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Ortner D, Strandt H, Tripp CH, Spoeck S, Seretis A, Hornsteiner F, Dieckmann S, Schmuth M, Stoitzner P. Langerhans cells orchestrate apoptosis of DNA-damaged keratinocytes upon high-dose UVB skin exposure. Eur J Immunol 2024:e2451020. [PMID: 39288297 DOI: 10.1002/eji.202451020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 08/27/2024] [Accepted: 08/30/2024] [Indexed: 09/19/2024]
Abstract
Ultraviolet (UV) irradiation of the skin causes mutations that can promote the development of melanoma and nonmelanoma skin cancer. High-dose UVB exposure triggers a vigorous skin reaction characterized by inflammation resulting in acute sunburn. This response includes the formation of sunburn cells and keratinocytes (KC) undergoing programmed cell death (apoptosis) when repair mechanisms of DNA damage are inadequate. The primary objective of this research was to clarify the involvement of Langerhans cells (LC) in the development of acute sunburn following intense UVB skin irradiation. To address this, we subjected the dorsal skin of mice to a single high-dose UVB exposure and analyzed the immediate immune response occurring within the skin tissue. Acute sunburn triggered an activation of LC, coinciding with a rapid influx of neutrophils that produced TNF-α. Furthermore, our investigation unveiled a marked increase in DNA-damaged KC and the subsequent induction of apoptosis in these cells. Importantly, we demonstrate a crucial link between the inflammatory cascade, the initiation of apoptosis in DNA-damaged KC, and the presence of LC in the skin. LC were observed to modulate the chemokine response in the skin following exposure to UVB, thereby affecting the trafficking of neutrophils. Skin lacking LC revealed diminished inflammation, contained fewer TNF-α-producing neutrophils, and due to the prevention of apoptosis induction, a lingering population of DNA-damaged KC, presumably carrying the risk of enduring genomic alterations. In summary, our results underscore the pivotal role of LC in preserving the homeostasis of UVB-irradiated skin. These findings contribute to a deeper understanding of the intricate mechanisms underlying acute sunburn responses and their implications for UV-induced skin cancer.
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Affiliation(s)
- Daniela Ortner
- Department of Dermatology, Venereology & Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Helen Strandt
- Department of Dermatology, Venereology & Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph H Tripp
- Department of Dermatology, Venereology & Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sarah Spoeck
- Division of Developmental Immunology, Medical University of Innsbruck, Innsbruck, Austria
| | - Athanasios Seretis
- Research Institute for Biomedical Ageing Research, University of Innsbruck, Innsbruck, Austria
| | - Florian Hornsteiner
- Department of Dermatology, Venereology & Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sophie Dieckmann
- Department of Dermatology, Venereology & Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Matthias Schmuth
- Department of Dermatology, Venereology & Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Patrizia Stoitzner
- Department of Dermatology, Venereology & Allergology, Medical University of Innsbruck, Innsbruck, Austria
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Olivet MM, Yang K, Graham LV. Improvement of systemic sclerosis-associated digital ulcers after ultraviolet A1 phototherapy. JAAD Case Rep 2024; 44:3-5. [PMID: 38292572 PMCID: PMC10824675 DOI: 10.1016/j.jdcr.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Affiliation(s)
| | - Kevin Yang
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lauren V. Graham
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
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Beyzaee AM, Goldust M, Patil A, Rokni GR, Beyzaee S. The role of cytokines and vitamin D in vitiligo pathogenesis. J Cosmet Dermatol 2022; 21:6314-6325. [PMID: 35871394 DOI: 10.1111/jocd.15272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 12/27/2022]
Abstract
Vitiligo is a pigment-related disease with a global prevalence of 0.2% to 1.8% associated with considerable burden on quality of life. The treatment is still a challenge because of relapses and/or incomplete re-pigmentation. Although the exact cause is still unclear, its pathogenesis seems to be justifiable with the autoimmune theory, supported by the results of clinical research. In this narrative review, we aimed to summarize the evidence related to cytokines and vitiligo development. This review is consisted of English articles published in PubMed and Google Scholar concerning levels of inflammatory mediators, especially interleukins, in vitiligo patients over the last 20 years. References of relevant articles were also considered for review. Crucial role of dysregulated levels of interleukins and their synergistic function to each other, in the onset or progression of the disease is evident. The theory of autoimmune vitiligo is reinforced by the results of the studies in the literature, due to the association of pathogenesis with increased secretion of pro-inflammatory mediators and reduction of anti-inflammatory mediators. Decreased vitamin D levels may have a considerable role in vitiligo development by affecting Th1- and Th17-related immune responses. Cytokines play an important role in the pathogenesis or progression of the disease. Moreover, we believe that decreased vitamin D level has a considerable role in vitiligo development by affecting Th1- and Th17-related immune responses.
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Affiliation(s)
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Ghasem Rahmatpour Rokni
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Samira Beyzaee
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Karamova AE, Chikin VV, Kubanov AA, Davletbaeva LK. Long-wavelength ultraviolet A (UVA-1) phototherapy for the treatment of patients with atopic dermatitis. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
One of the methods of therapy for atopic dermatitis is long-wavelength ultraviolet therapy A (UVA-1- therapy). This review aims to provide the mechanisms of action of UVA-1-therapy an overview about the effectiveness of UVA-1-therapy in patients with atopic dermatitis taking into account factors that can affect the effectiveness of treatment radiation dose, skin phototype of patients, concomitant drug therapy. The available data on a decrease in the severity of atopic dermatitis as a result of the course of UVA-1-therapy and on a decrease in the severity of itching in patients are presented. The data on the rate of onset of the therapeutic effect of UVA-1-therapy and the duration of its maintenance are considered. The safety of UVA-1-therapy is discussed, and the most frequent undesirable effects a feeling of warmth, fever, itching, hyperpigmentation, are given. The possibility of developing side effects requiring discontinuation of treatment is assessed. The data obtained indicate the effectiveness and safety of the UFA-1-radiation in the treatment of patients with moderate-to-severe atopic dermatitis.
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Vieyra-Garcia PA, Wolf P. A deep dive into UV-based phototherapy: Mechanisms of action and emerging molecular targets in inflammation and cancer. Pharmacol Ther 2020; 222:107784. [PMID: 33316286 DOI: 10.1016/j.pharmthera.2020.107784] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/25/2020] [Indexed: 02/07/2023]
Abstract
UV-based phototherapy (including psoralen plus UVA (PUVA), UVB and UVA1) has a long, successful history in the management of numerous cutaneous disorders. Photoresponsive diseases are etiologically diverse, but most involve disturbances in local (and occasionally systemic) inflammatory cells and/or abnormalities in keratinocytes that trigger inflammation. UV-based phototherapy works by regulating the inflammatory component and inducing apoptosis of pathogenic cells. This results in a fascinating and complex network of simultaneous events-immediate transcriptional changes in keratinocytes, immune cells, and pigment cells; the emergence of apoptotic bodies; and the trafficking of antigen-presenting cells in skin-that quickly transform the microenvironment of UV-exposed skin. Molecular elements in this system of UV recognition and response include chromophores, metabolic byproducts, innate immune receptors, neurotransmitters and mediators such as chemokines and cytokines, antimicrobial peptides, and platelet activating factor (PAF) and PAF-like molecules that simultaneously shape the immunomodulatory effects of UV and their interplay with the microbiota of the skin and beyond. Phototherapy's key effects-proapoptotic, immunomodulatory, antipruritic, antifibrotic, propigmentary, and pro-prebiotic-promote clinical improvement in various skin diseases such as psoriasis, atopic dermatitis (AD), graft-versus-host disease (GvHD), vitiligo, scleroderma, and cutaneous T-cell lymphoma (CTCL) as well as prevention of polymorphic light eruption (PLE). As understanding of phototherapy improves, new therapies (UV- and non-UV-based) are being developed that will modify regulatory T-cells (Treg), interact with (resident) memory T-cells and /or utilize agonists and antagonists as well as antibodies targeting soluble molecules such as cytokines and chemokines, transcription factors, and a variety of membrane-associated receptors.
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Affiliation(s)
- Pablo A Vieyra-Garcia
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria.
| | - Peter Wolf
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria.
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Abstract
There is a long history of utilization of phototherapy for treatment of skin conditions. Because of its longer wavelength, UVA1 phototherapy is able to penetrate into the dermis and subcutis. This depth of penetration, combined with its unique immunomodulating properties, makes UVA1 an effective treatment modality for many immune-mediated skin diseases. In some cases, it performs better than other types of phototherapy.
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Affiliation(s)
- Smriti Prasad
- University of Texas at Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9069, USA
| | - Jennifer Coias
- University of Texas at Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9069, USA
| | - Henry W Chen
- University of Texas at Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9069, USA
| | - Heidi Jacobe
- University of Texas at Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9069, USA.
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7
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Abstract
Phototherapeutic modalities induce apoptosis of keratinocytes and immune cells, impact cytokine production, downregulate the IL-23/Th17 axis, and induce regulatory T cells. As in anti-IL-17 or anti-IL-23 antibody treatment, the dual action of phototherapy on skin and the immune system is likely responsible for sustained resolution of lesions in diseases such as psoriasis. In cutaneous T cell lymphoma, phototherapy may function by causing tumor cell apoptosis and eliminating the neoplastic and inflammatory infiltrate. Further research on phototherapeutic mechanisms will help advance, optimize, and refine dermatologic treatments and may open up novel avenues for treatment strategies in dermatology and beyond.
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Affiliation(s)
- Zizi Yu
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Peter Wolf
- Department of Dermatology, Research Unit for Photodermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria.
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Pitney T, Pitney MJ. A retrospective review of UVA1 treatment: An Australian experience from a single centre. Australas J Dermatol 2020; 61:318-323. [PMID: 32390138 DOI: 10.1111/ajd.13321] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/07/2020] [Accepted: 04/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The therapeutic value of ultraviolet A1 (UVA1) phototherapy has been acknowledged for many years. Initially developed predominately for experimental and diagnostic purposes, it was subsequently recognised as a beneficial therapeutic modality in atopic dermatitis and localised scleroderma, and more recently a variety of sclerosing and fibrosing dermatoses, T-lymphocyte mediated disorders, both inflammatory and infiltrative, and several predominately dermal processes previously unresponsive to current therapies. METHODS We present a retrospective evaluation of outcomes and treatment tolerability in adult patients using a low dose (30 joules/cm2 ), regimen administered in our private dermatologic practice, between 2006 and December 2019. RESULTS Major clinical groups represented include atopic dermatitis, localised and systemic sclerodermas, mycosis fungoides, urticarial dermatitis, generalised pruritus and granuloma annulare. Eighty-seven patients are included in this study with 92% of all patients experiencing a beneficial result, 54% having complete and 38% partial relief of presenting signs and/or symptoms. UVA1 therapy was well tolerated, with no patients ceasing treatment due to adverse effects. CONCLUSIONS Ultraviolet A1 is an effective and safe treatment option in many hitherto recalcitrant cutaneous conditions.
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Affiliation(s)
- Thomas Pitney
- Pitney Dermatology, Toowong, Brisbane, Queensland, Australia
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Calıskan E, Gamsızkan M, Yurekli A, Botsali A, Kabalar ME, Demiriz M, Tunca M. Anti-TNF agent etanercept augments UV-induced skin cancer development in SKH-1 mice †. J DERMATOL TREAT 2020; 32:812-818. [PMID: 31868056 DOI: 10.1080/09546634.2019.1708851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Despite being employed in the treatment of inflammatory disorders for more than 20 years all over the world, data regarding photocarcinogenic risks of anti-TNF agents is scarce.Objective: To assess photocarcinogenic potential of anti-TNF agents.Methods: This was a placebo controlled, split-body (UVB-treated versus -untreated) study on mice. Treatment groups were infliximab (n = 11), etanercept (n = 11), cyclosporine (n = 11) and vehicle control (n = 11). Agents were introduced on the 10th week of phototherapy and continued through 24th week. The macroscopic, histological and immunohistochemical analysis of test sites were carried out.Results: Overall 132 tumors were detected on test sites. All of these tumors developed on UV-exposed sides. Histologic examination of these tumors was compatible with keratinocytic neoplasia in 128, mastocytosis in 3, epidermal cyst in 1. Median tumor burden in the UVB exposed areas for ETN, IFX, CYC, and control groups were 14.91, 10.20, 6.28, and 3.14 cm2, respectively. ETN group demonstrated both higher tumor burden and keratinocytic neoplasia numbers than controls (p = .03, p = .025). Although there were 1.8 and 1.7 times more keratinocytic neoplasms in IFX and CYC groups compared to controls, these differences didn't reach statistically significant levels (p = .14; p = .19).Conclusion: This study points out to a significant photocarcinogenic potential of anti-TNF agent etanercept.
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Affiliation(s)
- Ercan Calıskan
- Department of Dermatology, Gulhane School of Medicine, Health Sciences University, Ankara, Turkey
| | - Mehmet Gamsızkan
- Department of Pathology, Gulhane School of Medicine, Health Sciences University, Ankara, Turkey.,Department of Pathology, School of Medicine, Duzce University, Duzce, Turkey
| | - Aslan Yurekli
- Department of Dermatology, Gulhane School of Medicine, Health Sciences University, Ankara, Turkey.,Department of Dermatology, Kusadası State Hospital, Aydın, Turkey
| | - Aysenur Botsali
- Department of Dermatology, Gulhane School of Medicine, Health Sciences University, Ankara, Turkey
| | - Mehmet Esref Kabalar
- Department of Pathology, Health Sciences University, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Murat Demiriz
- Department of Pathology, Gulhane School of Medicine, Health Sciences University, Ankara, Turkey.,Department of Dermatology, Kusadası State Hospital, Aydın, Turkey
| | - Mustafa Tunca
- Department of Dermatology, Gulhane School of Medicine, Health Sciences University, Ankara, Turkey
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10
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Kim YJ, Lee GH, Kwong BY, Martires KJ. Evidence-based, Skin-directed Treatments for Cutaneous Chronic Graft-versus-host Disease. Cureus 2019; 11:e6462. [PMID: 32025391 PMCID: PMC6977575 DOI: 10.7759/cureus.6462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Chronic graft-versus host disease (cGVHD) occurs in 30% to 70% of patients undergoing allogeneic hematopoietic cell transplantation (HCT). Cutaneous cGVHD affects 75% of cGVHD patients, causing discomfort, limiting the range of movement, and increasing the risk of wound infections. Furthermore, systemic immunosuppression is often needed to treat cGVHD and long-term use can lead to adverse events. Optimal use of skin-directed therapies is integral to the management of cutaneous cGVHD and may decrease the amount of systemic immunosuppression required. This study reviewed English-language articles published from 1990 to 2017 that evaluated the effect of skin-directed treatments for cutaneous cGVHD. A total of 201 papers were identified, 164 articles were screened, 46 were read, and 18 publications were utilized in the review. Skin-directed treatments for cGVHD included topical steroids, topical calcineurin inhibitors, psoralen with ultraviolet A (PUVA) irradiation, ultraviolet A1 (UVA1) irradiation, and ultraviolet B (UVB) irradiation. We report the number of complete remissions, partial remissions, and systemic immunosuppression reduction in each study, as available. Twenty-two out of 30 (73.3%) patients experienced overall improvement with topical calcineurin inhibitors. At least 26 out of 76 patients (34.2%) receiving PUVA experienced complete remission, and 30 out of 76 patients (39.5%) experienced partial remission. In UVA1 studies, 44 out of 52 (84.6%) patients experienced overall improvement. In UVB studies, nine out of 14 patients (64.3%) experienced complete remission and four out of 14 patients (28.6%) experienced partial remission. As more HCTs are performed, more individuals will develop cGVHD. Awareness and optimal use of skin-directed therapies for cutaneous cGVHD may help improve patient outcomes and quality of life.
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Affiliation(s)
- Yoo Jung Kim
- Department of Dermatology, Stanford University School of Medicine, Stanford, USA
| | - Gun Ho Lee
- Department of Dermatology, Stanford University School of Medicine, Stanford, USA
| | - Bernice Y Kwong
- Department of Dermatology, Stanford University School of Medicine, Stanford, USA
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Omer SAE, Badi RM, Garelnabi MEM, Altayeb OA, Hussein MO, Fadul EA, Saeed AM. Effects of acute and chronic exposure to natural sunlight and UVB on CD4/CD8 ratio and circulating pro-inflammatory and anti-inflammatory cytokine levels in mice. SCIENTIFIC AFRICAN 2019. [DOI: 10.1016/j.sciaf.2019.e00102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Chia BKY, Chia GSZ, Tan EST, Tan VWD, Chong WS. Ultraviolet-A1 phototherapy in Asian skin: A review of 159 cases in Singapore. Indian J Dermatol Venereol Leprol 2019; 86:162-168. [PMID: 30829299 DOI: 10.4103/ijdvl.ijdvl_751_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Ultraviolet-A1 phototherapy has been used to treat many inflammatory dermatoses. Aims To determine the efficacy and safety of ultraviolet-A1 phototherapy in Asian skin. Materials and Methods We performed a review of records of patients undergoing ultraviolet-A1 phototherapy at our dermatology unit in Singapore from January 2007 to January 2011. Their electronic medical records were reviewed and a standardized questionnaire was filled up for data collection and tabulation. Chi-square or Fisher's exact tests were used to compare the difference in response between various groups for each characteristic. P value of < 0.05 was considered statistically significant. Results Our study comprised of 159 patients, of which 103 were patients with hand and foot eczema, 21 with atopic dermatitis, 17 with scleroderma and the remaining with miscellaneous dermatoses. Of these patients, 47.6% of patients with hand and feet eczema had good response after 10 sessions, which increased to 75% after 20 sessions and to 84.6% after 30 sessions. After 10 sessions, 47.6% of patients with atopic dermatitis had good response, which increased to 66.7% after 20 sessions. After 30 sessions, all the three remaining patients with atopic dermatitis experienced good response. For patients with scleroderma, only 11.8 and 10% had good response after 10 and 20 sessions, respectively, which increased to 40% after 30 sessions. Limitations Limitations of our study include its retrospective design and, consequently, the lack of standardized treatment protocol, as well as subjective assessment in terms of clinical improvement. Conclusions Ultraviolet-A1 phototherapy appears to be efficacious for the treatment of hand and foot eczema as well as atopic dermatitis. However, in patients with scleroderma, the response was partial and needed a longer duration of treatment.
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Affiliation(s)
| | - Gabriel S Z Chia
- Department of Occupational and Environmental Medicine, Singapore General Hospital, Singapore
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Lee KJ, Park KH, Hahn JH. Alleviation of Ultraviolet-B Radiation-Induced Photoaging by a TNFR Antagonistic Peptide, TNFR2-SKE. Mol Cells 2019; 42:151-160. [PMID: 30703869 PMCID: PMC6399009 DOI: 10.14348/molcells.2018.0423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/13/2018] [Accepted: 01/01/2019] [Indexed: 11/27/2022] Open
Abstract
Ultraviolet (UV) radiation of the sunlight, especially UVA and UVB, is the primary environmental cause of skin damage, including topical inflammation, premature skin aging, and skin cancer. Previous reports show that activation of nuclear factor-κB (NF-κB) in human skin fibroblasts and keratinocytes after UV exposure induces the expression and release of proinflammatory cytokines, such as interleukin-1 (IL-1) and tumor necrosis factor-α (TNF-α), and subsequently leads to the production of matrix metalloproteases (MMPs) and growth factor basic fibroblast growth factor (bFGF). Here, we demonstrated that TNFR2-SKEE and TNFR2-SKE, oligopeptides from TNF receptor-associated factor 2 (TRAF2)-binding site of TNF receptor 2 (TNFR2), strongly inhibited the interaction of TNFR1 as well as TNFR2 with TRAF2. In particular, TNFR2-SKE suppressed UVB- or TNF-α-induced nuclear translocalization of activated NF-κB in mouse fibroblasts. It decreased the expression of bFGF, MMPs, and COX2, which were upregulated by TNF-α, and increased procollagen production, which was reduced by TNF-α. Furthermore, TNFR2-SKE inhibited the UVB-induced proliferation of keratinocytes and melanocytes in the mouse skin and the infiltration of immune cells into inflamed tissues. These results suggest that TNFR2-SKE may possess the clinical potency to alleviate UV-induced photoaging in human skin.
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Affiliation(s)
- Kyoung-Jin Lee
- Department of Anatomy and Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341,
Korea
| | - Kyeong Han Park
- Department of Anatomy and Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341,
Korea
| | - Jang-Hee Hahn
- Department of Anatomy and Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341,
Korea
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Singh M, Kotnis A, Jadeja SD, Mondal A, Mansuri MS, Begum R. Cytokines: the yin and yang of vitiligo pathogenesis. Expert Rev Clin Immunol 2018; 15:177-188. [DOI: 10.1080/1744666x.2019.1550358] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Mala Singh
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Ashwin Kotnis
- Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, India
| | - Shahnawaz D. Jadeja
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Anushree Mondal
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Mohmmad S. Mansuri
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Rasheedunnisa Begum
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, India
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Abstract
The exposure to ultraviolet radiations and visible light, or phototherapy, is a well-known therapeutic tool available for the treatment of many dermatological disorders. The continuos medical and technological progresses, of the last 50 years, have involved the field of phototherapy, which evolved from UVA and PUVA in its various forms, to the development of narrowband UVB (NB-UVB) and NB-UVB micro-focused phototherapies. Further advances in technology have now permitted the introduction of a new device emitting UVA-1 radiations.
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Chaowattanapanit S, Choonhakarn C, Foocharoen C, Julanon N. Phototherapy in systemic sclerosis: Review. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 33:296-305. [PMID: 28703365 DOI: 10.1111/phpp.12331] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/06/2017] [Indexed: 12/16/2022]
Abstract
Systemic scleroderma-also known as systemic sclerosis (SSc)-is a chronic systemic connective tissue disease characterized by collagen deposition in cutaneous and internal organs, leading to skin sclerosis and multiple organ fibrosis. The pathogenesis is complex and remains poorly understood. Treatment is based on organ involvement and requires a multidisciplinary approach. Skin sclerosis can cause disability, leading to decreasing quality of life. Various systemic antifibrotic therapies have been used; however, most have unsatisfactory results. Recently, phototherapy and in particular ultraviolet A (UVA) has been used to treat skin sclerosis in SSc patients with satisfactory results. The main mechanisms include lymphocyte apoptosis, cytokine alteration, inhibition of collagen synthesis and increased collagenase production, and neovascularization, leading to the breakdown of collagen fibrils resulting in skin softening or even healing digital ulcers. Most studies reported that psoralen plus UVA (PUVA) and UVA1 phototherapy improved clinical outcomes vis-à-vis skin sclerosis, joint mobility, ulcers, and histopathology. PUVA and UVA1 phototherapy therefore have potential as an alternative or adjunctive therapy for patients with SSc.
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Affiliation(s)
| | - Charoen Choonhakarn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chingching Foocharoen
- Division of Allergy-Immunology-Rheumatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Narachai Julanon
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Su LN, Ren J, Cheng SM, Liu JL, Ding YF, Zhu NW. UVA1 vs. narrowband UVB phototherapy in the treatment of palmoplantar pustulosis: a pilot randomized controlled study. Lasers Med Sci 2017; 32:1819-1823. [DOI: 10.1007/s10103-017-2280-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 06/29/2017] [Indexed: 11/25/2022]
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18
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UVA1 phototherapy in the treatment of palmoplantar pustulosis: a pilot prospective study. Lasers Med Sci 2016; 31:1641-1643. [DOI: 10.1007/s10103-016-2031-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
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Barkauskaite V, Ek M, Popovic K, Harris HE, Wahren-Herlenius M, Nyberg F. Translocation of the novel cytokine HMGB1 to the cytoplasm and extracellular space coincides with the peak of clinical activity in experimentally UV-induced lesions of cutaneous lupus erythematosus. Lupus 2016; 16:794-802. [PMID: 17895302 DOI: 10.1177/0961203307081895] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
HMGB1 is a pro-inflammatory cytokine that together with TNF-α and IL-1β is involved in the pathogenesis of spontaneously occurring skin lesions in lupus erythematosus. The purpose of the present study was to explore the sequence of events in HMGB1, TNF-α and IL-1β expression under development and resolution of experimentally induced CLE lesions. The study involved investigation of 38 serial skin biopsies acquired from photoprovoked skin lesions of nine CLE patients, using immunohistochemical staining of tissue sections. In biopsies from the clinically most active phase of skin involvement extracellular, secreted HMGB1 and increased cytoplasmic HMGB1 were found, as compared with the late and fading lesions or non-lesional skin. Besides HMGB1, increased expression of TNF-α and IL-1β was observed in dermal infiltrates of the induced CLE lesions. These cytokines were however not upregulated in all lesions, and increased expression of IL-1β was seen predominantly in late biopsies. In conclusion, extracellular and cytoplasmic HMGB1 coincides with the clinically most active phase of photoinduced lesions of cutaneous lupus, and suggests that HMGB1 is an important factor in the inflammatory autoimmune process of CLE. HMGB1 can induce expression of TNF-α and IL-1β, and formation of a pro-inflammatory loop between HMGB1, TNF-α, and IL-1β may be responsible for the prolonged and sustained inflammation in CLE. Lupus (2007) 16, 794—802.
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Affiliation(s)
- V Barkauskaite
- Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
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Abstract
Phototherapy is an effective treatment strategy for a variety of sclerosing skin conditions. There are a number of phototherapeutic modalities used for the treatment of sclerosing skin conditions, including ultraviolet (UV)A1, broadband UVA, psoralen plus UVA, and narrowband UVB phototherapy. As controlled trials with validated outcome measures are lacking for these therapies, existing evidence is largely level II for morphea and is even more minimal for scleroderma and other sclerosing disorders (scleroderma, lichen sclerosus, and chronic graft-versus-host disease, among others). Studies do suggest that phototherapy may be effective for many of these disorders, including those that have been unresponsive to other therapies. Phototherapy remains an attractive therapeutic option for patients due to its efficacy and favorable risk-versus-benefit profile. Phototherapy also offers a therapeutic alternative to systemic immunosuppressives for patients who cannot tolerate these medications.
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Affiliation(s)
- Noelle M Teske
- Department of Dermatology, University of Texas at Southwestern Medical Center, Dallas, TX
| | - Heidi T Jacobe
- Department of Dermatology, University of Texas at Southwestern Medical Center, Dallas, TX.
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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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Babino G, Giunta A, Esposito M, Saraceno R, Pavlidis A, Del Duca E, Chimenti S, Nisticò SP. UVA1 Laser in the Treatment of Vitiligo. Photomed Laser Surg 2016; 34:200-4. [PMID: 27070209 DOI: 10.1089/pho.2015.4004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The purpose of this article was to evaluate the clinical efficacy and safety of a monochromatic 355 nm ultraviolet (UVA) laser in the treatment of vitiligo. BACKGROUND DATA Broadband and narrow-band UV phototherapy has been proposed as an effective therapeutic option in vitiligo patients. METHODS Seventeen consecutive, unselected patients (7 men and 10 women) were enrolled in an open-label, prospective study and treated twice weekly for 8 weeks at a fixed dose of 80-140 J/cm(2). Follow-up was 12 weeks. RESULTS Clinical repigmentation was observed in 15/17 patients (88.23%), with limited side effects (mild post-treatment erythema and itching). Results were maintained during the 12 week phototherapy-free follow-up period. CONCLUSIONS the present report suggests that UVA1 laser could be an applicable therapeutic option in patients with vitiligo.
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Affiliation(s)
- Graziella Babino
- 1 Department of Dermatology, University of Rome "Tor Vergata ," Rome, Italy
| | - Alessandro Giunta
- 1 Department of Dermatology, University of Rome "Tor Vergata ," Rome, Italy
| | - Maria Esposito
- 1 Department of Dermatology, University of Rome "Tor Vergata ," Rome, Italy
| | - Rosita Saraceno
- 1 Department of Dermatology, University of Rome "Tor Vergata ," Rome, Italy
| | | | - Ester Del Duca
- 1 Department of Dermatology, University of Rome "Tor Vergata ," Rome, Italy
| | - Sergio Chimenti
- 1 Department of Dermatology, University of Rome "Tor Vergata ," Rome, Italy
| | - Steven Paul Nisticò
- 1 Department of Dermatology, University of Rome "Tor Vergata ," Rome, Italy .,2 Department of Health Sciences, Magna Graecia University , Catanzaro, Italy
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Sobjanek M, Zabłotna M, Michajłowski I, Nedoszytko B, Lesiak A, Nowicki R. -308 G/A TNF-α gene polymorphism influences the course of basal cell carcinoma in a Polish population. Arch Med Sci 2015; 11:599-604. [PMID: 26170854 PMCID: PMC4495156 DOI: 10.5114/aoms.2015.52364] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 10/15/2012] [Accepted: 04/11/2013] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The etiopathogenesis of basal cell carcinoma (BCC) is multifactorial. The TNF-α gene seems to be an interesting gene candidate for BCC susceptibility because of the proinflammatory and immunosuppressive properties of its product. The aim of the study was to assess the frequency of -308 G/A and -238 G/A gene polymorphisms in the TNF-α gene and serum levels of cytokine in patients with BCC. MATERIAL AND METHODS The study included 176 (94 women, 82 men) patients with BCC and 261 healthy volunteers. -308 G/A and -238 G/A TNF-α polymorphisms were analyzed using the amplification refractory mutation system-polymerase chain reaction method (ARMS-PCR). Serum concentrations of TNF-α were measured using ELISA. RESULTS There was no statistically significant association between allele, genotype and haplotype frequencies in BCC patients in comparison with controls. Occurrence of the -308 TNF-α A allele or GA genotype in the group of patients with BCC increases risk of recurrence of tumor recurrence (OR = 4.8, 95% CI: 1.6-13.9, p = 0.004 and OR = 4.97, 95% CI: 1.7-14.5, p = 0.004). Moreover, -308 TNF-α GG genotype decreased risk of recurrence (OR = 0.2, 95% CI: 0.07-0.6, p = 0.004). The -238/-308 GA haplotype was connected with increased risk of recurrence (OR = 4.36, 95% CI: 1.49-12.7, p = 0.007). We also found significantly higher TNF-α levels among BCC patients in comparison with controls (p = 0.004). CONCLUSIONS The obtained results did not confirm the role of the -308 G/A and -238 G/A TNF-α gene polymorphisms in BCC development, but the presence of the A allele or GA genotype in -308 G/A TNF-α gene polymorphism may have an impact on the course of the disease.
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Affiliation(s)
- Michał Sobjanek
- Department of Dermatology, Venerology and Allergology, Medical University of Gdansk, Gdansk, Poland
| | - Monika Zabłotna
- Department of Dermatology, Venerology and Allergology, Medical University of Gdansk, Gdansk, Poland
| | - Igor Michajłowski
- Department of Dermatology, Venerology and Allergology, Medical University of Gdansk, Gdansk, Poland
| | - Bogusław Nedoszytko
- Department of Dermatology, Venerology and Allergology, Medical University of Gdansk, Gdansk, Poland
| | - Aleksandra Lesiak
- Department of Dermatology and Venerology, Medical University of Lodz, Lodz, Poland
| | - Roman Nowicki
- Department of Dermatology, Venerology and Allergology, Medical University of Gdansk, Gdansk, Poland
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Abstract
The ultraviolet (UV) radiation contained in sunlight is a powerful immune suppressant. While exposure to UV is best known for its ability to cause skin cancer, it is also associated with protection against a range of autoimmune diseases, particularly multiple sclerosis (MS). Although the precise mechanism by which sunlight affords protection from MS remains to be determined, some have hypothesised that UV immunosuppression explains the "latitude-gradient effect" associated with MS. By stimulating the release of soluble factors in exposed skin, UV activates immune suppressive pathways that culminate in the induction of regulatory cells in distant tissues. Each and every one of the immune suppressive cells and molecules activated by UV exposure are potential targets for treating and preventing MS. A thorough understanding of the mechanisms involved is therefore required if we are to realise the therapeutic potential of photoimmunology.
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Affiliation(s)
- Felix Marsh-Wakefield
- Cellular Photoimmunology Group, Discipline of Infectious Diseases and Immunology, Sydney Medical School, University of Sydney, Camperdown, Australia.,Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.,Discipline of Dermatology, Bosch Institute, Sydney Medical School, University of Sydney, Camperdown, Australia
| | - Scott N Byrne
- Cellular Photoimmunology Group, Discipline of Infectious Diseases and Immunology, Sydney Medical School, University of Sydney, Camperdown, Australia. .,Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. .,Discipline of Dermatology, Bosch Institute, Sydney Medical School, University of Sydney, Camperdown, Australia. .,Infectious Diseases and Immunology, Level 5 (East), The Charles Perkins Centre Hub (D17), University of Sydney, Camperdown, NSW, 2006, Australia.
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Abstract
UV phototherapy has a long history of use for the treatment of select diseases in dermatology. Its use has evolved into more effective and targeted modalities, including psoralen + UV-A photochemotherapy, narrowband UV-B, excimer laser, and UV-A1 phototherapy. With its proven record of efficacy and safety, UV phototherapy is an excellent option in the treatment of an ever-growing number of skin conditions.
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Affiliation(s)
- Mariam B Totonchy
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Melvin W Chiu
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLA, 52-121 Center for the Health Sciences, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA.
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VOLNUKHIN VA, SAMSONOV VA. UVA-1 therapy of localized scleroderma and other diseases accompanied by skin sclerosis. VESTNIK DERMATOLOGII I VENEROLOGII 2013. [DOI: 10.25208/vdv566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The study results confirm the efficacy of the UVA-1 therapy for patients with localized scleroderma, extragenital lichen sclerosus et atrophicus, sclerodermatous chronic graft-versus-host disease and scleredema adultorum. The therapy has an anti-inflammatory and anti^m^ action, arrests progression and reduces the activity of the disease process, and has a good efficacy and safety profile.
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Abdulahad DA, Westra J, Reefman E, Zuidersma E, Bijzet J, Limburg PC, Kallenberg CGM, Bijl M. High mobility group box1 (HMGB1) in relation to cutaneous inflammation in systemic lupus erythematosus (SLE). Lupus 2013; 22:597-606. [DOI: 10.1177/0961203313483377] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Summary Photosensitivity is characteristic of systemic lupus erythematosus (SLE). Upon ultraviolet B (UVB) exposure, patients develop inflammatory skin lesions in the vicinity of sunburn cells (SBCs). High mobility group box 1 (HMGB1) is released from apoptotic and activated cells and exerts inflammatory actions through ligation to its receptors. Methods Eleven SLE patients and 10 healthy controls (HCs) were exposed to UVB. Skin biopsies were taken before and at one, three and 10 days after irradiation. Sections were stained for SBC, HMGB1, CD3, CD68, interferon-induced protein MxA and cleaved caspase 3. In vitro experiments with UVB-irradiated keratinocytes were also performed. Higher numbers of cells that had released HMGB1 were seen in the skin of SLE patients compared to HCs before and after irradiation. HMGB1-negative nuclei correlated with the presence of SBCs, and with the number of cleaved caspase 3 positive cells in lupus skin. Results HMGB1 release is increased in the skin of SLE patients compared to HCs. Upon UVB exposure, HMGB1 release further increases in SLE patients and is related to the number of apoptotic cells. Our data suggest that HMGB1, probably released from apoptotic keratinocytes, contributes to the development of inflammatory lesions in the skin of SLE patients upon UVB exposure.
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Affiliation(s)
- DA Abdulahad
- Department of Rheumatology and Clinical Immunology, University Medical Center, University of Groningen, The Netherlands
| | - J Westra
- Department of Rheumatology and Clinical Immunology, University Medical Center, University of Groningen, The Netherlands
| | - E Reefman
- Department of Metabolic Health Research, TNO, The Netherlands
| | - E Zuidersma
- Department of Rheumatology and Clinical Immunology, University Medical Center, University of Groningen, The Netherlands
| | - J Bijzet
- Pathology and Laboratory Medicine, University Medical Center Groningen, University of Groningen, The Netherlands
| | - PC Limburg
- Pathology and Laboratory Medicine, University Medical Center Groningen, University of Groningen, The Netherlands
| | - CGM Kallenberg
- Department of Rheumatology and Clinical Immunology, University Medical Center, University of Groningen, The Netherlands
| | - M Bijl
- Department of Internal Medicine and Rheumatology, Martini Hospital, The Netherlands
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Abstract
BACKGROUND Phototherapy is one of the most efficacious treatment options for psoriasis. New, emerging studies are beginning to define the biologic mechanisms by which phototherapy improves psoriasis. METHODS To provide an overview of the mechanisms thought to be responsible for the therapeutic effects of phototherapy, a review was performed on all relevant published studies in the Medline database from January 1, 1985, to August 15, 2011. FINDINGS Four categories of action were proposed in the literature to describe the effects of phototherapy in psoriasis: (1) alteration of the cytokine profile, (2) induction of apoptosis, (3) promotion of immunosuppression, and (4) all other mechanisms. CONCLUSIONS Phototherapy acts through a combination of pathways to confer therapeutic benefits in psoriasis, and these different modalities may help explain its particular usefulness in treating this cutaneous disease.
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Affiliation(s)
- Tami Wong
- Department of Dermatology, University of California, San Francisco, CA, USA
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The pattern and time course of somatosensory changes in the human UVB sunburn model reveal the presence of peripheral and central sensitization. Pain 2013; 154:586-597. [DOI: 10.1016/j.pain.2012.12.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 11/14/2012] [Accepted: 12/20/2012] [Indexed: 12/21/2022]
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Zerbinati N, Portale S, Palmieri B, Rottigni V, Iannitti T. A preliminary study to assess the efficacy of a new UVA1 laser for treatment of psoriasis. Photomed Laser Surg 2012; 30:610-4. [PMID: 22889255 DOI: 10.1089/pho.2012.3281] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The aim of the present study was to assess the effectiveness of an UVA1 355 nm laser (Alba 355) for treatment of mild, moderate, and severe psoriasis. BACKGROUND DATA Psoriasis is an immune-inflammatory and proliferative skin disease. During the past few years, the instrumental treatment by UV radiation has been successfully described, either alone or in combination with topical and/or systemic drug administration to treat several skin-related diseases. MATERIALS AND METHODS Fourteen patients, aged between 25 and 50 years (37.7±2.3 [mean±SEM]), affected by mild-to-severe psoriatic plaques, were included in this study. Patients were treated with a new instrument, laser Alba 355, which administers energy in the UVA1 spectrum. This instrument is based on a 1064 wavelength neodymium-doped yttrium orthovanadate (Nd:YVO4) laser optically pumped using a 808 nm infrared beam able to achieve a third harmonic 355 nm wave delivery. The fluences administered were 80-140 J/cm2 four times a week for a total of up to 12 sessions over selected psoriatic plaques in different areas of the patients' bodies. The patients rated their satisfaction with the outcome of the procedure as 1 not satisfied, 2 quite satisfied, 3 very satisfied. RESULTS Overall, laser treatment of psoriatic plaques produced a significant improvement in Psoriasis Area and Severity Index (PASI) score (F [3, 55]=57.86; p<0.001). The mean PASI score decreased from a baseline value of 24.5±2.9 to a value of 15.6±1.9 at 1 week (p<0.001), 9.1±1.2 at 2 weeks (p<0.001), and 5.8±1.2 at 3 weeks (p<0.001). All the patients were very satisfied with the outcome of procedure. No side effects were observed in this study. CONCLUSIONS The present study outlines an original approach based on UVA1 355 nm laser therapy for treatment of mild, moderate, and severe psoriasis. In the present study, the high success rate was coupled with safety. Larger clinical trials are needed to definitely support the role of this medical device not only for treatment of psoriasis, but also for other skin-related diseases that share a similar pathophysiology. We speculate that in the near future, the use of this laser will grow in the dermatology clinic.
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Affiliation(s)
- Nicola Zerbinati
- Department of Surgical and Morphological Sciences, Faculty of Medicine and Surgery, University of Insubria, Varese, Italy
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Attwa E, Gamil H, Assaf M, Ghonemy S. Over-expression of tumor necrosis factor-α in vitiligo lesions after narrow-band UVB therapy: an immunohistochemical study. Arch Dermatol Res 2012; 304:823-30. [PMID: 22832941 DOI: 10.1007/s00403-012-1269-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 07/01/2012] [Accepted: 07/16/2012] [Indexed: 01/15/2023]
Abstract
There is a growing evidence that cytokines are important in the depigmentation process of vitiligo, however, the exact mechanism is not fully understood. The aim of this work was to study the possible role of the tumor necrosis factor-α (TNF-α) cytokine in the depigmentation process of the disease. Twenty patients with generalized vitiligo were exposed to narrow-band ultraviolet B (NB-UVB) therapy thrice weekly for a total of 60 sessions. Immunohistochemical examination was done, to assess the TNF-α expression in lesional and perilesional skin as compared to normal control skin, before and after therapy. At baseline, positive lesional TNF-α expression was detected in 60 % of patients which was significantly higher as compared to perilesional skin (20 %) and negative expression in healthy control skin. Post-treatment, a statistically significant increase in TNF-α expression was detected in both lesional (90 %) and perilesional skin (70 %) as compared to baseline (P < 0.05). The significant increase of TNF-α in vitiligo lesions compared with perilesional and healthy skin suggests a possible involvement of this cytokine in the depigmentation of vitiligo. The increase in TNF-α expression after NB-UVB phototherapy suggests another role in repigmentation.
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Affiliation(s)
- Enayat Attwa
- Departments of Dermatology, Venereology and Pathology, Zagazig University, Zagazig, Egypt.
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Tian YS, Kim NH, Lee AY. Antiphotoaging effects of light-emitting diode irradiation on narrow-band ultraviolet B-exposed cultured human skin cells. Dermatol Surg 2012; 38:1695-703. [PMID: 22804869 DOI: 10.1111/j.1524-4725.2012.02501.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Antiaging effects of light-emitting diodes (LEDs) have been clinically demonstrated using one or two wavelengths. The mechanism is unclear. OBJECTIVE To examine direct and indirect photobiomodulation effects of LEDs on narrow-band ultraviolet B (NB-UVB)-induced photoaging using seven different wavelengths alone or in combination. MATERIALS AND METHODS Four LED wavelengths were chosen based on type I collagen and metalloproteinase (MMP)-1 expression. NB-UVB-irradiated fibroblasts or keratinocytes were irradiated using these four wavelengths. The expression of collagen and MMP-1 in fibroblasts with or without conditioned medium from LED-irradiated keratinocytes and the expression of proinflammatory cytokines in the LED-irradiated keratinocytes were examined. RESULTS Irradiation with four wavelengths (630, 660, 830, and 850 nm) significantly increased the number of viable fibroblasts. These four wavelengths also increased type I collagen expression, particularly four combinations (630/830, 660/850, 630/850, and 660/830 nm). The fibroblasts cultured with the keratinocyte conditioned medium, particularly with a combination of 630/850 or 660/830 nm, increased collagen levels. Low tumor necrosis factor alpha (TNF-α) and high transforming growth factor beta 1 (TGF-β1) expression was detected in the LED-irradiated keratinocytes. CONCLUSION The combination of 630/850- or 660/830-nm irradiation led to better direct and indirect antiphotoaging outcomes than single LED wavelengths in NB-UVB-irradiated cultured normal human skin cells.
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Affiliation(s)
- Yu Shun Tian
- Department of Dermatology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, South Korea
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El-Zawahry BM, Bassiouny DA, Sobhi RM, Abdel-Aziz E, Zaki NS, Habib DF, Shahin DM. A comparative study on efficacy of UVA1 vs. narrow-band UVB phototherapy in the treatment of vitiligo. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2012; 28:84-90. [PMID: 22409711 DOI: 10.1111/j.1600-0781.2011.00643.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND/PURPOSE Narrow-band ultraviolet B (NB-UVB) is considered the most effective and safe initial treatment for moderate-to-severe vitiligo but phototoxicity and possible carcinogenicity are the reported side effects. Ultraviolet A1 (UVA1) phototherapy has overlapping biological effects to NB-UVB and is relatively free of side effects associated with other phototherapy regimens. METHODS Forty patients with vitiligo were included in this prospective, randomized controlled comparative clinical trial. Twenty patients received NB-UVB and 20 received UVA1 three times weekly for 12 weeks. The UVA1 group was divided into two subgroups. Ten patients received moderate and 10 received low dose of UVA1. Serum samples were collected before and after 36 sessions to assess soluble interleukin 2 receptor level. Patients were clinically evaluated before therapy then monthly according to Vitiligo Area Scoring Index (VASI) and Vitiligo European Task Force (VETF) scores. In addition, extent of response was determined by a blinded dermatologist comparing before and after therapy photographs. Pattern of response and side effects were recorded. RESULTS NB-UVB was superior to UVA1 with a significant difference in blinded dermatological assessment (P<0.001), percentage change in VASI score (P<0.001) and percentage change in VETF area score (P=0.001). No significant difference in side effects was observed between both groups. Comparing UVA1 subgroups, better response in moderate-dose group was found as regard to percentage change in VASI (P<0.001) and percentage change in VETF area score (P=0.001), while no significant difference was found in blinded dermatological assessment (P=0.121). CONCLUSION NB-UVB phototherapy remains to be an effective and safe therapeutic option in vitiligo. Response to UVA1 in vitiligo seems to be dose dependent and seems to be of limited value in treatment of vitiligo as a monotherapy. Further studies combining it with other lines of therapy such as systemic steroids may prove beneficial.
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Walker D, Jacobe H. Phototherapy in the Age of Biologics. ACTA ACUST UNITED AC 2011; 30:190-8. [DOI: 10.1016/j.sder.2011.08.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 08/07/2011] [Indexed: 11/29/2022]
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Gatson NT, Travers JB, Al-Hassani M, Warren SJP, Hyatt AM, Travers JB. Progression of toxic epidermal necrolysis after tanning bed exposure. ACTA ACUST UNITED AC 2011; 147:719-23. [PMID: 21339416 DOI: 10.1001/archdermatol.2011.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND In addition to recreational tanning bed use, UV radiation exposures are sometimes sought to self-treat skin conditions. The ability of tanning bed radiation exposure to trigger toxic epidermal necrolysis has not been reported. OBSERVATIONS A young woman attempted to treat a self-limiting drug hypersensitivity reaction via tanning bed radiation exposure, which resulted in a systemic toxic epidermal necrolysis-like reaction. Studies with cultured keratinocytes and an epithelial cell line reveal that UV-A radiation can synergize with other stimuli such as phorbol esters or interleukin 1 to produce large amounts of tumor necrosis factor, providing a potential mechanism for this exaggerated reaction. CONCLUSION In addition to inducing photodamage and skin cancer, tanning bed radiation exposure can trigger a toxic epidermal necrolysis-like reaction, possibly via the exaggerated production of keratinocyte cytokines such as tumor necrosis factor.
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Affiliation(s)
- Na Tosha Gatson
- Department of Dermatology, Indiana University School of Medicine, 550 N University Blvd, Indianapolis, IN 46202, USA
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Abstract
Ultraviolet radiation (UVR) phototherapy has been associated with both deleterious and beneficial effects to patients with both localized and systemic skin disorders. Phototherapy is advantageous in diseases of the epidermis and dermis, as it provides the most direct approach minimizing systemic side effects. Most recently, ultraviolet A1 (UVA1) phototherapy has emerged as a specific UVR phototherapeutic mechanism. It has shown to be therapeutic in a number of sclerosing skin conditions and other dermatitides, in many cases proving to be more effective than other phototherapy modalities. Treatment advantages of UVA1 phototherapy include the ability to penetrate into the deep layers of the skin to affect changes on disease-causing T cells, as well as activation of endothelial cells to promote neovascularization. UVA1 therapy also has been shown to be relatively free of side effects associated with other phototherapy regimens, including erythema and cellular transformation. These properties make UVA1 phototherapy an important treatment option for many debilitating skin conditions.
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Affiliation(s)
- Nathan R York
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas, TX 75390-9069, USA
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Matthews YJ, Halliday GM, Phan TA, Damian DL. Wavelength dependency for UVA-induced suppression of recall immunity in humans. J Dermatol Sci 2010; 59:192-7. [DOI: 10.1016/j.jdermsci.2010.07.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Revised: 03/18/2010] [Accepted: 07/12/2010] [Indexed: 11/29/2022]
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An L, Dong GQ, Gao Q, Zhang Y, Hu LW, Li JH, Liu Y. Effects of UVA on TNF-alpha, IL-1beta, and IL-10 expression levels in human keratinocytes and intervention studies with an antioxidant and a JNK inhibitor. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2010; 26:28-35. [PMID: 20070836 DOI: 10.1111/j.1600-0781.2009.00481.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To understand the expressions and transduction pathways of cytokines in ultraviolet (UV)A-irradiated keratinocytes. METHODS We cultured human keratinocytes of the HaCaT cell line and investigated both mRNA and protein expressions of cytokines in cells that were not irradiated or were exposed to 2.4 J/cm(2) UVA, with or without an antioxidant (beta-carotene) or a c-Jun N-terminal kinase (JNK) inhibitor (SP600125). RESULTS We demonstrated that the expression levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta were up-regulated in irradiated cells. IL-10 was not detected in non-irradiated cells, but was observed in irradiated cells. JNK was activated in irradiated cells and this could be antagonized by beta-carotene. The UVA-induced up-regulation of these cytokines was also antagonized by beta-carotene. SP600125 inhibited the UVA-induced increase in the expression of TNF-alpha mRNA and protein and in the expression of IL-1beta mRNA. CONCLUSIONS The results suggest that oxidative stress may be an early intermediate effect in JNK-dependent UVA induction of cytokine expression in human keratinocytes in vitro.
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Affiliation(s)
- Li An
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, China
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Wolverton JE, Al-Hassani M, Yao Y, Zhang Q, Travers JB. Epidermal platelet-activating factor receptor activation and ultraviolet B radiation result in synergistic tumor necrosis factor-alpha production. Photochem Photobiol 2009; 86:231-5. [PMID: 19769579 DOI: 10.1111/j.1751-1097.2009.00618.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Ultraviolet B radiation (UVB) is a potent stimulator of epidermal cytokine production which has been implicated in photoaggravated dermatoses. In addition to cytokines such as tumor necrosis factor-alpha (TNF-alpha), UVB generates bioactive lipids including platelet-activating factor (PAF). Our previous studies have demonstrated that UVB-mediated production of keratinocyte TNF-alpha is in part due to PAF. The current studies use a human PAF-receptor (PAF-R) negative epithelial cell line transduced with PAF-Rs and PAF-R-deficient mice to demonstrate that activation of the epidermal PAF-R along with UVB irradiation results in a synergistic production of TNF-alpha. It should be noted that PAF-R effects are mimicked by the protein kinase C (PKC) agonist phorbol myristic acetate, and are inhibited by pharmacological antagonists of the PKC gamma isoenzyme. These studies suggest that concomitant PAF-R activation and UVB irradiation results in a synergistic production of the cytokine TNF-alpha which is mediated in part via PKC. These studies provide a novel potential mechanism for photosensitivity responses.
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Affiliation(s)
- Jay E Wolverton
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA
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Muthusamy V, Piva TJ. The UV response of the skin: a review of the MAPK, NFkappaB and TNFalpha signal transduction pathways. Arch Dermatol Res 2009; 302:5-17. [PMID: 19756672 DOI: 10.1007/s00403-009-0994-y] [Citation(s) in RCA: 192] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 08/19/2009] [Accepted: 08/21/2009] [Indexed: 10/20/2022]
Abstract
The sun emits different types of ultraviolet (UV) light. Our skin is a natural target of UV radiation which is involved in vitamin D3 production in our body. UV radiation at high doses is an environmental carcinogen which can elicit skin damage as well as inducing skin cancer. It can mediate inflammatory and immunological reactions through activation of receptors, DNA/RNA damage and production of reactive oxygen species. It is also involved in the release of pro-inflammatory cytokines, of which TNFalpha has been implicated in tumorigenic activities. In order to mediate its effects, UV radiation is known to activate multiple signalling cascades such as the p38 MAPK, Jun N-terminal kinase, extracellular signal-regulated kinase 1/2 and NFkappaB pathways in skin cells. The role each of these pathways plays in mediating the release of cytokines such as TNFalpha remains to be fully characterized. Once the function of these pathways is known, this information may provide for the formulation of therapy which will prevent the release of immunosuppressive cytokines resulting in a reduction in skin cancer formation.
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Affiliation(s)
- Visalini Muthusamy
- School of Medical Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083, Australia.
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Janssens AS, Pavel S, Tensen CP, Teunissen MBM, Out-Luiting JJ, Willemze R, de Gruijl FR. Reduced IL-1Ra/IL-1 ratio in ultraviolet B-exposed skin of patients with polymorphic light eruption. Exp Dermatol 2009; 18:212-7. [DOI: 10.1111/j.1600-0625.2008.00785.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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UVB and proinflammatory cytokines synergistically activate TNF-alpha production in keratinocytes through enhanced gene transcription. J Invest Dermatol 2008; 129:994-1001. [PMID: 19005488 DOI: 10.1038/jid.2008.332] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
UVB irradiation potently induces cytokines in the skin, including IL-1alpha and tumor necrosis factor-alpha (TNF-alpha). The mechanism for TNF-alpha induction in UVB-irradiated keratinocytes is not clear. In this study, we explored the effects of UVB and cytokines, alone or in combination in human keratinocytes. Keratinocytes were sham- or UVB-irradiated with 30 mJ cm(-2), and then incubated in the absence or presence of IFN-alpha2b, TNF-alpha, or IL-1alpha. UVB and IL-1alpha treatment synergistically enhanced TNF-alpha secretion and mRNA levels in human keratinocytes, similar to the findings reported previously in human fibroblasts. Exogenous recombinant TNF-alpha up-regulates its own mRNA level. However, addition of IFN-alpha2b did not show any additive effect on TNF-alpha mRNA induction. To understand the regulation of TNF-alpha mRNA by UVB, with or without IL-1alpha, we examined the transcription rate and half-life of TNF-alpha mRNA. Treatment of keratinocytes with IL-1alpha or UVB alone increased TNF-alpha gene transcription 4- to 5-fold over sham treatment, and TNF-alpha gene transcription increased 11-fold in cells treated with UVB plus IL-1alpha over sham. UVB with IL-1alpha did not enhance the half-life of TNF-alpha mRNA over that seen with UVB alone. In conclusion, TNF-alpha expression in primary keratinocytes is upregulated transcriptionally by UVB and IL-1alpha.
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Cafardi JA, Elmets CA. T4 endonuclease V: review and application to dermatology. Expert Opin Biol Ther 2008; 8:829-38. [PMID: 18476794 DOI: 10.1517/14712598.8.6.829] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND T4 endonuclease V was originally isolated from Escherichia coli infected with T4 bacteriophage. It has been shown to repair ultraviolet (UV)-induced cyclobutane pyrimidine dimers in DNA, which, when unrepaired, contribute to mutations that result in actinic keratoses and non-melanoma skin cancers (NMSC). This is a particular concern in patients with genetic defects in their DNA repair systems, especially those with xeroderma pigmentosum (XP). When packaged in liposomes and applied topically, T4 endonuclease V can traverse the stratum corneum and become incorporated within the cytoplasm and nucleus of epidermal keratinocytes and Langerhans cells. OBJECTIVE To review all major studies evaluating the efficacy of T4 endonuclease V in animals and humans, the toxicity and safety profile of the topical medication and its potential clinical uses. METHODS A literature search was performed through PubMed/Medline, using the keywords 'T4N5', 'T4 endonuclease V' and 'dimericine'. Papers found in the bibliographies of those identified in the initial search and deemed relevant were also included. CONCLUSION This enzyme increases the repair of UV-damaged DNA and produces other beneficial effects on UV-damaged cells. In clinical trials in XP patients, topical application of liposome-encapsulated T4 endonuclease V reduced the incidence of basal cell carcinomas by 30% and of actinic keratoses by > 68%. Adverse effects were minimal, and there was no evidence of allergic or irritant contact dermatitis. Although the photoprotective effect of T4N5 has been investigated only in XP patients, the possibility exists that it may benefit others likely to develop premalignant keratoses and NMSC, such as organ transplant recipients receiving immunosuppressive therapy and individuals who have had numerous psoralen plus UVA photochemotherapy treatments. It may be also be effective for normal individuals.
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Narbutt J, Lesiak A, Sysa-Jedrzejowska A, Wozniacka A, Cierniewska-Cieslak A, Boncela J, Jochymski C, Kozlowski W, Zalewska A, Skibinska M, Norval M. Repeated low-dose ultraviolet (UV) B exposures of humans induce limited photoprotection against the immune effects of erythemal UVB radiation. Br J Dermatol 2007; 156:539-47. [PMID: 17300245 DOI: 10.1111/j.1365-2133.2006.07670.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Exposure of human subjects to ultraviolet (UV) B radiation causes immunosuppression. Most experiments to date have not tested the effects of low daily doses of UVB radiation. OBJECTIVES To ascertain whether photoprotection against several UV-induced immune effects might develop following repeated exposure. METHODS Groups of approximately 30 healthy individuals were given whole-body UVB irradiation on each of 10 consecutive days with 0.7 minimal erythema dose, or whole-body irradiation as before followed by a single erythemal UVB dose on a small body area, or irradiated only with a single erythemal UVB dose on a small body area, or were not irradiated. They were sensitized with diphenylcyclopropenone (DPCP) 24 h after the final dose, and skin biopsies collected to assess cytokine mRNA expression and the number of cells with thymine dimers and expression cyclooxygenase (COX)-1 and COX-2. RESULTS The contact hypersensitivity (CHS) response to DPCP was significantly lower in the three irradiated groups compared with the unirradiated controls, while cutaneous interleukin (IL)-1beta, IL-6, IL-10 and tumour necrosis factor-alpha mRNAs, COX-1 and COX-2 and thymine dimers were all significantly higher. When the single erythemal UVB dose was given following the repeated low exposures, a slight downregulation in cytokine expression and thymine dimer formation was indicated. CONCLUSIONS The repeated low doses of UVB protected to a limited extent against the effects of an erythemal UVB dose on cytokine expression and thymine dimer formation, but not on CHS or COX enzymes.
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Affiliation(s)
- J Narbutt
- Department of Dermatology, Medical University of Lodz, Krzemieniecka 5, 94-017 Lodz, Poland.
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Stoebner PE, Poosti R, Djoukelfit K, Martinez J, Meunier L. Decreased human epidermal antigen-presenting cell activity after ultraviolet A exposure: dose–response effects and protection by sunscreens. Br J Dermatol 2007; 156:1315-20. [PMID: 17535231 DOI: 10.1111/j.1365-2133.2007.07895.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ultraviolet (UV) exposure of human skin causes immunosuppression that contributes to the growth of skin cancer. The contribution of UVA in these processes is still a matter of debate. OBJECTIVES The purpose of our study was first to find a dose-response effect of UVA exposure on human epidermal antigen-presenting cell (APC) activity and to evaluate the protective capacity of two sunscreen formulations against a high level of acute UVA exposure. We also tried to evaluate the protective capacity afforded by the same sunscreens against UVA-induced clinical changes such as redness and pigmentation. METHODS The functional assessment of the alloantigen-presenting capacity of epidermal cells prepared from skin keratotome samples 3 days after UVA exposure was measured with a mixed epidermal cell-lymphocyte reaction (MECLR) in each healthy volunteer (n = 16). Redness and pigmentation were assessed by chromametry 24 h after exposure to a single UVA dose. RESULTS In vivo UVA exposure to 15, 30 and 60 J cm(-2) resulted in a dose-dependent decrease in purified allogeneic T cell (CD4+ T cells) proliferation induced by UVA-irradiated epidermal cells. The epidermal APC function was significantly decreased with a suberythemal exposure corresponding to 15 J cm(-2). The decrease, partial and not statistically different between 30 and 60 J cm(-2), exhibits a plateau-response effect. There was no correlation between the decrease of the epidermal APC function and the intensity of erythema and persistent pigment darkening. Both sunscreen formulations strongly inhibited the UVA-induced reduction of MECLR at 90 J cm(-2). CONCLUSION Our results clearly demonstrate that UVA impairs the APC activity of the epidermal cells and thus may contribute to UV-induced immunosuppression in humans. They also indicate that erythema and immunosuppression have different dose-response curves in the UVA range. The two sunscreen formulations afforded a significant protection against the decrease in epidermal APC activity induced by exposure to a high UVA dose (90 J cm(-2)).
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Affiliation(s)
- P E Stoebner
- Service de Dermatologie, CHU Caremeau, Place du Pr. Debre, 30029 Nîmes cedex 09, France
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Garssen J, De Gruijl F, Mol D, De Klerk A, Roholl P, Van Loveren H. UVA Exposure Affects UVB and cis-Urocanic Acid-Induced Systemic Suppression of Immune Responses in Listeria monocytogenes-infected Balb/c Mice¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2001)0730432ueauac2.0.co2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Comte C, Picot E, Peyron JL, Dereure O, Guillot B. Les UVA-1 : propriétés et indications thérapeutiques. Ann Dermatol Venereol 2007; 134:407-15. [PMID: 17483769 DOI: 10.1016/s0151-9638(07)89204-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- C Comte
- Université Montpellier II, Service de Dermatologie, CHU Saint Eloi, Montpellier.
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Steerenberg PA, Daamen F, Weesendorp E, Van Loveren H. No adaptation to UV-induced immunosuppression and DNA damage following exposure of mice to chronic UV-exposure. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2006; 84:28-37. [PMID: 16504533 DOI: 10.1016/j.jphotobiol.2006.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2005] [Revised: 01/18/2006] [Accepted: 01/18/2006] [Indexed: 12/24/2022]
Abstract
It is well known that ultraviolet (UV) radiation induces erythema, immunosuppression and carcinogenesis. We hypothesized that chronic exposure to solar UV radiation induces adaptation that eventually prevents the suppression of acquired immunity. We studied adaptation for UV-induced immunosuppression after chronic exposure of mice to a suberythemal dose of solar simulated radiation (SSR) with Cleo Natural lamps, and subsequent exposure to an immunosuppressive dose of solar or UVB radiation (TL12). After UV dosing, the mice were sensitized and challenged with either diphenylcyclopropenone (DPCP) or picryl chloride (PCl). To assess the adaptation induced by solar simulated radiation, we measured the proliferative response and cytokine production of skin-draining lymph node cells after immunization to DPCP, the contact hypersensitivity (CHS) response to PCl, and thymine-thymine (T-T) cyclobutane dimers in the skin of mice. After induction of immunosuppression by SSR or by TL12 lamps, the proliferative response of draining lymph node cells after challenge with DPCP, or the CHS after challenge with PCl, showed significant suppression of the immune response. Chronic irradiation from SSR preceding the immunosuppressive dose of UV failed to restore the suppressed immune response. Reduced lipopolysaccharide-triggered cytokine production (of IL-12p40, IFN-gamma, IL-6 and TNF-alpha) by draining lymph node cells of mice sensitized and challenged with DPCP indicated that no adaptation is induced. In addition, the mice were not protected from T-T dimer DNA damage after chronic solar irradiation. Our studies reveal no evidence that chronic exposure to low doses of SSR induces adaptation to UV-induced suppression of acquired immunity.
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Affiliation(s)
- Peter A Steerenberg
- Laboratory for Toxicology, Pathology and Genetics, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
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Szegedi A, Simics E, Aleksza M, Horkay I, Gaál K, Sipka S, Hunyadi J, Kiss E. Ultraviolet-A1 phototherapy modulates Th1/Th2 and Tc1/Tc2 balance in patients with systemic lupus erythematosus. Rheumatology (Oxford) 2005; 44:925-31. [PMID: 15827034 DOI: 10.1093/rheumatology/keh643] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Ultraviolet-A1 (UVA1) phototherapy is effective for a variety of dermatological diseases. We examined the effectiveness and reliability of low-dose UVA1 phototherapy (60 kJ/m2/treatment) in patients suffering from systemic lupus erythematosus (SLE). We studied the changes in immunological parameters. METHODS The patients received a 9-week course of phototherapy according to the following regimen: five times a week during the first 3 weeks, three times a week during the second 3 weeks and twice during the last 3 weeks. Among other things, we analysed the proportions of T helper 1 (Th1), Th2, T cytotoxic (Tc1) and Tc2 cell populations in the peripheral blood of patients by flow cytometric detection of intracytoplasmic interferon gamma (IFN-gamma) and interleukin 4 (IL-4). RESULTS Our study showed the improvement of clinical symptoms determined by the subjective clinical disease activity scoring and the SLE Disease Activity Index (SLEDAI). By the end of UVA1 phototherapy, the mean value of SLEDAI had decreased from 7.2+/-5.6 to 0.9+/-1.8, which was significant (P = 0.005). Immunological investigations detected a decrease in the frequency of IFN-gamma-producing Th1 and Tc1 cells and a decrease in the Th1/Th2 and Tc1/Tc2 ratios after UVA1 therapy. CONCLUSION According to the literature, IFN-gamma has a pathogenic role in the development of SLE. We observed a decreased proportion of IFN-gamma-secreting cells, which we think is presumably one of the beneficial effects of UVA1 therapy. On the basis of our study, UVA1 phototherapy does seem to be an effective adjuvant in the treatment of SLE patients.
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Affiliation(s)
- A Szegedi
- Department of Dermatology, Medical and Health Science Centre, University of Debrecen, 98 Nagyerdei Street, Debrecen H-4012, Hungary.
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Hofmann-Wellenhof R, Smolle J, Roschger A, Strunk D, Hubmer M, Hoffmann C, Quehenberger F, Horn M, Kerl H, Wolf P. Sunburn Cell Formation, Dendritic Cell Migration, and Immunomodulatory Factor Production After Solar-Simulated Irradiation of Sunscreen-Treated Human Skin Explants In Vitro. J Invest Dermatol 2004; 123:781-7. [PMID: 15373785 DOI: 10.1111/j.0022-202x.2004.23322.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Using human skin explants, we investigated the effects of two different sunscreen preparations containing a chemical UVB filter alone [sun protection factor (SPF) 5.2] or UVA+UVB filter [SPF 6.2] on sunburn cell formation, dendritic cell (DC) migration, CD86- and CD1a-positive cell number, and tumor necrosis factor alpha (TNFalpha) and interleukin (IL)-1, IL-10, and IL-12 production in the skin after irradiation with different doses of solar-simulated UV radiation. Sunscreen- or placebo-treated skin explants were irradiated with solar-simulated UV radiation at 0.5, 1, and 2 minimal erythematous dose equivalents (MEDE) (as determined in an in vivo human study) multiplied by the SPF of the placebo or sunscreens. After irradiation, skin explants were floated on RMPI medium for 48 h. Cells that had emigrated and the skin explants were histologically analyzed, and the soluble mediators were measured in the supernatants by ELISA. Exposure to UV radiation led to concentration-dependent increases in sunburn cell formation and TNFalpha production but a concentration-dependent decrease in DC migration and CD86- and CD1a-positive cell number in the epidermis. Both chemical sunscreens protected against those alterations. The immunoprotective capacity of the sunscreens correlated with their SPF but was independent of the sunscreens' UVA protection capacity, suggesting that UVA is not a major factor for immunosuppression under the conditions used in the model. UV irradiation did not significantly affect the vitality of emigrated DC; the expression of HLA, CD80, and lag on emigrated cells; the number of CD1a-positive cells in the dermis; or the production of IL-1, IL-10, and IL-12. We conclude that our model may be useful in determining the immunoprotective capacity of sunscreens.
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