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Sánchez-Pérez JF, Comendador-Jiménez B, Castro E, Cánovas M, Conesa M. Characterization of the effects of vitamin D synthesis and sunburn in the population due to solar radiation exposure using PROBIT methodology. Heliyon 2024; 10:e30864. [PMID: 38784536 PMCID: PMC11112326 DOI: 10.1016/j.heliyon.2024.e30864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
The main objective of this work is to present a set of equations that relates exposure time to solar radiation, the ultraviolet index (UVI), and its effects, both positive (vitamin D synthesis) and negative (sunburns), including the influence of repeated doses and the incorporation of protective factors. To do so, expressions are proposed for both effects and a time range is specified where repeated doses can be applied. Moreover, we propose expressions (PROBIT equations) that relate the percentage of a population that would reach the recommended daily amount of vitamin D and the repeated dosage to which the population is exposed for skin types I to IV. For all the cases studied, protective factors, such as the use of clothes or sunscreens, were taken into account. Additionally, comparisons were made based on skin types between the generation of daily vitamin D and the onset of sunburn, being able to establish a percentage of those who would suffer from first-degree sunburns when this population reached the recommended daily amount of vitamin D. Thus, it can be noted that when a large percentage of a population wants to obtain the recommended daily allowance of vitamin D of 2000 IU or more, and by exposing a small portion of skin to solar radiation, a considerable percentage of that population would suffer from first-degree sunburn as vitamin D generation is related to the area of exposed skin. Therefore, by increasing the area of skin that is exposed to solar radiation, vitamin D needs can be safely met even with higher daily amounts.
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Affiliation(s)
| | - Begoña Comendador-Jiménez
- General Directorate of Pharmacy and Health Products. Conselleria de Sanidad Universal y Salud Pública. Comunitat Valenciana. Spain
| | - Enrique Castro
- Department of Applied Physics and Naval Technology, Universidad Politécnica de Cartagena, Spain
| | - Manuel Cánovas
- Department of Metallurgical and Mining Engineering, Universidad Católica del Norte, Chile
| | - Manuel Conesa
- Department of Applied Physics and Naval Technology, Universidad Politécnica de Cartagena, Spain
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2
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Lerche CM, Frederiksen NJS, Thorsteinsson IS, Køster B, Nybo L, Flouris AD, Heydenreich J, Philipsen PA, Hædersdal M, Wulf HC, Granborg JR. Urinary thymidine dimer excretion reflects personal ultraviolet radiation exposure levels. Photochem Photobiol Sci 2024; 23:919-930. [PMID: 38589652 DOI: 10.1007/s43630-024-00563-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/11/2024] [Indexed: 04/10/2024]
Abstract
Exposure to ultraviolet radiation (UVR) leads to skin DNA damage, specifically in the form of cyclobutane pyrimidine dimers, with thymidine dimers being the most common. Quantifying these dimers can indicate the extent of DNA damage resulting from UVR exposure. Here, a new liquid chromatography-mass spectrometry (LC-MS) method was used to quantify thymidine dimers in the urine after a temporary increase in real-life UVR exposure. Healthy Danish volunteers (n = 27) experienced increased UVR exposure during a winter vacation. Individual exposure, assessed via personally worn electronic UVR dosimeters, revealed a mean exposure level of 32.9 standard erythema doses (SEDs) during the last week of vacation. Morning urine thymidine dimer concentrations were markedly elevated both 1 and 2 days post-vacation, and individual thymidine dimer levels correlated with UVR exposure during the last week of the vacation. The strongest correlation with erythema-weighted personal UVR exposure (Power model, r2 = 0.64, p < 0.001) was observed when both morning urine samples were combined to measure 48-h thymidine dimer excretion, whereas 24-h excretion based on a single sample provided a weaker correlation (Power model, r2 = 0.55, p < 0.001). Sex, age, and skin phototype had no significant effect on these correlations. For the first time, urinary thymidine dimer excretion was quantified by LC-MS to evaluate the effect of a temporary increase in personal UVR exposure in a real-life setting. The high sensitivity to elevated UVR exposure and correlation between urinary excretion and measured SED suggest that this approach may be used to quantify DNA damage and repair and to evaluate photoprevention strategies.
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Affiliation(s)
- Catharina Margrethe Lerche
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400, Copenhagen, Denmark.
- Department of Pharmacy, University of Copenhagen, 2100, Copenhagen, Denmark.
| | | | | | - Brian Køster
- Department of Prevention and Information, Danish Cancer Society, 2100, Copenhagen, Denmark
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 2200, Copenhagen, Denmark
| | - Andreas D Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Karies, 42100, Trikala, Greece
| | - Jakob Heydenreich
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400, Copenhagen, Denmark
| | - Peter Alshede Philipsen
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400, Copenhagen, Denmark
| | - Merete Hædersdal
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400, Copenhagen, Denmark
| | - Hans Christian Wulf
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400, Copenhagen, Denmark
| | - Jonatan Riber Granborg
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400, Copenhagen, Denmark
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Chu C, Chan YM, Tang J. Clinical Outcomes in Patients With Benign Paroxysmal Positional Vertigo and Vitamin D Deficiency: A Singaporean Perspective. Cureus 2024; 16:e60325. [PMID: 38883121 PMCID: PMC11177327 DOI: 10.7759/cureus.60325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 06/18/2024] Open
Abstract
INTRODUCTION Benign paroxysmal positional vertigo (BPPV) is the primary vestibular disorder causing peripheral vertigo. Given the role of vitamin D in maintaining otoconia homeostasis, its deficiency may elevate the risk of BPPV. Our study seeks to evaluate the correlation between vitamin D deficiency and clinical outcomes of patients with BPPV in the local Asian population. METHODOLOGY We performed a retrospective analysis of 149 consecutive adult patients referred to a tertiary center's Otolaryngology dizziness clinic between 2018 and 2021. All of these patients had both BPPV and vitamin D deficiency. RESULTS The mean serum vitamin D level was 19.4 ± 5.5 ng/mol. Approximately 51.7% (77/149) of patients experienced recurrent episodes of BPPV. Univariate Chi-square analyses demonstrated vitamin D levels (P < 0.001) and history of migraine (P = 0.04) were related to BPPV recurrence. On multivariate analyses, patients with higher serum vitamin D levels were 16.7% less likely to develop recurrent BPPV (odds ratio [OR] 0.83, 95% confidence interval [CI] 0.76-0.90, P < 0.001). However, migraine history was not significantly related to BPPV recurrence (OR 0.38, 95% CI 0.14-1.00, P = 0.050). There was no statistically significant difference in the duration of BPPV episodes based on vitamin D levels (P = 0.327). CONCLUSIONS Patients with vitamin D deficiency are at higher risk of recurrent BPPV. Future research directions that would be beneficial include conducting a randomized controlled trial to evaluate both the effectiveness of vitamin D supplementation and its optimal dosage.
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Affiliation(s)
- Clarisse Chu
- Otolaryngology, Singapore General Hospital, Singapore, SGP
| | - Yew Meng Chan
- Otolaryngology, Singapore General Hospital, Singapore, SGP
| | - Joyce Tang
- Otolaryngology, Singapore General Hospital, Singapore, SGP
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Borecka O, Dutton JJ, Tang JCY, Fraser WD, Webb AR, Rhodes LE. Comparative Study of Healthy Older and Younger Adults Shows They Have the Same Skin Concentration of Vitamin D 3 Precursor, 7-Dehydrocholesterol, and Similar Response to UVR. Nutrients 2024; 16:1147. [PMID: 38674838 PMCID: PMC11053405 DOI: 10.3390/nu16081147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Vitamin D3 synthesis in human skin is initiated by solar ultraviolet radiation (UVR) exposure of precursor 7-dehydrocholesterol (7DHC), but influence of age on the early stage of vitamin D3 metabolism is uncertain. We performed a prospective standardised study in healthy ambulant adults aged ≥65 and ≤40 years examining (1) if baseline skin 7DHC concentration differs between younger and older adults and (2) the impact of older age on serum vitamin D3 response to solar simulated UVR. Eleven younger (18-40 years) and 10 older (65-89 years) adults, phototype I-III, received low-dose UVR (95% UVA, 5% UVB, 1.3 SED) to ~35% of the body surface area. Biopsies were taken for 7DHC assay from unexposed skin, skin immediately and 24 h post-UVR, and blood sampled at baseline, 24 h and 7 d post-UVR for vitamin D3 assay. Samples were analysed by HPLC-MS/MS. Baseline skin 7DHC (mean ± SD) was 0.22 ± 0.07 and 0.25 ± 0.08 µg/mg in younger versus older adults (no significant difference). Baseline serum vitamin D3 concentration was 1.5 ± 1.5 and 1.5 ± 1.7 nmol/L in younger versus older adults, respectively, and showed a significant increase in both groups post-UVR (no significant differences between age groups). Thus, skin 7DHC concentration was not a limiting factor for vitamin D3 production in older relative to younger adults. This information assists public health guidance on sun exposure/vitamin D nutrition, with particular relevance to the growing populations of healthy ambulant adults ≥65 years.
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Affiliation(s)
- Oktawia Borecka
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK; (O.B.); (A.R.W.)
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M13 9PL, UK
- Photobiology Unit, Dermatology Research Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Greater Manchester M6 8HD, UK
| | - John J. Dutton
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (J.J.D.); (W.D.F.)
| | - Jonathan C. Y. Tang
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (J.J.D.); (W.D.F.)
- Departments of Clinical Biochemistry and Endocrinology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - William D. Fraser
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (J.J.D.); (W.D.F.)
- Departments of Clinical Biochemistry and Endocrinology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Ann R. Webb
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK; (O.B.); (A.R.W.)
| | - Lesley E. Rhodes
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M13 9PL, UK
- Photobiology Unit, Dermatology Research Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Greater Manchester M6 8HD, UK
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Cooke MS, Hu CW, Chao MR, Chang YJ, Rhodes LE, Evans MD. Letter to the Editor regarding "DNA photoproducts released by repair in biological fluids as biomarkers of the genotoxicity of UV radiation". Anal Bioanal Chem 2023; 415:517-519. [PMID: 36376715 DOI: 10.1007/s00216-022-04417-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Marcus S Cooke
- Oxidative Stress Group, Department Cell Biology, Microbiology, and Molecular Biology, University of South Florida, 4202 East Fowler Avenue, 33620, Tampa, USA.
| | - Chiung-Wen Hu
- Department of Public Health, Chung Shan Medical University, Taichung, 402, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, 402, Taiwan
| | - Mu-Rong Chao
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung, 402, Taiwan
| | - Yuan-Jhe Chang
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung, 402, Taiwan
| | - Lesley E Rhodes
- NIHR Manchester Biomedical Research Centre, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, Manchester, UK
| | - Mark D Evans
- Leicester School of Allied Health Sciences, Faculty of Health & Life Sciences, De Montfort University, Leicester, LE1 9BH, UK
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Webb AR, Alghamdi R, Kift R, Rhodes LE. 100 YEARS OF VITAMIN D: Dose-response for change in 25-hydroxyvitamin D after UV exposure: outcome of a systematic review. Endocr Connect 2021; 10:R248-R266. [PMID: 34519278 PMCID: PMC8558903 DOI: 10.1530/ec-21-0308] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/13/2021] [Indexed: 12/14/2022]
Abstract
A systematic review of publications addressing change in vitamin D status (25-hydroxyvitamin D (25OHD)) after exposure to UV radiation identified 2001 independent peer-reviewed publications. Of these, 21 used artificial sources of UV radiation, met all inclusion criteria and were quality assured; 13 publications used solar radiation and met sufficient inclusion criteria to be retained as supporting evidence; 1 further included publication used both solar and artificial sources. The review consistently identified that low dose, sub-erythemal doses are more effective for vitamin D synthesis than doses close to a minimum erythema dose; increasing skin area exposed increases the amount of vitamin D synthesised although not necessarily in a linear manner; constant dosing leads to a dose-dependent plateau in 25OHD, and dose-response is greatest at the start of a dosing regime; there is a large interpersonal variation in response to UV exposure. Fourteen of the studies using artificial sources of radiation were used to determine a dose-response relationship for change in 25OHD on whole-body exposure to repeated sub-erythemal doses of UV radiation, taking the form Δ25OHD (nmol/L) = A ln(standard vitamin D dose) + B. This helps quantify our understanding of UV as a source of vitamin D and enables exposure regimes for safe synthesis of vitamin D to be assessed. Specific studies of people with pigmented skin (Fitzpatrick skin types 5 and 6) were rare, and this dose-response relationship is only applicable to white-skinned individuals as skin type is a determinant of response to UV radiation. Findings provide information for vitamin D guidance updates.
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Affiliation(s)
- Ann R Webb
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - Rehab Alghamdi
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Richard Kift
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - Lesley E Rhodes
- Centre for Dermatology Research, School of Biological Sciences, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester, UK
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7
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Yanine Z, Dicker Jiménez V, Ortegón Pulido LF, Rueda Rugeles AJ, Buitrago-Medina DA. Photoaging factors in patients from two healthcare centers in Colombia. J Cosmet Dermatol 2021; 21:2984-2994. [PMID: 34633744 DOI: 10.1111/jocd.14501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/05/2021] [Accepted: 09/16/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Exposure to solar radiation has been documented as a direct cause of skin changes associated with aging, and its effects have been categorized as photoaging. OBJECTIVE To explore the clinical characteristics of photoaging and its relationship with external predisposing factors in a Colombian urban and rural population. METHODS We included 350 patients on outpatient consultation at Clínica Chía in Zipaquirá (rural) and Hospital Universitario Barrios Unidos in Bogotá (urban) in an observational, cross-sectional study with an analytical component included, between 2018 and 2019. A survey was conducted and photographs were taken. A group of experts determined the degree of photoaging. RESULTS The majority of respondents worked in closed environments (n = 222). The main sociodemographic variable associated was age (p = 0.000). Factors such as smoking, alcohol consumption, use of sunscreen, exercising, and sun exposure were also associated with scale progression (p < 0.05). Exercising (odds ratio (OR) 0.6, 95% confidence interval (CI) 0.3-0.9) and being from Bogotá (OR 0.6, 95% CI 0.2-0.9) appeared as protective factors. Smoking (OR 1.6, 95% CI 1.0-2.6) was defined as a risk factor. CONCLUSIONS Changes related to photoaging and photocarcinogenesis are associated with sun exposure. However, there are environmental factors, such as smoking, alcohol consumption, sedentary lifestyle, woman's age at first delivery, and number of children, among others, that affect the degree of photoaging. It is necessary to explore these relationships in higher evidence level studies to define their causality.
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Affiliation(s)
- Zamira Yanine
- Universidad del Rosario - School of Medicine and Health Sciences, Bogotá, Colombia.,Hospital Universitario Mayor - Méderi, Bogotá, Colombia
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Young AR, Morgan KA, Harrison GI, Lawrence KP, Petersen B, Wulf HC, Philipsen PA. A revised action spectrum for vitamin D synthesis by suberythemal UV radiation exposure in humans in vivo. Proc Natl Acad Sci U S A 2021; 118:e2015867118. [PMID: 34580202 PMCID: PMC8501902 DOI: 10.1073/pnas.2015867118] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2021] [Indexed: 11/24/2022] Open
Abstract
Action spectra are important biological weighting functions for risk/benefit analyses of ultraviolet (UV) radiation (UVR) exposure. One important human benefit of exposure to terrestrial solar UVB radiation (∼295 to 315 nm) is the cutaneous synthesis of vitamin D3 that is initiated by the photoconversion of 7-dehydrocholesterol to previtamin D3 An action spectrum for this process that is followed by other nonphotochemical steps to achieve biologically active vitamin D3 has been established from ex vivo data and is widely used, although its validity has been questioned. We tested this action spectrum in vivo by full- or partial-body suberythemal irradiation of 75 healthy young volunteers with five different polychromatic UVR spectra on five serial occasions. Serum 25-hydroxyvitamin D3 [25(OH)D3] levels, as the most accurate measure of vitamin D3 status, were assessed before, during, and after the exposures. These were then used to generate linear dose-response curves that were different for each UVR spectrum. It was established that the previtamin D3 action spectrum was not valid when related to the serum 25(OH)D3 levels, as weighting the UVR doses with this action spectrum did not result in a common regression line unless it was adjusted by a blue shift, with 5 nm giving the best fit. Such a blue shift is in accord with the published in vitro action spectra for vitamin D3 synthesis. Thus, calculations regarding the risk (typically erythema) versus the benefit of exposure to solar UVR based on the ex vivo previtamin D3 action spectrum require revision.
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Affiliation(s)
- Antony R Young
- St. John's Institute of Dermatology, School of Basic and Biomedical Sciences, Faculty of Life Sciences and Medicine, King's College London, London SE1 9RT, United Kingdom;
| | - Kylie A Morgan
- St. John's Institute of Dermatology, School of Basic and Biomedical Sciences, Faculty of Life Sciences and Medicine, King's College London, London SE1 9RT, United Kingdom
| | - Graham I Harrison
- St. John's Institute of Dermatology, School of Basic and Biomedical Sciences, Faculty of Life Sciences and Medicine, King's College London, London SE1 9RT, United Kingdom
| | - Karl P Lawrence
- St. John's Institute of Dermatology, School of Basic and Biomedical Sciences, Faculty of Life Sciences and Medicine, King's College London, London SE1 9RT, United Kingdom
| | - Bibi Petersen
- Global Medical Affairs, LEO Pharma, 2750 Ballerup, Denmark
| | - Hans Christian Wulf
- Department of Dermatology D92, Copenhagen University Hospital - Bispebjerg, DK-2400 Copenhagen, Denmark
| | - Peter A Philipsen
- Department of Dermatology D92, Copenhagen University Hospital - Bispebjerg, DK-2400 Copenhagen, Denmark
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9
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Oktaria V, Danchin M, Triasih R, Soenarto Y, Bines JE, Ponsonby AL, Clarke MW, Graham SM. The incidence of acute respiratory infection in Indonesian infants and association with vitamin D deficiency. PLoS One 2021; 16:e0248722. [PMID: 33755666 PMCID: PMC7987198 DOI: 10.1371/journal.pone.0248722] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/03/2021] [Indexed: 02/02/2023] Open
Abstract
Background Vitamin D deficiency has been associated with acute respiratory infection (ARI) in early life, but this has not been evaluated in Indonesia. We aimed to determine the incidence of ARI in Indonesian infants, and to evaluate the association with vitamin D deficiency. Methods From 23 December 2015 to 31 December 2017, we conducted a community-based prospective cohort study in Yogyakarta province. We enrolled 422 pregnant women and followed their infants from birth until 12 months of age for ARI episodes. Vitamin D status was measured at birth and at age six months. We performed Cox proportional hazard regression analysis to evaluate the association between vitamin D deficiency and pneumonia incidence. Results At study completion, 95% (400/422) of infants retained with a total of 412 child years of observation (CYO). The incidence of all ARI and of WHO-defined pneumonia was 3.89 (95% CI 3.70–4.08) and 0.25 (95% CI 0.21–0.30) episodes per CYO respectively. Vitamin D deficiency at birth was common (90%, 308/344) and associated with more frequent episodes of ARI non-pneumonia (adjusted odds ratio 4.48, 95% CI:1.04–19.34). Vitamin D status at birth or six months was not associated with subsequent pneumonia incidence, but greater maternal sun exposure during pregnancy was associated with a trend to less frequent ARI and pneumonia in infants. Conclusion ARI, pneumonia, and vitamin D deficiency at birth were common in Indonesian infants. Minimising vitamin D deficiency at birth such as by supplementation of mothers or safe sun exposure during pregnancy has the potential to reduce ARI incidence in infants in this setting.
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Affiliation(s)
- Vicka Oktaria
- Department of Paediatrics, Murdoch Children’s Research Institute, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
- Child Health Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- * E-mail:
| | - Margaret Danchin
- Department of Paediatrics, Murdoch Children’s Research Institute, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
| | - Rina Triasih
- Child Health Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yati Soenarto
- Child Health Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Julie E. Bines
- Department of Paediatrics, Murdoch Children’s Research Institute, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
| | - Anne-Louise Ponsonby
- Department of Paediatrics, Murdoch Children’s Research Institute, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
| | - Michael W. Clarke
- Metabolomics Australia, Centre for Microscopy, Characterisation, and Analysis, and School of Biomedical Sciences, Faculty of Health, and Medical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Stephen M. Graham
- Department of Paediatrics, Murdoch Children’s Research Institute, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
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10
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Neville JJ, Palmieri T, Young AR. Physical Determinants of Vitamin D Photosynthesis: A Review. JBMR Plus 2021; 5:e10460. [PMID: 33553995 PMCID: PMC7839826 DOI: 10.1002/jbm4.10460] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022] Open
Abstract
Vitamin D synthesis by exposure of skin to solar ultraviolet radiation (UVR) provides the majority of this hormone that is essential for bone development and maintenance but may be important for many other health outcomes. This process, which is the only well-established benefit of solar UVR exposure, depends on many factors including genetics, age, health, and behavior. However, the most important factor is the quantity and quality of UVR reaching the skin. Vitamin D synthesis specifically requires ultraviolet B (UVB) radiation that is the minority component (<5%) of solar UVR. This waveband is also the most important for the adverse effects of solar exposure. The most obvious of which is sunburn (erythema), but UVB is also the main cause of DNA damage to the skin that is a prerequisite for most skin cancers. UVB at the Earth's surface depends on many physical and temporal factors such as latitude, altitude, season, and weather. Personal, cultural, and behavioral factors are also important. These include skin melanin, clothing, body surface area exposed, holiday habits, and sunscreen use. There is considerable disagreement in the literature about the role of some of these factors, possibly because some studies have been done by researchers with little understanding of photobiology. It can be argued that vitamin D supplementation obviates the need for solar exposure, but many studies have shown little benefit from this approach for a wide range of health outcomes. There is also increasing evidence that such exposure offers health benefits independently of vitamin D: the most important of which is blood-pressure reduction. In any case, public health advice must optimize risk versus benefit for solar exposure. It is fortunate that the individual UVB doses necessary for maintaining optimal vitamin D status are lower than those for sunburn, irrespective of skin melanin. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Jonathan J Neville
- St John's Institute of Dermatology, School of Basic & Medical Biosciences King's College London London United Kingdom
| | - Tommaso Palmieri
- St John's Institute of Dermatology, School of Basic & Medical Biosciences King's College London London United Kingdom
| | - Antony R Young
- St John's Institute of Dermatology, School of Basic & Medical Biosciences King's College London London United Kingdom
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11
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Shih BB, Farrar MD, Vail A, Allan D, Chao MR, Hu CW, Jones GDD, Cooke MS, Rhodes LE. Influence of skin melanisation and ultraviolet radiation on biomarkers of systemic oxidative stress. Free Radic Biol Med 2020; 160:40-46. [PMID: 32768566 PMCID: PMC7938299 DOI: 10.1016/j.freeradbiomed.2020.07.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 12/22/2022]
Abstract
Skin melanisation ranges widely across human populations. Melanin has antioxidant properties and also acts as a filter to solar ultraviolet radiation (UVR) incident upon the skin. In this study we firstly examined whether melanin level might influence baseline levels of systemic oxidative stress, in 65 humans in vivo from the same geographical area ranging from the lightest to darkest skin type (phototype I-VI). This was examined in winter-time (latitude 53.5°N). Remarkably, we found that urinary biomarkers of oxidatively-generated DNA damage (8-oxodG) and RNA damage (8-oxoGuo) were significantly correlated with skin lightness (L*), such that 14-15% of the variation in their baseline levels could be explained by skin colour. Next we exposed 15 humans at the extremes of skin melanisation to a simulated summer-time exposure of solar UVR (95% UVA, 5% UVB; dose standardised to sunburn threshold), following which they provided a sample of every urine void over the next five days. We found that UVR induced a small but significant increase in urinary 8-oxodG and 8-oxoGuo, with differing kinetics between skin types. Thus greater melanisation is associated with protection against systemic oxidative stress, which may reflect melanin's antioxidant properties, and solar UVR exposure also influences systemic oxidative stress levels in humans. These novel findings may have profound implications for human physiology and health.
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Affiliation(s)
- Barbara B Shih
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
| | - Mark D Farrar
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
| | - Andy Vail
- Centre for Biostatistics, Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
| | - Donald Allan
- Medical Physics Department, Salford Royal NHS Foundation Trust and The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
| | - Mu-Rong Chao
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung, 402, Taiwan.
| | - Chiung-Wen Hu
- Department of Public Health, Chung Shan Medical University, Taichung, 402, Taiwan.
| | - George D D Jones
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK.
| | - Marcus S Cooke
- Oxidative Stress Group, Department of Cell Biology, Microbiology and Molecular Biology University of South Florida, Tampa, FL, 33620, USA.
| | - Lesley E Rhodes
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
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12
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Burchell K, Rhodes LE, Webb AR. Public Awareness and Behaviour in Great Britain in the Context of Sunlight Exposure and Vitamin D: Results from the First Large-Scale and Representative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6924. [PMID: 32971923 PMCID: PMC7557888 DOI: 10.3390/ijerph17186924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/19/2022]
Abstract
In recent years, UK public health messages about the risks of sunlight exposure (skin cancer) have been increasingly balanced by messages about its benefits (vitamin D production). Currently, data about the effects of this shift on public knowledge, awareness, and behaviour are scant. Thus, the objective of this paper is to report the findings of the first large-scale and representative survey of the awareness, knowledge, and behaviour of adults in Great Britain (England, Scotland, and Wales) (n = 2024) with respect to sunlight exposure, vitamin D, and sunburn and skin cancer. The findings suggest that the public in Great Britain is much more aware of public promotion of the risks of sunlight exposure than its benefits. That said, knowledge about sunlight exposure and vitamin D is fairly strong, though not with respect to the detail of the 'little and often' approach. However, the survey also suggests that levels of sunlight exposure among the public are often excessive. The survey indicates that knowledge and behaviour are both less satisfactory among men and people in lower socio-economic groups. The paper concludes with recommendations for public health communications and for research in this area.
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Affiliation(s)
- Kevin Burchell
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK;
| | - Lesley E. Rhodes
- Faculty of Medicine Biology and Health, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester M13 9PL, UK;
- Photobiology Unit, Dermatology Research Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK
| | - Ann R. Webb
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK;
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13
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Felton SJ, Shin BB, Watson REB, Kift R, Webb AR, Rhodes LE. Photoprotection conferred by low level summer sunlight exposures against pro-inflammatory UVR insult. Photochem Photobiol Sci 2020; 19:810-818. [PMID: 33856672 DOI: 10.1039/c9pp00452a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/31/2020] [Indexed: 11/21/2022]
Affiliation(s)
- S J Felton
- Dermatology Research Centre, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - B B Shin
- Dermatology Research Centre, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - R E B Watson
- Dermatology Research Centre, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - R Kift
- School of Earth and Environmental Sciences, Faculty of Science and Engineering, The University of Manchester, Manchester, UK
| | - A R Webb
- School of Earth and Environmental Sciences, Faculty of Science and Engineering, The University of Manchester, Manchester, UK
| | - L E Rhodes
- Dermatology Research Centre, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
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14
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Cashman KD. Food-based strategies for prevention of vitamin D deficiency as informed by vitamin D dietary guidelines, and consideration of minimal-risk UVB radiation exposure in future guidelines. Photochem Photobiol Sci 2020; 19:800-809. [PMID: 33856673 PMCID: PMC8047520 DOI: 10.1039/c9pp00462a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/30/2020] [Indexed: 12/16/2022]
Abstract
There is widespread acknowledgement of the presence of vitamin D deficiency in the community and the pressing need to address this. From a public health perspective, emphasis has been placed on addressing vitamin D deficiency through dietary means. However, naturally rich food sources of vitamin D are few and infrequently consumed, and nutrition survey data from various countries have indicated that habitual vitamin D intakes in the community are much lower than the current vitamin D dietary guidelines. This review will briefly overview the extent of vitamin D deficiency within the community, its causes, and how our food chain, once its embraces the evidence-based practise of food fortification and potentially biofortification, can cater for meeting the dietary vitamin D needs of the community. Finally, international authorities, briefed with establishing vitamin D dietary guidelines over the past decade, have struggled with uncertainties and gaps in our understanding of the relative contribution of sunshine and diet to vitamin D status and vitamin D requirements for health maintenance. The review will also consider how emerging evidence of a possible minimal-risk UVB radiation exposure relative to skin cancer that also enables vitamin D production could greatly inform future vitamin D dietary guidelines.
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Affiliation(s)
- Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
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15
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Si S, Tewara MA, Ji X, Wang Y, Liu Y, Dai X, Wang Z, Xue F. Body surface area, height, and body fat percentage as more sensitive risk factors of cancer and cardiovascular disease. Cancer Med 2020; 9:4433-4446. [PMID: 32342643 PMCID: PMC7300397 DOI: 10.1002/cam4.3076] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Limited studies have compared the association between various physical measurements and the risk of cancer or cardiovascular disease (CVD). We aim to explore the best-individualized indicators of cancer and CVD risk assessment. METHODS From May 2004 to December 2017, a community-based cohort in China involving 100 280 participants were enrolled. BMI, height, body surface area (BSA), and body fat percentage (BFP) were compared in parallel about cancer and CVD risk with the multivariable-adjusted Cox proportional hazard regression model. RESULTS Within the follow-up period, 3107 (3.10%) were diagnosed with cancer and 3721 (3.71%) had CVD. Per-level increased (in tertile: T1, T2, and T3 level) BSA, height, and BFP was positively associated with the risk of overall cancer [HR (95% CI): 1.10 (1.05-1.15), 1.12 (1.07-1.18), and 1.10 (1.03-1.16), respectively], whereas BMI was insignificant. Compared with the reference group (T2), the highest BSA level (T3) was positively associated with overall cancer incidence for both male [HR (95% CI): 1.28 (1.13-1.45)] and female [HR (95% CI): 1.13 (1.00-1.28)]. The BSA, height, and BFP also significantly associated with some site-specific cancers including thyroid, stomach, breast, urinary system, and skin cancer. Meanwhile, BFP presented a strong positive association with overall CVD [HR (95% CI): 1.22 (1.15-1.30) in trend] in both gender and associated with nearly all CVD subtypes especially the myocardial infarction and heart failure. CONCLUSION BSA, height, and BFP have more sensitivity in assessing cancer risk and BFP shows the largest hazard ratios for CVD incident. We provided valuable evidence for the application of height, BSA, and BFP in routine healthcare practice. These encouraging findings should be tested in more well-defined studies for risk prediction.
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Affiliation(s)
- Shucheng Si
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Marlvin A Tewara
- Institute for Medical Dataology, Shandong University, Jinan, P.R. China
| | - Xiaokang Ji
- Institute for Medical Dataology, Shandong University, Jinan, P.R. China
| | - Yongchao Wang
- Institute for Medical Dataology, Shandong University, Jinan, P.R. China
| | - Yanxun Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China.,Institute for Medical Dataology, Shandong University, Jinan, P.R. China
| | - Xiaoyu Dai
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Zhiheng Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China.,Institute for Medical Dataology, Shandong University, Jinan, P.R. China
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16
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Public Health Implications of Solar UV Exposure during Extreme Cold and Hot Weather Episodes in 2018 in Chilton, South East England. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020. [DOI: 10.1155/2020/2589601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Consideration of the implications of solar UV exposure on public health during extreme temperature events is important due to their increasing frequency as a result of climate change. In this paper public health impacts of solar UV exposure, both positive and negative, during extreme hot and cold weather in England in 2018 were assessed by analysing environmental variations in UV and temperature. Consideration was given to people’s likely behaviour, the current alert system and public health advice. During a period of severe cold weather in February-March 2018 UV daily doses were around 25–50% lower than the long-term average (1991–2017); however, this would not impact on sunburn risk or the benefit of vitamin D production. In spring 2018 unseasonably high temperatures coincided with high UV daily doses (40–75% above long-term average) on significant days: the London Marathon (22 April) and UK May Day Bank Holiday weekend, which includes a public holiday on the Monday (5–7 May). People were likely to have intermittent excess solar UV exposure on unacclimatised skin, causing sunburn and potentially increasing the risk of skin cancers. No alerts were raised for these events since they occurred outside the alerting period. During a heat-wave in summer 2018 the environmental availability of UV was high—on average of 25% above the long-term average. The public health implications are complex and highly dependent on behaviour and sociodemographic variables such as skin colour. For all three periods Pearson’s correlation analysis showed a statistically significant (p<0.05) positive correlation between maximum daily temperature and erythema-effective UV daily dose. Public health advice may be improved by taking account of both temperature and UV and their implications for behaviour. A health impact-based alert system would be of benefit throughout the year, particularly in spring and summer.
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17
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Sunlight, UV Radiation, Vitamin D, and Skin Cancer: How Much Sunlight Do We Need? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1268:19-36. [PMID: 32918212 DOI: 10.1007/978-3-030-46227-7_2] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Vitamin D is the sunshine vitamin for good reason. During exposure to sunlight, the ultraviolet B photons enter the skin and photolyze 7-dehydrocholesterol to previtamin D3 which in turn is isomerized by the body's temperature to vitamin D3. Most humans have depended on sun for their vitamin D requirement. Skin pigment, sunscreen use, aging, time of day, season, and latitude dramatically affect previtamin D3 synthesis. Vitamin D deficiency was thought to have been conquered, but it is now recognized that more than 50% of the world's population is at risk for vitamin D deficiency. This deficiency is in part due to the inadequate fortification of foods with vitamin D and the misconception that a healthy diet contains an adequate amount of vitamin D. Vitamin D deficiency causes growth retardation and rickets in children and will precipitate and exacerbate osteopenia, osteoporosis and increase risk of fracture in adults. The vitamin D deficiency pandemic has other serious consequences including increased risk of common cancers, autoimmune diseases, infectious diseases, and cardiovascular disease. There needs to be a renewed appreciation of the beneficial effect of moderate sensible sunlight for providing all humans with their vitamin D requirement for health.
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18
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Zhang S, Zhang Y, Zhang W, Chen S, Liu C. Chronic exposure to green light aggravates high-fat diet-induced obesity and metabolic disorders in male mice. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 178:94-104. [PMID: 30999185 DOI: 10.1016/j.ecoenv.2019.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 06/09/2023]
Abstract
Light is involved in many critical physiological or biochemical processes of human beings, such as visual sensing and the production of vitamin D. Recent studies have showed that the lights of different wavelengths have a profound influence in life activities. For example, blue light promotes alertness, whereas green light (GL) induces sleep in mice. On the other hand, metabolic homeostasis is regulated by a variety of factors, including dietary habits and light exposure. Our study aims to study whether certain wavelength of light would affect metabolic status of mice. Mice were divided into normal diet-fed group and high-fat diet (HFD)-fed group, and then exposed to various colors of the light. Physiological parameters, such as body weight, food intake and water drinking were regularly measured. Glucose tolerance test and pyruvate tolerance test were simultaneously performed. After mice were humanely sacrificed, liver histology and serologic analysis were performed for detecting lipid levels. We found that GL group showed obvious glucose intolerance and increased levels of serum and liver lipid contents compared to white light group. Meanwhile, the expression levels of lipid metabolism-related genes were almost down-regulated in liver. Furthermore, melatonin receptor-1b and thyroid hormone receptor-β expression levels were significantly lowered in liver of GL-treated obese mice, suggesting that these hormone pathways may mediate the changes of lipid metabolism. Our data indicate that GL has a detrimental effect on the energy metabolism and aggravates HFD-induced obesity in mice. In addition to malnutrition, the colors of the lights also have a profound influence in the metabolic homeostasis and should be taken into consideration in the therapy of metabolic disorders.
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Affiliation(s)
- Shiyao Zhang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 211198, PR China; School of Life Science and Technology, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Yanchen Zhang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 211198, PR China; School of Life Science and Technology, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Wenxiang Zhang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 211198, PR China; School of Life Science and Technology, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Siyu Chen
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 211198, PR China; School of Life Science and Technology, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Chang Liu
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 211198, PR China; School of Life Science and Technology, China Pharmaceutical University, Nanjing, 211198, PR China; State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, 210023, PR China.
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19
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Arriagada F, Nonell S, Morales J. Silica-based nanosystems for therapeutic applications in the skin. Nanomedicine (Lond) 2019; 14:2243-2267. [PMID: 31411537 DOI: 10.2217/nnm-2019-0052] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aging, exposure to oxidants, infectious pathogens, inflammogens, ultraviolet radiation and other environmental and genetic factors can result in the development of various skin disorders. Despite immense progress being made in dermatological treatments, many skin-associated problems still remain difficult to treat and various therapies have limitations. Progress in silica-based nanomaterials research provides an opportunity to overcome these drawbacks and improve therapies and is a promising tool for inclusion in clinical practice to treat skin diseases. This review focuses on the use of various types of silica nanoparticles with therapeutic applications in various skin disorders. These nanosystems improve treatment efficacy by maintaining or enhancing the effect of several drugs and are useful tools for nanomedicine, pharmaceutical sciences and future clinical applications.
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Affiliation(s)
- Francisco Arriagada
- Departamento de Ciencias y Tecnología Farmacéuticas, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago 8380494, Chile
| | - Santi Nonell
- Institut Químic de Sarrià (IQS), University Ramon Llull, Via Augusta 390, 08017 Barcelona, Spain
| | - Javier Morales
- Departamento de Ciencias y Tecnología Farmacéuticas, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago 8380494, Chile
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20
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Passeron T, Bouillon R, Callender V, Cestari T, Diepgen TL, Green AC, van der Pols JC, Bernard BA, Ly F, Bernerd F, Marrot L, Nielsen M, Verschoore M, Jablonski NG, Young AR. Sunscreen photoprotection and vitamin D status. Br J Dermatol 2019; 181:916-931. [PMID: 31069788 PMCID: PMC6899926 DOI: 10.1111/bjd.17992] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 12/16/2022]
Abstract
Background Global concern about vitamin D deficiency has fuelled debates on photoprotection and the importance of solar exposure to meet vitamin D requirements. Objectives To review the published evidence to reach a consensus on the influence of photoprotection by sunscreens on vitamin D status, considering other relevant factors. Methods An international panel of 13 experts in endocrinology, dermatology, photobiology, epidemiology and biological anthropology reviewed the literature prior to a 1‐day meeting in June 2017, during which the evidence was discussed. Methods of assessment and determining factors of vitamin D status, and public health perspectives were examined and consequences of sun exposure and the effects of photoprotection were assessed. Results A serum level of ≥ 50 nmol L−1 25(OH)D is a target for all individuals. Broad‐spectrum sunscreens that prevent erythema are unlikely to compromise vitamin D status in healthy populations. Vitamin D screening should be restricted to those at risk of hypovitaminosis, such as patients with photosensitivity disorders, who require rigorous photoprotection. Screening and supplementation are advised for this group. Conclusions Sunscreen use for daily and recreational photoprotection does not compromise vitamin D synthesis, even when applied under optimal conditions. What's already known about this topic? Knowledge of the relationship between solar exposure behaviour, sunscreen use and vitamin D is important for public health but there is confusion about optimal vitamin D status and the safest way to achieve this. Practical recommendations on the potential impact of daily and/or recreational sunscreens on vitamin D status are lacking for healthy people.
What does this study add? Judicious use of daily broad‐spectrum sunscreens with high ultraviolet (UV) A protection will not compromise vitamin D status in healthy people. However, photoprotection strategies for patients with photosensitivity disorders that include high sun‐protection factor sunscreens with high UVA protection, along with protective clothing and shade‐seeking behaviour are likely to compromise vitamin D status. Screening for vitamin D status and supplementation are recommended in patients with photosensitivity disorders.
Linked Comment: https://doi.org/10.1111/bjd.18126. https://doi.org/10.1111/bjd.18494 available online
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Affiliation(s)
- T Passeron
- Department of Dermatology, CHU Nice, Université Côte d'Azur, CHU Nice, 151, route de Ginestière, 06200, Nice, France.,C3M, INSERM U1065 Université Côte d'Azur, 151, route de Ginestière, 06200, Nice, France
| | - R Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Gasthuisberg, 3000, Leuven, Belgium
| | - V Callender
- Callender Dermatology & Cosmetic Center, 12200 Annapolis Road, Suite 315, Glenn Dale, MD, 20769, U.S.A
| | - T Cestari
- Federal University of Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Ramiro Barcellos 2350 zone 13, Porto Alegre, RS, 90035-903, Brazil
| | - T L Diepgen
- Department of Clinical Social Medicine, University of Heidelberg, Voßstr. 2, 69115, Heidelberg, Germany
| | - A C Green
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia.,CRUK Manchester Institute and Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, M13 9NQ, U.K
| | - J C van der Pols
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - B A Bernard
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - F Ly
- Faculty of Medicine, Pharmacy and Odontology, University Cheikh Anta Diop of Dakar, BP 5825, Dakar, Senegal
| | - F Bernerd
- L'Oréal R&I, 1 Avenue Eugène Schueller, 93600, Aulnay-sous-bois, France
| | - L Marrot
- L'Oréal R&I, 1 Avenue Eugène Schueller, 93600, Aulnay-sous-bois, France
| | - M Nielsen
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - M Verschoore
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - N G Jablonski
- Department of Anthropology, The Pennsylvania State University, 409 Carpenter Building, University Park, PA, 16802, U.S.A
| | - A R Young
- St John's Institute of Dermatology, King's College London, London, SE1 9RT, U.K
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21
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Abstract
Although first discovered in 1931, vitamin D has seen an increased interest in the scientific community over the past decades, including the dermatology field. Vitamin D promotes calcium and phosphorus absorption; however, the actions of vitamin D are not confined to bone. Indeed, there is now overwhelming and compelling scientific data that vitamin D plays a crucial role in a plethora of cellular function and in extra-skeletal health. Except for fatty fish livers, very few foods naturally contain vitamin D; and the major source of vitamin D comes from skin exposure to sunlight via ultraviolet B. Keratinocytes are unique in the body as not only do they provide the primary source of vitamin D for the body, but they also possess both the enzymatic machinery to metabolize the vitamin D produced to active metabolites. This has been referred to as the photoendocrine vitamin D system. Vitamin D regulates keratinocytes proliferation and differentiation; and plays a role in the defense against opportunistic infections. Multiple factors are linked to vitamin D status; and a growing number of dermatologic diseases has been linked to vitamin D status such as atopic dermatitis, psoriasis, vitiligo, and cutaneous cancers. In this article, we reviewed the potential determinants of vitamin D status, as its implications in dermatologic diseases.
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Affiliation(s)
- Christina Bergqvist
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, Université Paris-Est Créteil, Créteil, France
| | - Khaled Ezzedine
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, Université Paris-Est Créteil, Créteil, France - .,EA 7379 EpidermE, Université Paris-Est Créteil, Créteil, France
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22
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Abu-Samak MS, AbuRuz ME, Masa'Deh R, Khuzai R, Jarrah S. Correlation of selected stress associated factors with vitamin D deficiency in Jordanian men and women. Int J Gen Med 2019; 12:225-233. [PMID: 31303782 PMCID: PMC6612048 DOI: 10.2147/ijgm.s198175] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/20/2019] [Indexed: 12/25/2022] Open
Abstract
Background: To identify stress associated factors for vitamin D deficiency (VDD) in healthy Jordanian people based on serum 25(OH)D levels. Design: Prospective cohort study. Methods: Three hundred and seventy-one Jordanian men and women aged 17–52 years, who were identified as VD deficient 25(OH)D <30 ng/mL, were eligible to participate in the study. Serum vitamin 25(OH) D was measured using chemiluminescent immunoassay. Cortisol, parathyroid hormone, calcium, phosphate, fasting lipid profile, and blood glucose were also analyzed. Questionnaires were used to collect lifestyles parameters. Anthropometric parameters including: body mass index (BMI), waist (W) and hip (H) circumferences, W/H ratio (WHR) were also calculated. Results: The vast majority (91%) of the participants had vitamin D deficiency (25- (OH) D <30 ng/mL). Positive correlations were observed between vitamin D deficiency and the following anthropometric parameters in all study sample; gender (P=0.010), height (P=0.22), height/hip ratio (P=0.015) and waist/hip ratio (P=0.013). Lifestyle parameters that indicated very weak positive correlations with VDD were number of family members (P=0.011) and insufficient exposure to sunlight (P=0.023). The following clinical parameters showed weak or very weak correlations with VDD; serum cortisol (r=0.318), low density lipoprotein (r=0.246) and total cholesterol (r=0.133). Skin color and water pipe tobacco smoking were added to the multivariable stepwise regression analyses as they have been weakly correlated with VDD. These predictors together explained only 12.2% of the variance in serum cortisol levels in the VDD study sample. Conclusion: A weak positive association between VDD and elevated serum cortisol was observed in this study. Subcutaneous changes may be involved in that association but further studies are needed to clarify a potential role for adrenocorticotropic hormone (ACTH).
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Affiliation(s)
- Mahmoud S Abu-Samak
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan
| | - Mohannad Eid AbuRuz
- Department of Clinical Nursing, School of Nursing, Applied Science Private University, Amman, Jordan
| | - Rami Masa'Deh
- Department of Clinical Nursing, School of Nursing, Applied Science Private University, Amman, Jordan
| | - Rula Khuzai
- Department of Clinical Nursing, School of Nursing, Applied Science Private University, Amman, Jordan
| | - Samiha Jarrah
- Department of Clinical Nursing, School of Nursing, Applied Science Private University, Amman, Jordan
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23
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Vitamin D Deficiency: Effects on Oxidative Stress, Epigenetics, Gene Regulation, and Aging. BIOLOGY 2019; 8:biology8020030. [PMID: 31083546 PMCID: PMC6627346 DOI: 10.3390/biology8020030] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 02/21/2019] [Accepted: 03/18/2019] [Indexed: 12/11/2022]
Abstract
Recent advances in vitamin D research indicate that this vitamin, a secosteroid hormone, has beneficial effects on several body systems other than the musculoskeletal system. Both 25 dihydroxy vitamin D [25(OH)2D] and its active hormonal form, 1,25-dihydroxyvitamin D [1,25(OH)2D] are essential for human physiological functions, including damping down inflammation and the excessive intracellular oxidative stresses. Vitamin D is one of the key controllers of systemic inflammation, oxidative stress and mitochondrial respiratory function, and thus, the aging process in humans. In turn, molecular and cellular actions form 1,25(OH)2D slow down oxidative stress, cell and tissue damage, and the aging process. On the other hand, hypovitaminosis D impairs mitochondrial functions, and enhances oxidative stress and systemic inflammation. The interaction of 1,25(OH)2D with its intracellular receptors modulates vitamin D–dependent gene transcription and activation of vitamin D-responsive elements, which triggers multiple second messenger systems. Thus, it is not surprising that hypovitaminosis D increases the incidence and severity of several age-related common diseases, such as metabolic disorders that are linked to oxidative stress. These include obesity, insulin resistance, type 2 diabetes, hypertension, pregnancy complications, memory disorders, osteoporosis, autoimmune diseases, certain cancers, and systemic inflammatory diseases. Vitamin D adequacy leads to less oxidative stress and improves mitochondrial and endocrine functions, reducing the risks of disorders, such as autoimmunity, infections, metabolic derangements, and impairment of DNA repair; all of this aids a healthy, graceful aging process. Vitamin D is also a potent anti-oxidant that facilitates balanced mitochondrial activities, preventing oxidative stress-related protein oxidation, lipid peroxidation, and DNA damage. New understandings of vitamin D-related advances in metabolomics, transcriptomics, epigenetics, in relation to its ability to control oxidative stress in conjunction with micronutrients, vitamins, and antioxidants, following normalization of serum 25(OH)D and tissue 1,25(OH)2D concentrations, likely to promise cost-effective better clinical outcomes in humans.
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Mendes MM, Darling AL, Hart KH, Morse S, Murphy RJ, Lanham-New SA. Impact of high latitude, urban living and ethnicity on 25-hydroxyvitamin D status: A need for multidisciplinary action? J Steroid Biochem Mol Biol 2019; 188:95-102. [PMID: 30610914 DOI: 10.1016/j.jsbmb.2018.12.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 12/17/2018] [Accepted: 12/31/2018] [Indexed: 12/12/2022]
Abstract
The effects of urban living on health are becoming increasingly important, due to an increasing global population residing in urban areas. Concomitantly, due to immigration, there is a growing number of ethnic minority individuals (African, Asian or Middle Eastern descent) living in westernised Higher Latitude Countries (HLC) (e.g. Europe, Canada, New Zealand). Of concern is the fact that there is already a clear vitamin D deficiency epidemic in HLC, a problem which is likely to grow as the ethnic minority population in these countries increases. This is because 25-hydroxyvitamin D (25(OH)D) status of ethnic groups is significantly lower compared to native populations. Environmental factors contribute to a high prevalence of vitamin D deficiency in HLC, particularly during the winter months when there is no sunlight of appropriate wavelength for vitamin D synthesis via the skin. Also, climatic factors such as cloud cover may reduce vitamin D status even in the summer. This may be further worsened by factors related to urban living, including air pollution, which reduces UVB exposure to the skin, and less occupational sun exposure (may vary by individual HLC). Tall building height may reduce sun exposure by making areas more shaded. In addition, there are ethnicity-specific factors which further worsen vitamin D status in HLC urban dwellers, such as low dietary intake of vitamin D from foods, lower production of vitamin D in the skin due to increased melanin and reduced skin exposure to UVB due to cultural dress style and sun avoidance. A multidisciplinary approach applying knowledge from engineering, skin photobiology, nutrition, town planning and social science is required to prevent vitamin D deficiency in urban areas. Such an approach could include reduction of air pollution, modification of sun exposure advice to emphasise spending time each day in non-shaded urban areas (e.g. parks, away from tall buildings), and advice to ethnic minority groups to increase sun exposure, take vitamin D supplements and/or increase consumption of vitamin D rich foods in a way that is safe and culturally acceptable. This review hopes to stimulate further research to assess the impact of high latitude, urban environment and ethnicity on the risk of vitamin D deficiency.
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Affiliation(s)
- Marcela M Mendes
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, UK.
| | - Andrea L Darling
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, UK.
| | - Kathryn H Hart
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, UK.
| | - Stephen Morse
- Centre for Environment and Sustainability, University of Surrey, UK.
| | - Richard J Murphy
- Centre for Environment and Sustainability, University of Surrey, UK.
| | - Susan A Lanham-New
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, UK.
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Lucas RM, Yazar S, Young AR, Norval M, de Gruijl FR, Takizawa Y, Rhodes LE, Sinclair CA, Neale RE. Human health in relation to exposure to solar ultraviolet radiation under changing stratospheric ozone and climate. Photochem Photobiol Sci 2019; 18:641-680. [PMID: 30810559 DOI: 10.1039/c8pp90060d] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Montreal Protocol has limited increases in the UV-B (280-315 nm) radiation reaching the Earth's surface as a result of depletion of stratospheric ozone. Nevertheless, the incidence of skin cancers continues to increase in most light-skinned populations, probably due mainly to risky sun exposure behaviour. In locations with strong sun protection programs of long duration, incidence is now reducing in younger age groups. Changes in the epidemiology of UV-induced eye diseases are less clear, due to a lack of data. Exposure to UV radiation plays a role in the development of cataracts, pterygium and possibly age-related macular degeneration; these are major causes of visual impairment world-wide. Photodermatoses and phototoxic reactions to drugs are not uncommon; management of the latter includes recognition of the risks by the prescribing physician. Exposure to UV radiation has benefits for health through the production of vitamin D in the skin and modulation of immune function. The latter has benefits for skin diseases such as psoriasis and possibly for systemic autoimmune diseases such as multiple sclerosis. The health risks of sun exposure can be mitigated through appropriate sun protection, such as clothing with both good UV-blocking characteristics and adequate skin coverage, sunglasses, shade, and sunscreen. New sunscreen preparations provide protection against a broader spectrum of solar radiation, but it is not clear that this has benefits for health. Gaps in knowledge make it difficult to derive evidence-based sun protection advice that balances the risks and benefits of sun exposure.
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Affiliation(s)
- R M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia. and Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - S Yazar
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia and MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | | | - M Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, Scotland, UK
| | - F R de Gruijl
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Y Takizawa
- Akita University School of Medicine, National Institute for Minamata Disease, Nakadai, Itabashiku, Tokyo, Japan
| | - L E Rhodes
- Centre for Dermatology Research, School of Biological Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - R E Neale
- QIMR Berghofer Institute of Medical Research, Herston, Brisbane, Australia and School of Public Health, University of Queensland, Australia
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Designing Safe General LED Lighting that Provides the UVB Benefits of Sunlight. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9050826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The ultraviolet (UV) rays emitted from sunlight greatly influence human health. Excessive exposure to UV rays can be harmful to eyes and skin; however, limited UVB exposure is essential for the synthesis of vitamin D. Nowadays, owing to insufficient exposure to natural light, there is increasing concerns about low vitamin D amongst individuals. To address this issue, many lighting devices that provide UVB doses have been released; however, such devices are only used for treatments or for special purposes. This study proposes a general indoor lighting system with a UVB LED light source to provide safe UVB doses to users who spend large amounts of time indoors. The optical characteristics of two UVB LEDs with output of 20 and 100 mW were analyzed based on their distances and applied currents. The light source combination of UVB LEDS that meets the UV hazard standard of IEC-62471 was derived; this is a photobiological safety evaluation standard of LED lighting devices. We then produced a lighting module in which the UVB LED light source was applied to general LED lighting and measured and analyzed the spectral irradiance of the proposed lighting according to the measurement standard for the general lighting of IEC 62471. The actinic UV hazard (AUV) and near-UV hazard (NUV) were calculated to be 0.001 and 10 W/m2, respectively. Thus, the provision of UVB dose did not pose any risks. In addition, the total EUV (Erythemal weighted UV) dose when the proposed lighting was implemented for 16 h was 187.66 J/m2, confirming that this dose did not cause erythema for the general skin types (Skin Types 1–6). Further, the design plan of general indoor lighting with a UVB LED light source is presented.
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Cadet J, Douki T. Formation of UV-induced DNA damage contributing to skin cancer development. Photochem Photobiol Sci 2018; 17:1816-1841. [PMID: 29405222 DOI: 10.1039/c7pp00395a] [Citation(s) in RCA: 216] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
UV-induced DNA damage plays a key role in the initiation phase of skin cancer. When left unrepaired or when damaged cells are not eliminated by apoptosis, DNA lesions express their mutagneic properties, leading to the activation of proto-oncogene or the inactivation of tumor suppression genes. The chemical nature and the amount of DNA damage strongly depend on the wavelength of the incident photons. The most energetic part of the solar spectrum at the Earth's surface (UVB, 280-320 nm) leads to the formation of cyclobutane pyrimidine dimers (CPDs) and pyrimidine (6-4) pyrimidone photoproducts (64PPs). Less energetic but 20-times more intense UVA (320-400 nm) also induces the formation of CPDs together with a wide variety of oxidatively generated lesions such as single strand breaks and oxidized bases. Among those, 8-oxo-7,8-dihydroguanine (8-oxoGua) is the most frequent since it can be produced by several mechanisms. Data available on the respective yield of DNA photoproducts in cells and skin show that exposure to sunlight mostly induces pyrimidine dimers, which explains the mutational signature found in skin tumors, with lower amounts of 8-oxoGua and strand breaks. The present review aims at describing the basic photochemistry of DNA and discussing the quantitative formation of the different UV-induced DNA lesions reported in the literature. Additional information on mutagenesis, repair and photoprotection is briefly provided.
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Affiliation(s)
- Jean Cadet
- Département de Médecine Nucléaire et Radiobiologie, Faculté de Médecine, 3001 12e Avenue Nord, Université de Sherbrooke, Sherbrooke, Québec JIH 5N4, Canada.
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Lucas RM, Neale RE, Madronich S, McKenzie RL. Are current guidelines for sun protection optimal for health? Exploring the evidence. Photochem Photobiol Sci 2018; 17:1956-1963. [PMID: 29904757 DOI: 10.1039/c7pp00374a] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Exposure of the skin to ultraviolet (UV) radiation is the main risk factor for skin cancer, and a major source of vitamin D, in many regions of the world. Sun protection messages to minimize skin cancer risks but avoid vitamin D deficiency are challenging, partly because levels of UV radiation vary by location, season, time of day, and atmospheric conditions. The UV Index provides information on levels of UV radiation and is a cornerstone of sun protection guidelines. Current guidelines from the World Health Organization are that sun protection is required only when the UV Index is 3 or greater. This advice is pragmatic rather than evidence based. The UV Index is a continuous scale; more comprehensive sun protection is required as the UV Index increases. In addition, a wide range of UVA doses is possible with a UVI of 3, from which there may be health consequences, while full sun protection when the UVI is "moderate" (between 3 and 5) may limit vitamin D production. Finally, the duration of time spent in the sun is an essential component of a public health message, in addition to the intensity of ambient UV radiation as measured by the UV Index. Together these provide the dose of UV radiation that is relevant to both skin cancer genesis and vitamin D production. Further education is required to increase the understanding of the UV Index; messages framed using the UV Index need to incorporate the importance of duration of exposure and increasing sun protection with increasing dose of UV radiation.
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Affiliation(s)
- Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia.
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Narbutt J, Philipsen PA, Lesiak A, Sandberg Liljendahl T, Segerbäck D, Heydenreich J, Chlebna-Sokol D, Olsen P, Harrison GI, Pearson A, Baczynska K, Rogowski-Tylman M, Wulf HC, Young AR. Children sustain high levels of skin DNA photodamage, with a modest increase of serum 25-hydroxyvitamin D 3 , after a summer holiday in Northern Europe. Br J Dermatol 2018; 179:940-950. [PMID: 29691848 DOI: 10.1111/bjd.16668] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Childhood solar ultraviolet radiation (UVR) exposure increases the risk of skin cancer in adulthood, which is associated with mutations caused by UVR-induced cyclobutane pyrimidine dimers (CPD). Solar UVR is also the main source of vitamin D, essential for healthy bone development in children. OBJECTIVES To assess the impact of a 12-day Baltic Sea (54° N) beach holiday on serum 25-hydroxyvitamin D3 [25(OH)D3 ] and CPD in 32 healthy Polish children (skin types I-IV). METHODS Blood and urine were collected before and after the holiday and assessed for 25(OH)D3 and excreted CPD, respectively, and personal UVR exposure was measured. Diaries were used to record sunbathing, sunburn and sunscreen use. Before- and after-holiday skin redness and pigmentation were measured by reflectance spectroscopy. RESULTS The average ± SD daily exposure UVR dose was 2·4 ± 1·5 standard erythema doses (SEDs), which is borderline erythemal. The mean concentration of 25(OH)D3 increased (× 1·24 ± 0·19) from 64·7 ± 13·3 to 79·3 ± 18·7 nmol L-1 (P < 0·001). Mean CPD increased 12·6 ± 10·0-fold from 26·9 ± 17·9 to 248·9 ± 113·4 fmol μmol-1 creatinine (P < 0·001). Increased 25(OH)D3 was accompanied by a very much greater increase in DNA damage associated with carcinogenic potential. Overall, skin type had no significant effects on behavioural, clinical or analytical outcomes, but skin types I/II had more CPD (unadjusted P = 0·0496) than skin types III/IV at the end of the holiday. CONCLUSIONS Careful consideration must be given to the health outcomes of childhood solar exposure, and a much better understanding of the risk-benefit relationships of such exposure is required. Rigorous photoprotection is necessary for children, even in Northern Europe.
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Affiliation(s)
- J Narbutt
- Department of Dermatology, Paediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-419, Łódź, Poland
| | - P A Philipsen
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - A Lesiak
- Department of Dermatology, Paediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-419, Łódź, Poland
| | - T Sandberg Liljendahl
- Karolinska Institute, Department of Biosciences and Nutrition, S-141 83, Huddinge, Sweden
| | - D Segerbäck
- Karolinska Institute, Department of Biosciences and Nutrition, S-141 83, Huddinge, Sweden
| | - J Heydenreich
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - D Chlebna-Sokol
- Department of Paediatric Propedeutics and Bone Metabolic Diseases, Medical University of Łódź, 90-419, Łódź, Poland
| | - P Olsen
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - G I Harrison
- St John's Institute of Dermatology, King's College London, London, SE1 9RT, U.K
| | - A Pearson
- Public Health England, Laser and Optical Radiation Dosimetry Group, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, OX11 ORQ, U.K
| | - K Baczynska
- Public Health England, Laser and Optical Radiation Dosimetry Group, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, OX11 ORQ, U.K
| | | | - H C Wulf
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - A R Young
- St John's Institute of Dermatology, King's College London, London, SE1 9RT, U.K
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Cooke MS. Mycosporine-like amino acids: does Nature make a better sunscreen? Br J Dermatol 2018; 178:1239-1240. [PMID: 29897128 DOI: 10.1111/bjd.16598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M S Cooke
- Oxidative Stress Group, Department of Environmental Health Sciences, Florida International University, Miami, FL, 33199, U.S.A
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Shih BB, Farrar MD, Cooke MS, Osman J, Langton AK, Kift R, Webb AR, Berry JL, Watson REB, Vail A, de Gruijl FR, Rhodes LE. Fractional Sunburn Threshold UVR Doses Generate Equivalent Vitamin D and DNA Damage in Skin Types I-VI but with Epidermal DNA Damage Gradient Correlated to Skin Darkness. J Invest Dermatol 2018; 138:2244-2252. [PMID: 29730334 PMCID: PMC6158343 DOI: 10.1016/j.jid.2018.04.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 03/19/2018] [Accepted: 04/01/2018] [Indexed: 11/27/2022]
Abstract
Public health guidance recommends limiting sun exposure to sub-sunburn levels, but it is unknown whether these can gain vitamin D (for musculoskeletal health) while avoiding epidermal DNA damage (initiates skin cancer). Well-characterized healthy humans of all skin types (I–VI, lightest to darkest skin) were exposed to a low-dose series of solar simulated UVR of 20%–80% their individual sunburn threshold dose (minimal erythema dose). Significant UVR dose responses were seen for serum 25-hydroxyvitamin D and whole epidermal cyclobutane pyrimidine dimers (CPDs), with as little as 0.2 minimal erythema dose concurrently producing 25-hydroxyvitamin D and CPD. Fractional MEDs generated equivalent levels of whole epidermal CPD and 25-hydroxyvitamin D across all skin types. Crucially, we showed an epidermal gradient of CPD formation strongly correlated with skin darkness (r = 0.74, P < 0.0001), which reflected melanin content and showed increasing protection across the skin types, ranging from darkest skin, where high CPD levels occurred superficially, with none in the germinative basal layer, to lightest skin, where CPD levels were induced evenly across the epidermal depth. People with darker skin can be encouraged to use sub-sunburn UVR-exposure to enhance their vitamin D. In people with lighter skin, basal cell damage occurs concurrent with vitamin D synthesis at exquisitely low UVR levels, providing an explanation for their high skin cancer incidence; greater caution is required.
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Affiliation(s)
- Barbara B Shih
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Mark D Farrar
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Marcus S Cooke
- Department of Environmental & Occupational Health, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Joanne Osman
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Abigail K Langton
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Richard Kift
- School of Earth and Environmental Sciences, The University of Manchester, Manchester, UK
| | - Ann R Webb
- School of Earth and Environmental Sciences, The University of Manchester, Manchester, UK
| | - Jacqueline L Berry
- Specialist Assay Laboratory, The University of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Rachel E B Watson
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Andy Vail
- Centre for Biostatistics, Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Frank R de Gruijl
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Lesley E Rhodes
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
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Webb AR, Kazantzidis A, Kift RC, Farrar MD, Wilkinson J, Rhodes LE. Meeting Vitamin D Requirements in White Caucasians at UK Latitudes: Providing a Choice. Nutrients 2018; 10:E497. [PMID: 29673142 PMCID: PMC5946282 DOI: 10.3390/nu10040497] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 12/25/2022] Open
Abstract
The body gains vitamin D through both oral intake (diet/supplementation) and synthesis in skin upon exposure to ultraviolet radiation (UVR). Sun exposure is the major source for most people even though sun exposure is complex and limited by climate and culture. We aimed to quantify the sun exposure required to meet vitamin D targets year-round and determine whether this can be safely achieved in a simply defined manner in the UK as an alternative to increasing vitamin D oral intake. Data from observation (sun exposure, diet, and vitamin D status) and UVR intervention studies performed with white Caucasian adults were combined with modeled all-weather UVR climatology. Daily vitamin D effective UVR doses (all-weather) were calculated across the UK based on ten-year climatology for pre-defined lunchtime exposure regimes. Calculations then determined the time necessary to spend outdoors for the body to gain sufficient vitamin D levels for year-round needs without being sunburnt under differing exposure scenarios. Results show that, in specified conditions, white Caucasians across the UK need nine minutes of daily sunlight at lunchtime from March to September for 25(OH)D levels to remain ≥25 nmol/L throughout the winter. This assumes forearms and lower legs are exposed June-August, while in the remaining, cooler months only hands and face need be exposed. Exposing only the hands and face throughout the summer does not meet requirements.
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Affiliation(s)
- Ann R Webb
- School of Earth and Environmental Science, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK.
| | - Andreas Kazantzidis
- School of Earth and Environmental Science, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK.
- Physics Department, University of Patras, 265 00 Patras, Greece.
| | - Richard C Kift
- School of Earth and Environmental Science, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK.
| | - Mark D Farrar
- Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK.
| | - Jack Wilkinson
- Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester M13 9PL, UK.
| | - Lesley E Rhodes
- Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK.
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Felton SJ, Kendall AC, Almaedani AFM, Urquhart P, Webb AR, Kift R, Vail A, Nicolaou A, Rhodes LE. Serum endocannabinoids and N-acyl ethanolamines and the influence of simulated solar UVR exposure in humans in vivo. Photochem Photobiol Sci 2018; 16:564-574. [PMID: 28138687 DOI: 10.1039/c6pp00337k] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Solar ultraviolet radiation (UVR) exposure of human skin has beneficial and harmful effects on health, including impact on immune function, inflammation and reportedly mood, but these are not fully elucidated. Since the endocannabinoid system is implicated in many activities including mood alteration, our objective was to (i) determine and quantify circulating levels of a wide range of endocannabinoid and N-acyl ethanolamine (NAE) species (ii) evaluate whether these are modulated by cutaneous UVR exposures, as attained through repeated low level summer sunlight exposure. Wearing goggles to prevent eye exposure, 16 healthy volunteers (23-59 y; 10 light skin, phototype II, and 6 dark skin, phototype V) received the same UVR exposures (1.3 SED, 95% UVA/5% UVB) thrice weekly for 6 weeks, whilst casually dressed to expose ∼35% skin surface area. Blood samples were taken at baseline, days 1, 3 and 5 of week one, then at weekly intervals, and analysed by LC-MS/MS. Eleven endocannabinoids and NAEs were detected and quantified at baseline, with N-palmitoyl ethanolamine the most abundant (30% of total). Levels did not vary according to phototype (p > 0.05), except for the NAE docosapentaenoyl ethanolamide, which was higher in phototype II than V (p = 0.0002). Level of the endocannabinoid, 2-AG, was elevated during the UVR exposure course (p < 0.05 vs. baseline for all subjects; p < 0.01 for each phototype group), with maximum levels reached by week 2-3, while NAE species did not significantly alter. These findings suggest differential involvement of the cutaneous endocannabinoid system in low dose solar UVR responses in humans.
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Affiliation(s)
- Sarah J Felton
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK.
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Abstract
Vitamin D plays a key role in skeletal and cardiovascular disorders, cancers, central nervous system diseases, reproductive diseases, infections, and autoimmune and dermatological disorders. The two main sources of vitamin D are sun exposure and oral intake, including vitamin D supplementation and dietary intake. Multiple factors are linked to vitamin D status, such as Fitzpatrick skin type, sex, body mass index, physical activity, alcohol intake, and vitamin D receptor polymorphisms. Patients with photosensitive disorders tend to avoid sun exposure, and this practice, along with photoprotection, can put this category of patients at risk for vitamin D deficiency. Maintaining a vitamin D serum concentration within normal levels is warranted in atopic dermatitis, psoriasis, vitiligo, polymorphous light eruption, mycosis fungoides, alopecia areata, systemic lupus erythematosus, and melanoma patients. The potential determinants of vitamin D status, as well as the benefits and risks of vitamin D (with a special focus on the skin), will be discussed in this article.
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Bais F, Luca RM, Bornman JF, Williamson CE, Sulzberger B, Austin AT, Wilson SR, Andrady AL, Bernhard G, McKenzie RL, Aucamp PJ, Madronich S, Neale RE, Yazar S, Young AR, de Gruijl FR, Norval M, Takizawa Y, Barnes PW, Robson TM, Robinson SA, Ballaré CL, Flint SD, Neale PJ, Hylander S, Rose KC, Wängberg SÅ, Häder DP, Worrest RC, Zepp RG, Paul ND, Cory RM, Solomon KR, Longstreth J, Pandey KK, Redhwi HH, Torikai A, Heikkilä AM. Environmental effects of ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2017. Photochem Photobiol Sci 2018; 17:127-179. [PMID: 29404558 PMCID: PMC6155474 DOI: 10.1039/c7pp90043k] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 12/11/2022]
Abstract
The Environmental Effects Assessment Panel (EEAP) is one of three Panels of experts that inform the Parties to the Montreal Protocol. The EEAP focuses on the effects of UV radiation on human health, terrestrial and aquatic ecosystems, air quality, and materials, as well as on the interactive effects of UV radiation and global climate change. When considering the effects of climate change, it has become clear that processes resulting in changes in stratospheric ozone are more complex than previously held. Because of the Montreal Protocol, there are now indications of the beginnings of a recovery of stratospheric ozone, although the time required to reach levels like those before the 1960s is still uncertain, particularly as the effects of stratospheric ozone on climate change and vice versa, are not yet fully understood. Some regions will likely receive enhanced levels of UV radiation, while other areas will likely experience a reduction in UV radiation as ozone- and climate-driven changes affect the amounts of UV radiation reaching the Earth's surface. Like the other Panels, the EEAP produces detailed Quadrennial Reports every four years; the most recent was published as a series of seven papers in 2015 (Photochem. Photobiol. Sci., 2015, 14, 1-184). In the years in between, the EEAP produces less detailed and shorter Update Reports of recent and relevant scientific findings. The most recent of these was for 2016 (Photochem. Photobiol. Sci., 2017, 16, 107-145). The present 2017 Update Report assesses some of the highlights and new insights about the interactive nature of the direct and indirect effects of UV radiation, atmospheric processes, and climate change. A full 2018 Quadrennial Assessment, will be made available in 2018/2019.
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Affiliation(s)
- F. Bais
- Aristotle Univ. of Thessaloniki, Laboratory of Atmospheric Physics, Thessaloniki, Greece
| | - R. M. Luca
- National Centre for Epidemiology and Population Health, Australian National Univ., Canberra, Australia
| | - J. F. Bornman
- Curtin Univ., Curtin Business School, Perth, Australia
| | | | - B. Sulzberger
- Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - A. T. Austin
- Univ. of Buenos Aires, Faculty of Agronomy and IFEVA-CONICET, Buenos Aires, Argentina
| | - S. R. Wilson
- School of Chemistry, Centre for Atmospheric Chemistry, Univ. of Wollongong, Wollongong, Australia
| | - A. L. Andrady
- Department of Chemical and Biomolecular Engineering, North Carolina State Univ., Raleigh, NC, USA
| | - G. Bernhard
- Biospherical Instruments Inc., San Diego, CA, USA
| | | | - P. J. Aucamp
- Ptersa Environmental Consultants, Faerie Glen, South Africa
| | - S. Madronich
- National Center for Atmospheric Research, Boulder, Colorado, USA
| | - R. E. Neale
- Queensland Institute of Medical Research, Royal Brisbane Hospital, Brisbane, Australia
| | - S. Yazar
- Univ. of Western Australia, Centre for Ophthalmology and Visual Science, Lions Eye Institute, Perth, Australia
| | | | - F. R. de Gruijl
- Department of Dermatology, Leiden Univ. Medical Centre, Leiden, The Netherlands
| | - M. Norval
- Univ. of Edinburgh Medical School, UK
| | - Y. Takizawa
- Akita Univ. School of Medicine, National Institute for Minamata Disease, Nakadai, Itabashiku, Tokyo, Japan
| | - P. W. Barnes
- Department of Biological Sciences and Environment Program, Loyola Univ., New Orleans, USA
| | - T. M. Robson
- Research Programme in Organismal and Evolutionary Biology, Viikki Plant Science Centre, Univ. of Helsinki, Finland
| | - S. A. Robinson
- Centre for Sustainable Ecosystem Solutions, School of Biological Sciences, Univ. of Wollongong, Wollongong, NSW 2522, Australia
| | - C. L. Ballaré
- Univ. of Buenos Aires, Faculty of Agronomy and IFEVA-CONICET, Buenos Aires, Argentina
| | - S. D. Flint
- Dept of Forest, Rangeland and Fire Sciences, Univ. of Idaho, Moscow, ID, USA
| | - P. J. Neale
- Smithsonian Environmental Research Center, Edgewater, Maryland, USA
| | - S. Hylander
- Centre for Ecology and Evolution in Microbial model Systems, Linnaeus Univ., Kalmar, Sweden
| | - K. C. Rose
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - S.-Å. Wängberg
- Dept Marine Sciences, Univ. of Gothenburg, Göteborg, Sweden
| | - D.-P. Häder
- Friedrich-Alexander Univ. Erlangen-Nürnberg, Dept of Biology, Möhrendorf, Germany
| | - R. C. Worrest
- CIESIN, Columbia Univ., New Hartford, Connecticut, USA
| | - R. G. Zepp
- United States Environmental Protection Agency, Athens, Georgia, USA
| | - N. D. Paul
- Lanter Environment Centre, Lanter Univ., LA1 4YQ, UK
| | - R. M. Cory
- Earth and Environmental Sciences, Univ. of Michigan, Ann Arbor, MI, USA
| | - K. R. Solomon
- Centre for Toxicology, School of Environmental Sciences, Univ. of Guelph, Guelph, ON, Canada
| | - J. Longstreth
- The Institute for Global Risk Research, Bethesda, MD, USA
| | - K. K. Pandey
- Institute of Wood Science and Technology, Bengaluru, India
| | - H. H. Redhwi
- Chemical Engineering Dept, King Fahd Univ. of Petroleum and Minerals, Dhahran, Saudi Arabia
| | - A. Torikai
- Materials Life Society of Japan, Kayabacho Chuo-ku, Tokyo, Japan
| | - A. M. Heikkilä
- Finnish Meteorological Institute R&D/Climate Research, Helsinki, Finland
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37
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Shi Y, Manco M, Moyal D, Huppert G, Araki H, Banks A, Joshi H, McKenzie R, Seewald A, Griffin G, Sen-Gupta E, Wright D, Bastien P, Valceschini F, Seité S, Wright JA, Ghaffari R, Rogers J, Balooch G, Pielak RM. Soft, stretchable, epidermal sensor with integrated electronics and photochemistry for measuring personal UV exposures. PLoS One 2018; 13:e0190233. [PMID: 29293664 PMCID: PMC5749742 DOI: 10.1371/journal.pone.0190233] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 12/11/2017] [Indexed: 12/21/2022] Open
Abstract
Excessive ultraviolet (UV) radiation induces acute and chronic effects on the skin, eye and immune system. Personalized monitoring of UV radiation is thus paramount to measure the extent of personal sun exposure, which could vary with environment, lifestyle, and sunscreen use. Here, we demonstrate an ultralow modulus, stretchable, skin-mounted UV patch that measures personal UV doses. The patch contains functional layers of ultrathin stretchable electronics and a photosensitive patterned dye that reacts to UV radiation. Color changes in the photosensitive dyes correspond to UV radiation intensity and are analyzed with a smartphone camera. A software application has feature recognition, lighting condition correction, and quantification algorithms that detect and quantify changes in color. These color changes are then correlated with corresponding shifts in UV dose, and compared to existing UV dose risk levels. The soft mechanics of the UV patch allow for multi-day wear in the presence of sunscreen and water. Two evaluation studies serve to demonstrate the utility of the UV patch during daily activities with and without sunscreen application.
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Affiliation(s)
- Yunzhou Shi
- L’Oréal Tech Incubator–California Research Center, San Francisco, California, United States of America
| | - Megan Manco
- L’Oréal Early Clinical, Clark, NJ, United States of America
| | - Dominique Moyal
- La Roche-Posay Dermatological Laboratories, Asnières Cedex, France
| | - Gil Huppert
- MC10 Inc., Lexington, Massachusetts, United States of America
| | - Hitoshi Araki
- Science and Engineering, and Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Anthony Banks
- Science and Engineering, and Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Hemant Joshi
- L’Oréal Tech Incubator, Clark, NJ, United States of America
| | - Richard McKenzie
- National Institute of Water and Atmospheric Research (NIWA), Lauder, Central Otago, New Zealand
| | - Alex Seewald
- MyStudioFactory, The Landing, Media City UK, Salford, United Kingdom
| | - Guy Griffin
- MC10 Inc., Lexington, Massachusetts, United States of America
| | | | - Donald Wright
- MC10 Inc., Lexington, Massachusetts, United States of America
| | | | | | - Sophie Seité
- L’Oréal Early Clinical, Clark, NJ, United States of America
| | - John A. Wright
- MC10 Inc., Lexington, Massachusetts, United States of America
| | | | - John Rogers
- Science and Engineering, and Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Guive Balooch
- L’Oréal Tech Incubator–California Research Center, San Francisco, California, United States of America
- L’Oréal Tech Incubator, Clark, NJ, United States of America
| | - Rafal M. Pielak
- L’Oréal Tech Incubator–California Research Center, San Francisco, California, United States of America
- * E-mail:
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38
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Gies P, van Deventer E, Green AC, Sinclair C, Tinker R. Review of the Global Solar UV Index 2015 Workshop Report. HEALTH PHYSICS 2018; 114:84-90. [PMID: 30085971 PMCID: PMC5728586 DOI: 10.1097/hp.0000000000000742] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The Global Solar UV Index was developed as an easy-to-understand measure of the amount of biologically-effective ambient solar ultraviolet radiation (UVR) at different locations on the earth's surface. Over the past few years, questions have been raised about the global applicability of the UV Index, about the evidence base for exposure risk thresholds and related protective measures, and about whether the overall impact of the UV Index could be improved with modifications. An international workshop was organized by several organizations, including the World Health Organization, to assess if current evidence was sufficiently strong to modify the UV Index and to discuss different ways it might be improved in order to influence sun-protective behavior. While some animal research suggests there may be no threshold effect, the relative importance of sub-erythemal doses of sunlight in causing skin cancer in humans remains unknown. Evidence suggests that regular use of sunscreen can prevent skin cancer and that sunglasses are an effective method of protecting the eyes from solar UVR. The UV Index as a risk communication tool continues to be useful for raising awareness and to support sun-protection behavior. Although there was agreement that guidance on the use of the UV Index could be improved, the workshop participants identified that strong health outcome-based human evidence would be needed as the basis for a revision. For the UV Index to be relevant in as many countries as possible, it should continue to be adapted to suit local conditions.
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Affiliation(s)
- Peter Gies
- *Australian Radiation Protection and Nuclear Safety Agency, 619 Lower Plenty Road, Yallambie, Victoria, Australia; †Radiation Programme, Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland; ‡International Commission on Non-Ionizing Radiation Protection, 85764 Oberschleissheim, Germany; QIMR Berghofer Medical Research Institute 300 Herston Road, Herston, Queensland, Australia and CRUK Manchester Institute, University of Manchester, Wilmslow Road, Manchester, UK; §Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia
| | - Emilie van Deventer
- *Australian Radiation Protection and Nuclear Safety Agency, 619 Lower Plenty Road, Yallambie, Victoria, Australia; †Radiation Programme, Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland; ‡International Commission on Non-Ionizing Radiation Protection, 85764 Oberschleissheim, Germany; QIMR Berghofer Medical Research Institute 300 Herston Road, Herston, Queensland, Australia and CRUK Manchester Institute, University of Manchester, Wilmslow Road, Manchester, UK; §Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia
| | - Adèle C. Green
- *Australian Radiation Protection and Nuclear Safety Agency, 619 Lower Plenty Road, Yallambie, Victoria, Australia; †Radiation Programme, Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland; ‡International Commission on Non-Ionizing Radiation Protection, 85764 Oberschleissheim, Germany; QIMR Berghofer Medical Research Institute 300 Herston Road, Herston, Queensland, Australia and CRUK Manchester Institute, University of Manchester, Wilmslow Road, Manchester, UK; §Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia
| | - Craig Sinclair
- *Australian Radiation Protection and Nuclear Safety Agency, 619 Lower Plenty Road, Yallambie, Victoria, Australia; †Radiation Programme, Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland; ‡International Commission on Non-Ionizing Radiation Protection, 85764 Oberschleissheim, Germany; QIMR Berghofer Medical Research Institute 300 Herston Road, Herston, Queensland, Australia and CRUK Manchester Institute, University of Manchester, Wilmslow Road, Manchester, UK; §Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia
| | - Rick Tinker
- *Australian Radiation Protection and Nuclear Safety Agency, 619 Lower Plenty Road, Yallambie, Victoria, Australia; †Radiation Programme, Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland; ‡International Commission on Non-Ionizing Radiation Protection, 85764 Oberschleissheim, Germany; QIMR Berghofer Medical Research Institute 300 Herston Road, Herston, Queensland, Australia and CRUK Manchester Institute, University of Manchester, Wilmslow Road, Manchester, UK; §Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia
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39
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Holick MF. Can you have your cake and eat it too? The sunlight D-lema. Br J Dermatol 2017; 175:1129-1131. [PMID: 27996132 DOI: 10.1111/bjd.15127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- M F Holick
- Section of Endocrinology, Nutrition and Diabetes, Department of Medicine, Boston University Medical Center, Boston, MA, 02118, U.S.A
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40
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Zhao Z, Xing X, Ou X, Liu X, Zhou R, Zhang H, Yang L, Zhuang Z, Su X, Lu Y, Jiang J, Yang Y, Cui D, He Y. DNA damage levels in electronics workers in Southern China: A micro-whole blood comet assay. Mutat Res 2017; 803-805:17-21. [PMID: 28759748 DOI: 10.1016/j.mrfmmm.2017.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 06/20/2017] [Accepted: 07/14/2017] [Indexed: 06/07/2023]
Abstract
We evaluated DNA damage levels of different categories of workers exposed to hazards inside electronics factories in Southern China. To find out the most dangerous risk factor, a cross-sectional study was conducted on a total of 584 exposed subjects and 138 controls in an electronics factory in Southern China, where the electronics industry is prevalent. The exposed hazards included isopropanol (IPO), lead, noise, video display terminals (VDT), lead in a high-temperature (high-temp) environment, and IPO in a high-temp environment. DNA damage detection was performed by the micro-whole blood comet assay using peripheral blood. DNA damage levels were estimated by percent tail DNA (%T). Linear regression models were used to test DNA damage differences between exposed groups and control group with adjustments for potential confounding factors. The level of DNA damage was more significant in both lead in a high-temp and IPO in a high-temp environment groups than in that of the controls (p<0.05). The differences remained significant after stratifying by smoking status (p<0.05). There were no significant differences between groups exposed to IPO, lead, noise, VDT environment and controls. In conclusion, we identified potential risk factors for DNA damage to electronics workers. Special attention should be paid to workers exposed to IPO and lead in a high-temp environment.
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Affiliation(s)
- Zhiqiang Zhao
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiumei Xing
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyan Ou
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xinxia Liu
- Prevention and Control Center for Occupational Diseases, Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong, China
| | - Ridong Zhou
- Prevention and Control Center for Occupational Diseases, Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong, China
| | - Huimin Zhang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Linqing Yang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhixiong Zhuang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Xiaolin Su
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yao Lu
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jun Jiang
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yarui Yang
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Dong Cui
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yun He
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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41
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Ultraviolet B Light Emitting Diodes (LEDs) Are More Efficient and Effective in Producing Vitamin D 3 in Human Skin Compared to Natural Sunlight. Sci Rep 2017; 7:11489. [PMID: 28904394 PMCID: PMC5597604 DOI: 10.1038/s41598-017-11362-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 08/22/2017] [Indexed: 12/02/2022] Open
Abstract
Vitamin D, the sunshine vitamin is important for health. Those with fat malabsorption disorders malabsorb vitamin D and thus must rely on cutaneous production of vitamin D3. Vitamin D3 is generated secondary to exposure to ultraviolet B (UVB) radiation (whether from the sun or from an artificial source). Light emitting diodes (LEDs) have been developed to emit ultraviolet radiation. Little is known about the efficiency of UVB emitting LEDs tuned to different wavelengths for producing vitamin D3 in human skin. Ampoules containing 7-dehydrocholesterol were exposed to a LED that emitted a peak wavelength at 293, 295, 298 or 305 nm to determine their efficiency to produce previtamin D3. The 293 nm LED was best suited for evaluating its effectiveness for producing vitamin D in human skin due to the shorter exposure time. This LED was found to be 2.4 times more efficient in producing vitamin D3 in human skin than the sun in less than 1/60th the time. This has significant health implications for medical device development in the future that can be used for providing vitamin D supplementation to patients with fat malabsorption syndromes as well as patients with other metabolic abnormalities including patients with chronic kidney disease.
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42
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Pesarini JR, Oliveira RJ, Pessatto LR, Antoniolli-Silva ACMB, Felicidade I, Nardi NB, Camassola M, Mantovani MS, Ribeiro LR. Vitamin D: Correlation with biochemical and body composition changes in a southern Brazilian population and induction of cytotoxicity in mesenchymal stem cells derived from human adipose tissue. Biomed Pharmacother 2017; 91:861-871. [DOI: 10.1016/j.biopha.2017.05.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/28/2017] [Accepted: 05/02/2017] [Indexed: 11/25/2022] Open
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43
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Holick MF. Reply to Whiteman et al.: In-Deed wise to get some sensible sun exposure. Br J Dermatol 2017; 177:1136-1137. [PMID: 28605014 DOI: 10.1111/bjd.15725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- M F Holick
- Section of Endocrinology, Nutrition and Diabetes, Department of Medicine, Boston University Medical Center, Boston, MA, 02118, U.S.A
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44
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Whiteman DC, Olsen CM, Green AC. Response to: M.F. Holick 'Can you have your cake and eat it too? The sunlight D-lema'. Br J Dermatol 2017; 177:1136. [PMID: 28600814 DOI: 10.1111/bjd.15724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- D C Whiteman
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, 4006, Australia.,The University of Queensland, School of Public Health, Herston, QLD, 4006, Australia
| | - C M Olsen
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, 4006, Australia.,The University of Queensland, School of Public Health, Herston, QLD, 4006, Australia
| | - A C Green
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, 4006, Australia.,The University of Queensland, School of Public Health, Herston, QLD, 4006, Australia.,Cancer Research UK, Manchester Institute and Institute of Inflammation and Repair, The University of Manchester, Manchester, U.K
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45
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Abstract
Vitamin D deficiency and insufficiency is a global health issue that afflicts more than one billion children and adults worldwide. The consequences of vitamin D deficiency cannot be under estimated. There has been an association of vitamin D deficiency with a myriad of acute and chronic illnesses including preeclampsia, childhood dental caries, periodontitis, autoimmune disorders, infectious diseases, cardiovascular disease, deadly cancers, type 2 diabetes and neurological disorders. This review is to put into perspective the controversy surrounding the definition for vitamin D deficiency and insufficiency as well as providing guidance for how to treat and prevent vitamin D deficiency.
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Affiliation(s)
- Michael F Holick
- Endocrinology, Nutrition and Diabetes, Department of Medicine, Boston University Medical Center, Boston, MA, 02118, USA.
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46
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Holick MF, Hossein-Nezhad A. The D-lemma: narrow-band UV type B radiation versus vitamin D supplementation versus sunlight for cardiovascular and immune health. Am J Clin Nutr 2017; 105:1031-1032. [PMID: 28424191 PMCID: PMC5402039 DOI: 10.3945/ajcn.117.155713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Michael F Holick
- Section of Endocrinology, Nutrition, and Diabetes, Department of Medicine, Boston University Medical Center, Boston, MA
| | - Arash Hossein-Nezhad
- Section of Endocrinology, Nutrition, and Diabetes, Department of Medicine, Boston University Medical Center, Boston, MA
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47
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Environmental effects of ozone depletion and its interactions with climate change: Progress report, 2016. Photochem Photobiol Sci 2017; 16:107-145. [PMID: 28124708 PMCID: PMC6400464 DOI: 10.1039/c7pp90001e] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/05/2017] [Indexed: 12/12/2022]
Abstract
The Parties to the Montreal Protocol are informed by three Panels of experts. One of these is the Environmental Effects Assessment Panel (EEAP), which deals with two focal issues. The first focus is the effects of UV radiation on human health, animals, plants, biogeochemistry, air quality, and materials. The second focus is on interactions between UV radiation and global climate change and how these may affect humans and the environment. When considering the effects of climate change, it has become clear that processes resulting in changes in stratospheric ozone are more complex than previously believed. As a result of this, human health and environmental issues will be longer-lasting and more regionally variable. Like the other Panels, the EEAP produces a detailed report every four years; the most recent was published as a series of seven papers in 2015 (Photochem. Photobiol. Sci., 2015, 14, 1-184). In the years in between, the EEAP produces less detailed and shorter Progress Reports of the relevant scientific findings. The most recent of these was for 2015 (Photochem. Photobiol. Sci., 2016, 15, 141-147). The present Progress Report for 2016 assesses some of the highlights and new insights with regard to the interactive nature of the direct and indirect effects of UV radiation, atmospheric processes, and climate change. The more detailed Quadrennial Assessment will be made available in 2018.
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48
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Kohler LN, Hibler EA, Harris RB, Oren E, Roe DJ, Jurutka PW, Jacobs ET. Greater Adherence to Cancer Prevention Guidelines Is Associated with Higher Circulating Concentrations of Vitamin D Metabolites in a Cross-Sectional Analysis of Pooled Participants from 2 Chemoprevention Trials. J Nutr 2017; 147:421-429. [PMID: 28122932 DOI: 10.3945/jn.116.243352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 11/28/2016] [Accepted: 01/04/2017] [Indexed: 12/14/2022] Open
Abstract
Background: Several lifestyle factors targeted by the American Cancer Society (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines are also associated with circulating concentrations of vitamin D metabolites. This suggests that greater adherence to the ACS guidelines may be related to better vitamin D status.Objective: We examined the relation between adherence to the ACS guidelines and circulating concentrations of 2 vitamin D metabolites, 25-hydroxycholecalciferol [25(OH)D] and 1α,25-dihydroxyvitamin D [1,25(OH)2D].Methods: We conducted cross-sectional analyses of pooled participants from the Wheat Bran Fiber (n = 503) and Ursodeoxycholic Acid (n = 854) trials. A cumulative adherence score was constructed with the use of baseline data on body size, diet, physical activity, and alcohol consumption. Continuous vitamin D metabolite concentrations and clinically relevant categories were evaluated with the use of multiple linear and logistic regression models, respectively.Results: The most adherent participants were more likely to be older, white, and nonsmokers than were the least adherent. A statistically significant association was observed between guideline adherence and concentrations of circulating 25(OH)D (means ± SEs-high adherence: 32.0 ± 0.8 ng/mL; low adherence: 26.4 ± 0.7 ng/mL; P-trend < 0.001). For 1,25(OH)2D concentrations, high adherence was again significantly related to greater metabolite concentrations, with mean ± SE concentrations of 36.3 ± 1.3 pg/mL and 31.9 ± 1.0 pg/mL for high- and low-adherers, respectively (P-trend = 0.008). Furthermore, the odds of attaining a sufficient 25(OH)D status were 4.37 times higher for those most adherent than for those least adherent (95% CI: 2.47, 7.71 times).Conclusion: These findings demonstrate that greater adherence to the ACS guidelines is associated with higher circulating concentrations of both of 25(OH)D and 1,25(OH)2D.
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Affiliation(s)
- Lindsay N Kohler
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, and
| | - Elizabeth A Hibler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Robin B Harris
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, and.,University of Arizona Cancer Center, Tucson, AZ
| | - Eyal Oren
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, and
| | - Denise J Roe
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, and.,University of Arizona Cancer Center, Tucson, AZ
| | - Peter W Jurutka
- School of Mathematical and Natural Sciences, Arizona State University, Phoenix, AZ; and.,Department of Basic Medical Sciences, University of Arizona College of Medicine, Phoenix, AZ
| | - Elizabeth T Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, and .,Department of Nutritional Sciences, University of Arizona, Tucson, AZ.,University of Arizona Cancer Center, Tucson, AZ
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Ultraviolet B Radiation: The Vitamin D Connection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 996:137-154. [DOI: 10.1007/978-3-319-56017-5_12] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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