We show that MCPyV-negative MCCs have a high mutation burden (median of 1121 somatic single nucleotide variants (SSNVs) per-exome with frequent mutations in RB1 and TP53 and additional damaging mutations in genes in the chromatin modification (ASXL1, MLL2, and MLL3), JNK (MAP3K1 and TRAF7), and DNA-damage pathways (ATM, MSH2, and BRCA1). In contrast, MCPyV-positive MCCs harbor few SSNVs (median of 12.5 SSNVs/tumor) with none in the genes listed above. In both subgroups, there are rare cancer-promoting mutations predicted to activate the PI3K pathway (HRAS, KRAS, PIK3CA, PTEN, and TSC1) and to inactivate the Notch pathway (Notch1 and Notch2). TP53 mutations appear to be clinically relevant in virus-negative MCCs as 37% of these tumors harbor potentially targetable gain-of-function mutations in TP53 at p.R248 and p.P278. Moreover, TP53 mutational status predicts death in early stage MCC (5-year survival in TP53 mutant vs wild-type stage I and II MCCs is 20% vs. 92%, respectively; P = 0.0036). Lastly, we identified the tumor neoantigens in MCPyV-negative and MCPyV-positive MCCs. We found that virus-negative MCCs harbor more tumor neoantigens than melanomas or non-small cell lung cancers (median of 173, 65, and 111 neoantigens/sample, respectively), two cancers for which immune checkpoint blockade can produce durable clinical responses. Collectively, these data support the use of immunotherapies for virus-negative MCCs.
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Affiliation(s)
- Gerald Goh
- Department of Genetics, Yale School of Medicine, New Haven, CT, USA.,Howard Hughes Medical Institute, Yale School of Medicine, New Haven, CT, USA
| | - Trent Walradt
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Vladimir Markarov
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Astrid Blom
- Department of Dermatology, University of Washington, Seattle, WA, USA
| | - Nadeem Riaz
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Pathology, University of Washington, Seattle, WA, USA
| | - Ryan Doumani
- Department of Dermatology, University of Washington, Seattle, WA, USA
| | - Krista Stafstrom
- Department of Dermatology, University of Washington, Seattle, WA, USA
| | - Ata Moshiri
- Department of Dermatology, University of Washington, Seattle, WA, USA
| | - Lola Yelistratova
- Department of Dermatology, University of Washington, Seattle, WA, USA
| | | | - Timothy A Chan
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paul Nghiem
- Department of Dermatology, University of Washington, Seattle, WA, USA.,Department of Pathology, University of Washington, Seattle, WA, USA.,Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Richard P Lifton
- Department of Genetics, Yale School of Medicine, New Haven, CT, USA.,Howard Hughes Medical Institute, Yale School of Medicine, New Haven, CT, USA
| | - Jaehyuk Choi
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA.,Department of Dermatology, Veterans Affairs Healthcare, West Haven, CT, USA.,Current address: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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16
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Sunlight Effects on Immune System: Is There Something Else in addition to UV-Induced Immunosuppression? BIOMED RESEARCH INTERNATIONAL 2016; 2016:1934518. [PMID: 28070504 PMCID: PMC5187459 DOI: 10.1155/2016/1934518] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/02/2016] [Accepted: 11/06/2016] [Indexed: 12/22/2022]
Abstract
Sunlight, composed of different types of radiation, including ultraviolet wavelengths, is an essential source of light and warmth for life on earth but has strong negative effects on human health, such as promoting the malignant transformation of skin cells and suppressing the ability of the human immune system to efficiently detect and attack malignant cells. UV-induced immunosuppression has been extensively studied since it was first described by Dr. Kripke and Dr. Fisher in the late 1970s. However, skin exposure to sunlight has not only this and other unfavorable effects, for example, mutagenesis and carcinogenesis, but also a positive one: the induction of Vitamin D synthesis, which performs several roles within the immune system in addition to favoring bone homeostasis. The impact of low levels of UV exposure on the immune system has not been fully reported yet, but it bears interesting differences with the suppressive effect of high levels of UV radiation, as shown by some recent studies. The aim of this article is to put some ideas in perspective and pose some questions within the field of photoimmunology based on established and new information, which may lead to new experimental approaches and, eventually, to a better understanding of the effects of sunlight on the human immune system.
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Calkins MJ, Vartanian V, Owen N, Kirkali G, Jaruga P, Dizdaroglu M, McCullough AK, Lloyd RS. Enhanced sensitivity of Neil1 -/- mice to chronic UVB exposure. DNA Repair (Amst) 2016; 48:43-50. [PMID: 27818081 DOI: 10.1016/j.dnarep.2016.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/17/2016] [Accepted: 10/27/2016] [Indexed: 01/02/2023]
Abstract
Oxidative stress and reactive oxygen species (ROS)-induced DNA base damage are thought to be central mediators of UV-induced carcinogenesis and skin aging. However, increased steady-state levels of ROS-induced DNA base damage have not been reported after chronic UV exposure. Accumulation of ROS-induced DNA base damage is governed by rates of lesion formation and repair. Repair is generally performed by Base Excision Repair (BER), which is initiated by DNA glycosylases, such as 8-oxoguanine glycosylase and Nei-Endonuclease VIII-Like 1 (NEIL1). In the current study, UV light (UVB) was used to elicit protracted low-level ROS challenge in wild-type (WT) and Neil1-/- mouse skin. Relative to WT controls, Neil1-/- mice showed an increased sensitivity to tissue destruction from the chronic UVB exposure, and corresponding enhanced chronic inflammatory responses as measured by cytokine message levels and profiling, as well as neutrophil infiltration. Additionally, levels of several ROS-induced DNA lesions were measured including 4,6-diamino-5-formamidopyrimidine (FapyGua), 2,6-diamino-4-hydroxy-5-formamidopyrimidine (FapyAde), 8-hydroxyguanine (8-OH-Gua), 5,6-dihydroxyuracil (5,6-diOH-Ura) and thymine glycol (ThyGly). In WT mice, chronic UVB exposure led to increased steady-state levels of FapyGua, FapyAde, and ThyGly with no significant increases in 8-OH-Gua or 5,6-diOH-Ura. Interestingly, the lesions that accumulated were all substrates of NEIL1. Collectively, these data suggest that NEIL1-initiated repair of a subset of ROS-induced DNA base lesions may be insufficient to prevent the initiation of inflammatory pathways during chronic UV exposure in mouse skin.
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Affiliation(s)
- Marcus J Calkins
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University Portland, OR 97239-3098, United States
| | - Vladimir Vartanian
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University Portland, OR 97239-3098, United States
| | - Nichole Owen
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University Portland, OR 97239-3098, United States
| | - Guldal Kirkali
- Biomolecular Measurement Division, National Institute of Standards and Technology, Gaithersburg MD 20899-8311, United States
| | - Pawel Jaruga
- Biomolecular Measurement Division, National Institute of Standards and Technology, Gaithersburg MD 20899-8311, United States
| | - Miral Dizdaroglu
- Biomolecular Measurement Division, National Institute of Standards and Technology, Gaithersburg MD 20899-8311, United States
| | - Amanda K McCullough
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University Portland, OR 97239-3098, United States; Department of Molecular and Medical Genetics, Oregon Health & Science University Portland, OR 97239-3098, United States
| | - R Stephen Lloyd
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University Portland, OR 97239-3098, United States; Department of Physiology and Pharmacology, Oregon Health & Science University Portland, OR 97239-3098, United States.
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18
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Ferrándiz C, Malvehy J, Guillén C, Ferrándiz-Pulido C, Fernández-Figueras M. Precancerous Skin Lesions. ACTAS DERMO-SIFILIOGRAFICAS 2016; 108:31-41. [PMID: 27658688 DOI: 10.1016/j.ad.2016.07.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/06/2016] [Accepted: 07/28/2016] [Indexed: 12/30/2022] Open
Abstract
Certain clinically and histologically recognizable skin lesions with a degree of risk of progression to squamous cell carcinoma have been traditionally grouped as precancerous skin conditions but now tend to be classified as in situ carcinomas. This consensus statement discusses various aspects of these lesions: their evaluation by means of clinical and histopathologic features, the initial evaluation of the patient, the identification of risk factors for progression, and the diagnostic and treatment strategies available today.
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Affiliation(s)
- C Ferrándiz
- Servicio de Dermatología, Hospital Universitari germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, España.
| | - J Malvehy
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Guillén
- Servicio de Dermatología, Hospital Universitari de la Vall de Hebron, Barcelona, España
| | - C Ferrándiz-Pulido
- Servicio de Anatomía Patológica, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, España
| | - M Fernández-Figueras
- Servicio de Dermatología, Hospital Universitari germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Anatomía Patológica, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, España
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20
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Abstract
The health benefits of natural sunlight have been noted since the rise of civilization, even without the knowledge of its mechanisms of action. Currently, phototherapy remains an effective and widely used treatment for a variety of skin diseases. Ultraviolet radiation, from either the sun or artificial light sources, has a profound immunomodulatory effect that is responsible for its beneficial clinical outcomes. Ultraviolet radiation mostly induces the innate while suppressing the adaptive immune system, leading to both local and systemic effects. It is antigen specific, acts on both effector and regulatory T cells, alters antigen-presenting cell function, and induces the secretion of cytokines and soluble mediators. This review provides an overview of the immunologic mechanisms by which ultraviolet radiation is responsible for the therapeutic effects of phototherapy.
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Affiliation(s)
- Tiago R Matos
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Academic Medical Center, Department of Dermatology, University of Amsterdam, Amsterdam, 1105 AZ, Netherlands.
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Werner R, Stockfleth E, Connolly S, Correia O, Erdmann R, Foley P, Gupta A, Jacobs A, Kerl H, Lim H, Martin G, Paquet M, Pariser D, Rosumeck S, Röwert-Huber HJ, Sahota A, Sangueza O, Shumack S, Sporbeck B, Swanson N, Torezan L, Nast A. Evidence- and consensus-based (S3) Guidelines for the Treatment of Actinic Keratosis - International League of Dermatological Societies in cooperation with the European Dermatology Forum - Short version. J Eur Acad Dermatol Venereol 2015; 29:2069-79. [DOI: 10.1111/jdv.13180] [Citation(s) in RCA: 188] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 04/02/2015] [Indexed: 12/22/2022]
Affiliation(s)
- R.N. Werner
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - E. Stockfleth
- Department of Dermatology, Venerology and Allergology; Skin Cancer Center (HTCC); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S.M. Connolly
- Department of Dermatology; Mayo Clinic; Scottsdale Arizona USA
| | - O. Correia
- Centro Dermatologia Epidermis; Instituto CUF and Faculty of Medicine of University of Porto; Porto Portugal
| | - R. Erdmann
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - P. Foley
- Skin and Cancer Foundation Victoria; Carlton Victoria Australia
- St. Vincent's Hospital Melbourne; Fitzroy Victoria Australia
- The University of Melbourne; Melbourne Victoria Australia
| | - A.K. Gupta
- Division of Dermatology; Department of Medicine; University of Toronto; Toronto Ontario Canada
- Mediprobe Research Inc.; London Ontario Canada
| | - A. Jacobs
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - H. Kerl
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - H.W. Lim
- Department of Dermatology; Henry Ford Hospital; Detroit Michigan USA
| | - G. Martin
- Dermatology Laser Center of Maui; Kihei Hawaii USA
| | - M. Paquet
- Mediprobe Research Inc.; London Ontario Canada
| | - D.M. Pariser
- Division of Dermatology and Virginia Clinical Research Inc; Eastern Virginia Medical School; Norfolk Virginia USA
| | - S. Rosumeck
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - H.-J. Röwert-Huber
- Division of Dermatopathology; Department of Dermatology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Sahota
- Department of Dermatology; Whipps Cross University Hospital; London UK
| | - O.P. Sangueza
- Department of Pathology; Wake Forest Baptist Medical Center; Winston-Salem North Carolina USA
- Department of Dermatology; Wake Forest Baptist Medical Center; Winston-Salem North Carolina USA
| | - S. Shumack
- Department of Dermatology; Northern Medical School; University of Sydney; Sydney New South Wales Australia
| | - B. Sporbeck
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - N.A. Swanson
- Dermatology, Surgery, and Otolaryngology; Oregon Health and Science University; Portland Oregon USA
- Surgical and Cosmetic Dermatology and Clinical Operations; Oregon Health and Science University Knight Cancer Institute; Portland Oregon USA
| | - L. Torezan
- Faculty of Medicine; Hospital das Clínicas; Universidade de São Paulo; São Paulo Brazil
| | - A. Nast
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
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22
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Hori T, Kuribayashi K, Saito K, Wang L, Torii M, Uemoto S, Kato T. Alloantigen-specific CD4(+) regulatory T cells induced in vivo by ultraviolet irradiation after alloantigen immunization require interleukin-10 for their induction and activation, and flexibly mediate bystander immunosuppression of allograft rejection. Transpl Immunol 2015; 32:156-63. [PMID: 25861842 DOI: 10.1016/j.trim.2015.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 03/31/2015] [Accepted: 03/31/2015] [Indexed: 01/04/2023]
Abstract
Ultraviolet (UV) irradiation prior to antigen immunization is employed to induce antigen-specific regulatory T cells (Tregs). UV-induced Tregs demonstrate unique bystander suppression, although antigen-specific activation is required initially. We previously reported the phenotype of alloantigen-specific transferable Tregs induced by UV-B irradiation after immunization was the same as T regulatory type 1-like CD4(+) T cells, with antigen-specific interleukin (IL)-10 production. Here, by using semi-allogeneic transplantation models in vivo, we investigated the role of IL-10 in the induction and activation of these Tregs, and the possibility of bystander suppression of third-party allograft rejection. Naïve mice (H-2(b)) were immunized with alloantigen (H-2(b/d)), and received UV-B irradiation (40 kJ/m(2)) 1 week later. Four weeks afterwards, splenic CD4(+) T cells were purified from the UV-irradiated immunized mice, and were transferred into naïve mice (H-2(b)). Allografts expressing the same alloantigen as T-cell donors were immunized against (H-2(b/d)) or an irrelevant alloantigen (H-2(b/k)) were transplanted to CD4(+) T-cell-transferred mice, and an alloantigen-specific prolongation of allograft survival observed. Experiments where IL-10 was neutralized by monoclonal antibody in the induction or effector phase revealed that IL-10 is critical, not only for induction but also for immunosuppressive function of CD4(+) Tregs induced by UV irradiation after alloantigen immunization. Third-party allografts (H-2(d/k)) were transplanted to CD4(+) T-cell-transferred mice, and graft survival was also prolonged. Even a graft only partially compatible with immunized alloantigen worked well in vivo to activate CD4(+) Tregs induced by UV irradiation after alloantigen immunization, which resulted in the bystander suppression of third-party allograft rejection.
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Affiliation(s)
- Tomohide Hori
- Department of Cellular and Molecular Immunology, Mie University Graduate School of Medicine, Tsu, Japan; Department of Hepato-pancreato-biliary and Transplant Surgery, Kyoto University Hospital, Kyoto, Japan.
| | - Kagemasa Kuribayashi
- Department of Cellular and Molecular Immunology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kanako Saito
- Department of Cellular and Molecular Immunology, Mie University Graduate School of Medicine, Tsu, Japan; Department of Hematology and Medical Oncology, Mie University Hospital, Tsu, Japan
| | - Linan Wang
- Department of Cellular and Molecular Immunology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Mie Torii
- Department of Cellular and Molecular Immunology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Shinji Uemoto
- Department of Hepato-pancreato-biliary and Transplant Surgery, Kyoto University Hospital, Kyoto, Japan
| | - Takuma Kato
- Department of Cellular and Molecular Immunology, Mie University Graduate School of Medicine, Tsu, Japan.
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Hori T, Kuribayashi K, Saito K, Wang L, Torii M, Uemoto S, Iida T, Yagi S, Kato T. Ultraviolet-induced alloantigen-specific immunosuppression in transplant immunity. World J Transplant 2015; 5:11-18. [PMID: 25815267 PMCID: PMC4371157 DOI: 10.5500/wjt.v5.i1.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 12/02/2014] [Accepted: 01/19/2015] [Indexed: 02/05/2023] Open
Abstract
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 40th anniversary of its discovery.
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Li H, Prasad R, Katiyar SK, Yusuf N, Elmets CA, Xu H. Interleukin-17 mediated inflammatory responses are required for ultraviolet radiation-induced immune suppression. Photochem Photobiol 2014; 91:235-41. [PMID: 25250896 DOI: 10.1111/php.12351] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 09/15/2014] [Indexed: 12/21/2022]
Abstract
Ultraviolet radiation (UVR) induces immunosuppression and is a major factor for development of skin cancer. Numerous efforts have been made to determine mechanisms for UVR-induced immunosuppression and to develop strategies for prevention and treatment of UVR-induced cancers. In the current study, we use IL-17 receptor (IL-17R) deficient mice to examine whether IL-17 mediated responses have a role in UVB (290-320)-induced immunosuppression of contact hypersensitivity responses. Results demonstrate that IL-17 mediated responses are required for UVB-induced immunosuppression of contact hypersensitivity responses. The systemic immune suppression and development of regulatory T cells are inhibited in UVB-treated IL-17R deficient mice compared to wild-type animals. The deficiency in IL-17R inhibits the infiltration and development of a tolerogenic myeloid cell population in UVB-treated skin, which expresses CD11b and Gr-1 and produces reactive oxygen species. We speculate that the development of the tolerogenic myeloid cells is dependent on IL-17-induced chemokines and inflammatory mediators in UVB-treated skin. The inhibition of the tolerogenic myeloid cells may be attributed to the suppression of regulatory T cells in UVR-treated IL-17R(-/-) mice. The findings may be exploited to new strategies for prevention and treatment of UVR-induced skin diseases and cancers.
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Affiliation(s)
- Hui Li
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL
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25
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Activation of the arylhydrocarbon receptor causes immunosuppression primarily by modulating dendritic cells. J Invest Dermatol 2014; 135:435-444. [PMID: 25251932 DOI: 10.1038/jid.2014.419] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 09/01/2014] [Accepted: 09/04/2014] [Indexed: 01/09/2023]
Abstract
UVR suppresses the immune system in an antigen-specific manner via induction of regulatory T cells (Tregs). The specific immunosuppression by UVR harbors therapeutic potential but is associated with UVR-induced DNA damage, requiring the identification of other triggers inducing the same immunosuppressive effects without DNA damage. The aryl hydrocarbon receptor (AhR) was identified as a molecular target for UVR and its activation to be involved in UVR-induced immunosuppression. Accordingly, the AhR agonist 4-n-nonylphenol (NP) suppressed sensitization and induced Treg similar to UVR. Here we show that antigen-presenting cells are critically involved in AhR-induced immunosuppression. Injection of hapten-coupled dendritic cells (DCs) treated with NP into mice did not result in sensitization but induced Treg. NP induced the release of IL-2 by DC that subsequently triggered the release of IL-10. NP upregulated the negative regulatory molecule B7-H4 via the release of IL-2 that was functionally relevant as inhibition of B7-H4 prevented the induction of Treg. Together, this indicates that activation of the AhR switches antigen-presenting cells from a stimulatory into a regulatory phenotype, ultimately inducing Treg. Thus, AhR agonists may represent an alternative to suppress the immune system like UVR but without causing the adverse effects of UVR including DNA damage.
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