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Hu C, Yang M. Trends of serum 25(OH) vitamin D and association with cardiovascular disease and all-cause mortality: from NHANES survey cycles 2001-2018. Front Nutr 2024; 11:1328136. [PMID: 38371503 PMCID: PMC10869563 DOI: 10.3389/fnut.2024.1328136] [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: 10/26/2023] [Accepted: 01/19/2024] [Indexed: 02/20/2024] Open
Abstract
Background The focus of this survey is on survey data for adults aged 20 and above, covering nine survey cycles from 2001 to 2018. Additionally, the present study explored the correlation between vitamin D concentrations and both cardiovascular disease (CVD) and all-cause mortality. Objective The objectives of this study were to evaluate the trend of changes in the serum 25(OH)D concentration changes in US adults during the survey period, the prevalence of vitamin D deficiency, and the current status of vitamin D dietary intake and supplementation. Methods In-home health interviews were performed using meticulously designed questionnaires that gathered information on demographic details, socioeconomic conditions, dietary patterns, and overall health status. Health assessments were conducted in specially designed mobile centers. Results Survey data from 2001 to 2018 revealed a rise in serum 25(OH)D levels, from a weighted mean (95% CI) of 65.6 (63.8-67.4) nmol/L during 2001-2002 to 73.5 (70.4-76.5) nmol/L during 2017-2018, among US adults, while overall vitamin D deficiency rates remained stable (p = 0.152). Notably, in adults aged 20-39, 25(OH)D levels decreased (p = 0.002 for trend), and 25(OH)D deficiency increased (p = 0.003 for trend), especially among those with low incomes (deficiency >30%). Upon multivariable adjustment, an L-shaped relationship was found between serum 25(OH)D concentrations and both CVD and all-cause mortality (p < 0.001 for nonlinearity), as corroborated by sensitivity analyses. Conclusion From 2001 to 2018, US adults experienced a significant increase in their serum 25(OH) D concentration. However, subgroups of individuals, including young adults and individuals with lower socioeconomic status, exhibited a heightened risk of 25(OH)D deficiency. Furthermore, an L-shaped relationship was found between 25(OH)D concentration and both all-cause and CVD mortality among US adults.
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Affiliation(s)
| | - Mei Yang
- Department of Internal Medicine, Chongqing Nanan District Traditional Chinese and Western Medicine Hospital, Chongqing, China
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2
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Lee SH, Joo NS. Effects of narrowband ultraviolet B exposure on serum 25-hydroxyvitamin D concentrations: A pilot study. Medicine (Baltimore) 2022; 101:e29937. [PMID: 35984188 PMCID: PMC9387955 DOI: 10.1097/md.0000000000029937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
It is known that ultraviolet B exposure increases serum 25-hydroxyvitamin D(25(OH)D) concentrations. However, little is known about the influence of narrowband ultraviolet B exposure from a light-emitting diode (NBUVB-LED) on serum 25(OH)D levels. Thus, the purpose of this study was to investigate the effect of NBUVB-LED exposure on serum 25(OH)D concentrations. Two healthy adults were enrolled in this pilot study. Their skin was exposed to ultraviolet B light (60 mJ/cm2) 3 times a week for 4 weeks in the first intervention and every day for 4 weeks in the second intervention. Serum levels of 25(OH)D were measured every 2 weeks. Serum 25(OH)D levels were decreased in both subjects at the end of the first intervention (32.1 → 21.4 ng/mL, 33.9 → 21.4 ng/mL, respectively), whereas serum 25(OH)D levels were increased in the 2 weeks of the second intervention (29.5 and 28.0 ng/mL, respectively). At the end of the second intervention, the 25(OH)D concentrations were 19.0 and 20.4 ng/mL, respectively. NBUVB-LED exposure might increase serum 25(OH)D concentrations. Future studies should expand the number of participants and adjust for confounding factors.
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Affiliation(s)
- Seok-Hoon Lee
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Nam-Seok Joo
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
- *Correspondence: Nam-Seok Joo, Department of Family Practice and Community Health, Ajou University School of Medicine, 164 Worldcup-ro, Youngtong-gu, Suwon, Gyeonggi-do, Republic of Korea (e-mail: )
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3
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Vashurin I, Barzilai A, Baum S, Ohana O, Pavlotsky F, Greenberger S. The effect of narrow-band ultraviolet B radiation on sleep, happiness, and appetite: A prospective cohort study. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 37:278-284. [PMID: 33351211 DOI: 10.1111/phpp.12648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/09/2020] [Accepted: 12/19/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The health benefits of sunlight are well documented, including the effects on happiness and sleep. However, only a few studies have investigated the benefits of artificial narrow-band ultraviolet B (NB-UVB) radiation. OBJECTIVES To investigate the effect of NB-UVB on sleep quality, happiness, and appetite. METHODS Patients from a single phototherapy unit were selected, and their epidemiological characteristics were documented. Subjects were asked to complete questionnaires including the Pittsburg Sleep Quality Index (PSQI), Subjective Happiness Scale (SHS), and the Simplified Nutritional Appetite Questionnaire (SNAQ) 4 weeks before and after the initiation of the NB-UVB therapy. The sample consisted of 52 patients. RESULTS Four weeks after the initiation of NB-UVB sessions, sleep quality was significantly improved (the PSQI decreased from 6.5 to 5.23 (t = -3.52, P < .01). In contrast, subjective happiness did not improve (the SHS decreased from baseline 5.5 to 5.2, P > .05). Similarly, appetite did not change (the SNAQ score increased from baseline 14.75 to 15.05, P > .05) and body mass index was not affected by phototherapy. In general, men were found to have better sleep quality before and after UV light therapy. CONCLUSION Our data suggest that NB-UVB exposure over 4 weeks improves sleep quality; however, it does not influence happiness or appetite.
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Affiliation(s)
- Ilan Vashurin
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Aviv Barzilai
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Sharon Baum
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Orly Ohana
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Felix Pavlotsky
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Phototherapy Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Shoshana Greenberger
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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4
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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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5
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Serrano MA, Moreno JC. Spectral transmission of solar radiation by plastic and glass materials. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 208:111894. [PMID: 32450467 DOI: 10.1016/j.jphotobiol.2020.111894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/30/2020] [Accepted: 05/10/2020] [Indexed: 12/14/2022]
Abstract
It is well known that excessive exposure to solar ultraviolet (UV) radiation can have serious adverse effects. Many everyday materials influence the UV radiation received by humans, for example, those used in construction and on the exterior of buildings such as plastics and glass can reduce the UV exposure of persons exposed to solar radiation. In this paper we analyse the spectral transmission of solar radiation of widely used materials using the transmittance parameter. The measurements were performed on clear days, at 8 h and 12 solar hours, in July 2018 (five days) and in January 2019 (three days). The spectral transmittances of these materials and the integrated transmittances in the UVB from 300 nm, UVA, visible (VIS) and near infrared ranges (NIR) were calculated. In summer in the UVB range from 300 nm methacrylate and smoked glass have the highest transmittance values (56%) and polycarbonate present the lowest (30%). In the VIS and NIR ranges methacrylate (95%) and smoked glass (80%) have the highest transmittances and polycarbonate the lowest (45%). In general the 8 h transmittances are higher than those at 12 h and are also higher in winter than summer. For two biological functions (erythemal and DNA-damage) and for the UVB range from 300 nm, the transmittance for most materials (except fibreglass) is in the range 6-14%. The exposure times obtained show that erythemal damage could occur after long exposure to solar radiation through the materials studied, information which should be made available to the general public.
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Affiliation(s)
- María-Antonia Serrano
- Centre for Biomaterials and Tissue Engineering, Universitat Politècnica de València, Camino de Vera, s/n, 46022 Valencia, Spain..
| | - Juan Carlos Moreno
- Departamento de Física Aplicada, Universitat Politècnica de València, Valencia, Spain.
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Effects of ultraviolet irradiation with a LED device on bone metabolism associated with vitamin D deficiency in senescence-accelerated mouse P6. Heliyon 2020; 6:e03499. [PMID: 32140604 PMCID: PMC7052073 DOI: 10.1016/j.heliyon.2020.e03499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/13/2019] [Accepted: 02/24/2020] [Indexed: 12/31/2022] Open
Abstract
Aims This study investigated effects of narrow-range ultraviolet irradiation (UVR) by a new UV–LED device on vitamin D supply and changes of bone in senescence-accelerated mouse P6 (SAMP6) with vitamin D deficiency. Main methods We used female SAMP6 mice as a senile osteoporotic model. We set a total of 3 groups (n = 4 per group); D-UVR+ group (vitamin D deficient–dietary and UVR), D- (vitamin D deficient–dietary), and D+ groups (vitamin D contained–dietary). Mice in the D-UVR + group were UV–irradiated (305nm) with 1 kJ/m2 twice a week for 12 weeks from 20 to 32 weeks of age. Serum 25(OH)D, 1,25(OH)2D, and micro–computed tomography (CT) were assessed over time. Mechanical test, and histological assay were performed for femurs removed at 32 weeks of age. Key findings UVR increased both serum 25(OH)D and 1,25(OH)2D levels at 4 and 8 weeks–UVR in the D-UVR+ group compared with that in the D- group (P < 0.05, respectively). Relative levels of trabecular bone mineral density in micro–CT were higher in the D-UVR+ group than in the D- group at 8 weeks–UVR (P = 0.048). The ultimate load was significantly higher in the D-UVR+ group than in the D- group (P = 0.036). In histological assay, fewer osteoclasts and less immature bone (/mature bone) could be observed in the D-UVR+ group than in the D- group, significantly. Significance UVR may have possibility to improve bone metabolism associated with vitamin D deficiency in SAMP6 mice.
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Scragg RKR, Stewart AW, McKenzie RL, Reeder AI, Liley JB, Allen MW. Sun exposure and 25-hydroxyvitamin D 3 levels in a community sample: Quantifying the association with electronic dosimeters. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:471-477. [PMID: 27599885 DOI: 10.1038/jes.2016.51] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 11/02/2015] [Indexed: 06/06/2023]
Abstract
There is uncertainty about the amount of sun exposure required to increase low blood 25-hydroxyvitamin D (25(OH)D3) levels, a possible disease risk factor. The study aimed to quantify the association between sun exposure and serum 25(OH)D3 concentrations in a multiethnic community sample (n=502) living in Auckland (37°S) and Dunedin (46°S), New Zealand, aged 18-85 years. They wore electronic ultraviolet dosimeters between March and November (autumn, winter and spring) for 8 weeks to record their sun exposure. This was converted to standard erythemal doses (SEDs), corrected for clothing to generate equivalent full-body exposures, SEDEFB. Blood samples were collected at the end of weeks 4 and 8 to measure 25(OH)D3. Median weekly SEDEFB was 0.33 during weeks 1-4 and 0.34 during weeks 5-8. Weekly exposures <0.5 SEDEFB during weeks 5-8 were associated with decreasing 25(OH)D3 concentrations at the end of week 8. There was a non-linear association between sun exposure and 25(OH)D3, with most of the increase in 25(OH)D3 being at exposures <2 SEDEFB per week. This finding suggests that vitamin D status is increased by regular small sun exposures (<2 SEDEFB per week), and that greater exposures result in only small additional increases in 25(OH)D3.
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Affiliation(s)
- Robert K R Scragg
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Alistair W Stewart
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Richard L McKenzie
- National Institute of Water and Atmospheric Research, Lauder, New Zealand
| | - Anthony I Reeder
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - J Ben Liley
- National Institute of Water and Atmospheric Research, Lauder, New Zealand
| | - Martin W Allen
- Department of Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand
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8
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Libon F, Courtois J, Le Goff C, Lukas P, Fabregat-Cabello N, Seidel L, Cavalier E, Nikkels AF. Effect of Body Site and Surface on Vitamin D and 25-Hydroxyvitamin D Production after a Single Narrowband UVB Exposure. J Invest Dermatol 2017; 137:1391-1393. [DOI: 10.1016/j.jid.2017.01.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/24/2017] [Accepted: 01/27/2017] [Indexed: 12/21/2022]
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9
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Weber B, Bachmann CC, Braun R, Abraham AG, Serra AL, Hofbauer GFL. 25-Hydroxyvitamin-D3 serum modulation after use of sunbeds compliant with European Union standards: A randomized open observational controlled trial. J Am Acad Dermatol 2017; 77:48-54. [PMID: 28416344 DOI: 10.1016/j.jaad.2017.02.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Regular use of sunbed exposure has been reported to increase 25-hydroxyvitamin-D3 [25(OH)D] serum levels. However, the influence of sunbeds compliant with the recent European Union standard EN-60335-2-27 on 25(OH)D serum levels is unknown. OBJECTIVE We investigated the impact of standard sunbed use compliant with the European Union standard on 25(OH)D serum modulation and well-being. METHODS In a randomized controlled study, 25(OH)D serum levels were measured at enrollment, after 1 week, and after completion of the 12-week period of sunbed use with twice weekly exposure and compared with the control group without any sunbed exposure. RESULTS In the sunbed intervention group (N = 31), a 27% increase of mean 25(OH)D levels was noted 1 week after starting sunbed use (P < .01). However, after 12 weeks, mean 25(OH)D levels had declined and were no longer different from baseline (P = .06). After 12 weeks, 25(OH)D levels did not differ between the intervention and control group (P = .36). Also the 5-item World Health Organization Well-Being Index score did not differ between the sunbed and control groups (P = .19). LIMITATIONS For ethical reasons recruitment was limited to persons actively seeking sunbed exposure. CONCLUSIONS Standard use of sunbeds compliant with the European Union standard induced a transient increase of 25(OH)D levels, whereas no change in well-being was observed.
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Affiliation(s)
- Benedikt Weber
- Department of Dermatology, University Hospital Zurich, Zürich, Switzerland
| | - Chantal C Bachmann
- Department of Dermatology, University Hospital Zurich, Zürich, Switzerland
| | - Ralph Braun
- Department of Dermatology, University Hospital Zurich, Zürich, Switzerland
| | - Alison G Abraham
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Andreas L Serra
- Department of Internal Medicine, Hirslanden Hospital, Zürich, Switzerland
| | - Günther F L Hofbauer
- Department of Dermatology, University Hospital Zurich, Zürich, Switzerland; Department of Internal Medicine, Hirslanden Hospital, Zürich, Switzerland.
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10
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Vitamin D and ultraviolet phototherapy in Caucasians. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 147:69-74. [DOI: 10.1016/j.jphotobiol.2015.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 02/02/2023]
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11
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Osmancevic A, Sandström K, Gillstedt M, Landin-Wilhelmsen K, Larkö O, Wennberg Larkö AM, F. Holick M, Krogstad AL. Vitamin D production after UVB exposure – A comparison of exposed skin regions. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 143:38-43. [DOI: 10.1016/j.jphotobiol.2014.12.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 12/18/2014] [Accepted: 12/27/2014] [Indexed: 12/29/2022]
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12
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Gruber-Wackernagel A, Byrne SN, Wolf P. Polymorphous light eruption: clinic aspects and pathogenesis. Dermatol Clin 2015; 32:315-34, viii. [PMID: 24891054 DOI: 10.1016/j.det.2014.03.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Polymorphous light eruption is an immunologically mediated photodermatosis with high prevalence, particularly among young women in temperate climates, characterized by pruritic skin lesions of variable morphology, occurring in spring or early summer on sun-exposed body sites. A resistance to ultraviolet radiation (UVR)-induced immunosuppression and a subsequent delayed-type hypersensitivity response to a photoantigen have been suggested as key factors in the disease. Molecular and immunologic disturbances associated with disease pathogenesis include a failure of skin infiltration by neutrophils and other regulatory immune cells on UVR exposure linked to a disturbed cytokine microenvironment. Standard management is based on prevention.
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Affiliation(s)
- Alexandra Gruber-Wackernagel
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria
| | - Scott N Byrne
- Cellular Photoimmunology Group, Infectious Diseases and Immunology, Department of Dermatology, Sydney Medical School, Royal Prince Alfred Hospital, The University of Sydney, 676, Blackburn Building D06, Darlington, New South Wales 2006, Australia
| | - Peter Wolf
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria.
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Sehrawat M, Arora TC, Chauhan A, Kar HK, Poonia A, Jairath V. Correlation of Vitamin D Levels with Pigmentation in Vitiligo Patients Treated with NBUVB Therapy. ISRN DERMATOLOGY 2014; 2014:493213. [PMID: 25006488 PMCID: PMC4005019 DOI: 10.1155/2014/493213] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 02/05/2014] [Indexed: 01/21/2023]
Abstract
Cholecalciferol (vitamin D) might play a physiological role in photo-induced melanogenesis in human skin. We estimated the levels of 25-hydroxy vitamin D [25(OH)D] before, during, and after Narrow Band Ultraviolet B (NBUVB) radiation in patients of vitiligo and their correlation with NBUVB induced pigmentation. Thirty patients of vitiligo and equal number of age and sex matched controls were recruited for the study. Vitiligo patients were treated with NBUVB thrice weekly for 12 weeks. [25(OH)D] levels and Vitiligo Area and Severity Index (VASI) were calculated at 0 (baseline), 6, and 12 weeks. Baseline [25(OH)D] levels were measured in controls. Significant reduction in VASI score was observed after 12 weeks of therapy. Comparison and correlation between mean improvement in VASI and [25(OH)D] levels at 12 weeks showed moderate correlation, and the results were statistically insignificant. Mean reduction in VASI and increase in [25(OH)D] levels after 12 weeks of NBUVB showed moderate correlation. Thus, vitamin D might play a significant role in photo-induced melanogenesis. However, there might be additional effects of the phototherapy on melanogenesis. The complete mechanism of NBUVB induced pigmentation in vitiligo needs to be elucidated.
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Affiliation(s)
| | | | | | | | - Amitabh Poonia
- Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana 124001, India
| | - Vijayeeta Jairath
- Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana 124001, India
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14
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Rose RF, Williams C, Oliphant T, Browne F, Turner D, Goulden V. Serum 25-hydroxyvitamin D levels in patients with atopic eczema and the influence of narrowband ultraviolet B phototherapy. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2014; 30:287-93. [DOI: 10.1111/phpp.12117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | - Fiona Browne
- Dermatology Department; Chapel Allerton Hospital; Leeds UK
| | - David Turner
- Dermatology Department; Chapel Allerton Hospital; Leeds UK
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15
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Shin YH, Park JH, Sung MS, Kim SW. Correlation between serum 25-hydroxyvitamin D levels and severity of atopic dermatitis in children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2014. [DOI: 10.4168/aard.2014.2.2.114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Young Hye Shin
- Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea
| | - Jong Ha Park
- Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea
| | - Myoung Soon Sung
- Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea
| | - Sung Won Kim
- Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea
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16
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Phototherapy with UVB narrowband, UVA/UVBnb, and UVA1 differentially impacts serum 25-hydroxyvitamin-D3. J Am Acad Dermatol 2013; 69:530-6. [DOI: 10.1016/j.jaad.2013.04.058] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/02/2013] [Accepted: 04/16/2013] [Indexed: 01/30/2023]
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17
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Gruber-Wackernagel A, Obermayer-Pietsch B, Byrne SN, Wolf P. Patients with polymorphic light eruption have decreased serum levels of 25-hydroxyvitamin-D3 that increase upon 311 nm UVB photohardening. Photochem Photobiol Sci 2013; 11:1831-6. [PMID: 22952008 DOI: 10.1039/c2pp25188d] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Polymorphic light eruption (PLE) is a very common condition whose pathogenesis may involve immunological abnormalities. Vitamin D sufficiency is thought to be important for normal immune function. OBJECTIVE To determine whether PLE patients are vitamin D deficient and to study how photohardening with 311 nm UVB affects the vitamin D status of PLE patients. METHODS The vitamin D status of 23 PLE patients (21 females and 2 males; age range, 18-55 years) was analysed at four different time points (early spring, late spring, summer, and winter) by measuring 25-hydroxyvitamin-D(3) (25(OH)D) serum levels through a standardised immunoassay. Fifteen of those patients received 311 nm UVB in early spring for prevention of PLE symptoms. 25(OH)D levels of the PLE patients were compared to that of 23 sex-, age-, and body-mass-index post hoc-matched control subjects. RESULTS PLE patients had low levels of 25(OH)D throughout the year compared to that of the control subjects. At baseline in early spring, the mean ± SD 25(OH)D level was 14.9 ± 3.0 ng ml(-1) in the PLE patients that would later receive 311 nm UVB and 14.4 ± 2.4 ng ml(-1) in the patients not receiving 311 nm UVB. Successful prophylactic treatment with 311 nm UVB significantly increased 25(OH)D levels to a mean of 21.0 ± 3.4 ng ml(-1) (p < 0.001; ANOVA, Tukey's test). Heading into summer, the 25(OH)D levels in treated patients decreased again, reaching their lowest levels in winter. In contrast, the 25(OH)D levels of untreated PLE patients stayed in the low range in early and late spring but increased by trend towards summer, reaching similar levels to that of the PLE patients who had received 311 nm UVB (17.1 ± 2.3 vs. 17.3 ± 6.0 ng ml(-1)). Like the treated PLE patients, 25(OH)D levels of untreated patients significantly decreased in winter to comparable levels (12.2 ± 1.9 vs. 13.8 ± 1.8 ng ml(-1)). Taken together, the 25(OH)D levels of PLE patients were significantly lower at all time points than that observed in the matched control population (34.4 ± 12.5 ng ml(-1)) (p < 0.000003). CONCLUSIONS PLE patients have low 25(OH)D serum levels. 311 nm UVB phototherapy that prevented PLE symptoms increased those levels. Thus, we speculate that boosting levels of vitamin D may be important in ameliorating PLE.
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Macdonald HM. Contributions of sunlight and diet to vitamin D status. Calcif Tissue Int 2013; 92:163-76. [PMID: 23001438 DOI: 10.1007/s00223-012-9634-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 07/16/2012] [Indexed: 10/27/2022]
Abstract
Vitamin D is made in the skin using ultraviolet radiation of specific low wavelength, 290-315 nm (UVB). For many parts of the world there is a period when there is insufficient intensity of UVB to make vitamin D, which is reflected by a clear seasonal variation in vitamin D status. Sun avoidance practices, melanin in pigmented skin, and sun protection creams (sunscreen), if used properly, can dramatically reduce vitamin D synthesis. Few foods naturally contain vitamin D, although some countries fortify foods with vitamin D. Regulatory mechanisms in the skin mean there is no danger of vitamin D toxicity through sunlight synthesis. Although oral vitamin D is potentially toxic with high-dose supplements, there is a wide safety margin. Long-term safety data covering a range of potential adverse outcomes are limited.
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Affiliation(s)
- Helen M Macdonald
- Musculoskeletal Research, Health Sciences Building, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK.
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19
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Roth DE, Al Mahmud A, Raqib R, Black RE, Baqui AH. Pharmacokinetics of a single oral dose of vitamin D3 (70,000 IU) in pregnant and non-pregnant women. Nutr J 2012; 11:114. [PMID: 23268736 PMCID: PMC3552819 DOI: 10.1186/1475-2891-11-114] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 12/21/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Improvements in antenatal vitamin D status may have maternal-infant health benefits. To inform the design of prenatal vitamin D3 trials, we conducted a pharmacokinetic study of single-dose vitamin D3 supplementation in women of reproductive age. METHODS A single oral vitamin D3 dose (70,000 IU) was administered to 34 non-pregnant and 27 pregnant women (27 to 30 weeks gestation) enrolled in Dhaka, Bangladesh (23°N). The primary pharmacokinetic outcome measure was the change in serum 25-hydroxyvitamin D concentration over time, estimated using model-independent pharmacokinetic parameters. RESULTS Baseline mean serum 25-hydroxyvitamin D concentration was 54 nmol/L (95% CI 47, 62) in non-pregnant participants and 39 nmol/L (95% CI 34, 45) in pregnant women. Mean peak rise in serum 25-hydroxyvitamin D concentration above baseline was similar in non-pregnant and pregnant women (28 nmol/L and 32 nmol/L, respectively). However, the rate of rise was slightly slower in pregnant women (i.e., lower 25-hydroxyvitamin D on day 2 and higher 25-hydroxyvitamin D on day 21 versus non-pregnant participants). Overall, average 25-hydroxyvitamin D concentration was 19 nmol/L above baseline during the first month. Supplementation did not induce hypercalcemia, and there were no supplement-related adverse events. CONCLUSIONS The response to a single 70,000 IU dose of vitamin D3 was similar in pregnant and non-pregnant women in Dhaka and consistent with previous studies in non-pregnant adults. These preliminary data support the further investigation of antenatal vitamin D3 regimens involving doses of ≤70,000 IU in regions where maternal-infant vitamin D deficiency is common.
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Affiliation(s)
- Daniel E Roth
- Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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20
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Ala-Houhala MJ, Vähävihu K, Hasan T, Kautiainen H, Ylianttila L, Viljakainen HT, Snellman E, Reunala T. Comparison of narrowband ultraviolet B exposure and oral vitamin D substitution on serum 25-hydroxyvitamin D concentration. Br J Dermatol 2012; 167:160-4. [PMID: 22512509 DOI: 10.1111/j.1365-2133.2012.10990.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND A short course of narrowband ultraviolet B (NB-UVB) exposures increases the serum 25-hydroxyvitamin D [25(OH)D] concentration in patients with psoriasis and healthy subjects. OBJECTIVES To compare the effects of NB-UVB and oral vitamin D substitution in healthy subjects in winter. METHODS Healthy adult hospital employees and medical students were screened for serum 25(OH)D concentration. Those with 25(OH)D below 75 nmol L(-1) were randomly given either 12 NB-UVB exposures or 20 μg of oral cholecalciferol daily for 4 weeks. The NB-UVB exposures were given with a Waldmann UV 7001 cabin and the mean cumulative dose was 48·4 standard erythema doses. Serum 25(OH)D was measured before and after the treatments by radioimmunoassay. RESULTS The baseline serum 25(OH)D concentrations were 52·9 ± 10·4 (mean ± SD) in the 33 NB-UVB-treated and 53·5 ± 12·7 nmol L(-1) in the 30 oral cholecalciferol-treated subjects. The mean increase in serum 25(OH)D was 41·0 nmol L(-1) [95% confidence interval (CI) 34·8-47·2; P < 0·001] in the NB-UVB group and 20·2 nmol L(-1) (95% CI 14·6-26·0; P < 0·001) in the cholecalciferol group. The difference between the two treatments was significant at 2 weeks (P = 0·033) and at 4 weeks (P < 0·001). One month after the treatments the 25(OH)D concentrations had increased further. CONCLUSIONS The present study shows that 12 NB-UVB exposures given during 4 weeks increase serum 25(OH)D concentration significantly more than 20 μg of oral cholecalciferol daily. A short NB-UVB course is an effective way to improve vitamin D balance in winter and the response is still evident 2 months after the course.
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Affiliation(s)
- M J Ala-Houhala
- Department of Dermatology, Tampere University Hospital, PO Box 2000, FIN-33521, Tampere, Finland.
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21
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Milliken SVI, Wassall H, Lewis BJ, Logie J, Barker RN, Macdonald H, Vickers MA, Ormerod AD. Effects of ultraviolet light on human serum 25-hydroxyvitamin D and systemic immune function. J Allergy Clin Immunol 2012; 129:1554-61. [PMID: 22502796 DOI: 10.1016/j.jaci.2012.03.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 02/28/2012] [Accepted: 03/01/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many immune-mediated diseases are associated with low levels of vitamin D and sunlight. UV light or supplementation with vitamin D can increase regulatory T-cell activity and prevent animal models of autoimmune disease. Increasing population vitamin D levels may therefore alleviate the burden of human immune-mediated disease. OBJECTIVE To determine the responses of circulating 25-hydroxyvitamin D [25(OH)D] levels, regulatory T-cell numbers, and immune function to UV light exposure in patients being treated for skin disease. METHODS Twenty-four subjects with skin disease from the North of Scotland were recruited between December and March. At baseline, and after 2 and 4 weeks of narrowband UV light exposure, we measured peripheral blood 25(OH)D level, numbers of regulatory T cells (CD4(+)CD25(hi)FoxP3(+)), and T-cell proliferative and cytokine responses to anti-CD3/CD28 stimulation. RESULTS Median (interquartile range) narrowband UV-B received during the study was 39.1 (30.9) as standard erythema dose, comparable to a quarter of the median summer sunlight exposure received locally. This increased the 25(OH)D level from a mean ± SD of 34 ± 17 nmol/L to 58 ± 16 nmol/L after 2 weeks and 78 ± 19 nmol/L after 4 weeks. The mean proportion of circulating regulatory T cells increased from 0.5% to 1.6% CD3(+) cells, which significantly correlated with the increased 25(OH)D level. UV treatment was also followed by reduced proliferative and IL-10 responses to anti-CD3/CD28 independent of the 25(OH)D level. CONCLUSION Narrowband UV light reduces systemic immune responsiveness via the induction of regulatory T cells. Light and 25(OH)D levels may affect particular immune functions independently. The levels of serum 25(OH)D over which these effects are apparent should guide future interventions.
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Affiliation(s)
- Sarah V I Milliken
- Division of Applied Medicine, University of Aberdeen, Aberdeen, United Kingdom
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22
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Lesiak A, Narbutt J, Pawlaczyk M, Sysa-Jedrzejowska A, Krzyścin J. Vitamin D serum level changes in psoriatic patients treated with narrowband ultraviolet B phototherapy are related to the season of the irradiation. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2012; 27:304-10. [PMID: 22092734 DOI: 10.1111/j.1600-0781.2011.00617.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Vitamin D is produced in the human skin by short wavelength (290-315 nm) ultraviolet (UV) radiation. PURPOSE The aim of the study was to investigate how outdoor conditions may influence the serum levels of 25(OH) vitamin D in psoriasis patients under narrowband ultraviolet B (UVB) phototherapy. METHODS The winter and summer groups of patients received almost the same narrowband UV (nUVB) doses during whole-body phototherapy. The 25(OH)D serum concentration was measured before and after two series of 10 exposures. The cabinet doses were compared with potentially available cumulative solar doses. The solar doses (unweighted UVB and vitamin D effective dose) and duration of solar intensity sufficient to produce vitamin D were calculated using a model based on local atmospheric data. RESULTS After an initial 10 nUVB treatments, 25(OH)D serum concentration increased by 68% for winter patients in relation to the level before therapy, whereas a 20% increase was found for the summer patients. The next 10 treatments caused a much lower increase in 25(OH)D concentration: 5% and 3.5% for the winter and summer patients, respectively. No statistically significant relationship was observed between post-therapy 25(OH)D serum concentration and solar radiation variability. CONCLUSIONS The different baseline values of 25(OH)D serum levels in winter and summer patients result from seasonal variability in solar irradiance. Thus, outdoor solar radiation affects the patients over a much longer period, and artificial UV light is the main factor responsible for increase in 25(OH)D serum level over a 30-day period of cabinet therapy.
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23
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McKenzie R, Scragg R, Liley B, Johnston P, Wishart J, Stewart A, Prematunga R. Serum 25-hydroxyvitamin-D responses to multiple UV exposures from solaria: inferences for exposure to sunlight. Photochem Photobiol Sci 2012; 11:1174-85. [PMID: 22411223 DOI: 10.1039/c2pp05403e] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We investigate the relationship between blood serum 25-hydroxyvitamin D (25(OH)D) and UV exposure from two artificial sources. We then use the results to test the validity of the action spectrum for vitamin D production, and to infer the production from summer and winter sunlight. The results are based on a two-arm randomised clinical trial of biweekly UV exposure for 12 weeks using two different types of dermatological booths: one emitting primarily UV-A radiation, and the other emitting primarily UV-B radiation (booth A and booth B respectively). In terms of the vitamin D production per unit erythema, one of the booths mimics summer noon sunlight, while the other mimics winter noon sunlight. Blood samples were taken before and after the exposures. For all participants, the phototherapy booth treatments arrested the usual wintertime decline in 25(OH)D, and for most the treatments from either booth resulted in significant increases. The increases were highly non-linear and there was a high degree of variability in 25(OH)D and its response to UV from person to person. By the end of the 12 week period, the mean increase was >30 nmol l(-1) from a cumulative exposure of 17 SED from the UV-A booth, and twice that for the UV-B booth for which the cumulative exposure was 268 SED. Assuming a logarithmic relationship between UV and vitamin D, the results for the two booths show no obvious inconsistency in the action spectrum for pre-vitamin D production. However, further measurements with similar exposures from each booth are required to confirm its validity. A model was developed to describe the increases in serum 25(OH)D resulting from the UV exposures, which differed markedly between the two booths. The deduced initial rate of increase of 25(OH)D was approximately 5 nmol l(-1) per SED. From the large increases in 25(OH)D from each booth, along with knowledge of the spectral distribution of sunlight and assuming the currently-accepted action spectrum for photo-conversion to pre-vitamin D, we infer that the production of 25(OH)D from sunlight should be possible throughout the year, although in winter the exposures necessary to maintain optimal levels of 25(OH)D would be impractically long. This finding is at variance with the commonly-held view that no vitamin D is produced at mid-latitudes in the winter. Further work is needed to resolve that inconsistency.
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Affiliation(s)
- Richard McKenzie
- National Institute of Water & Atmospheric Research, NIWA Lauder, PB 50061, Omakau, Central Otago, 9352, New Zealand.
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24
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Ala-Houhala MJ, Vähävihu K, Hasan T, Kautiainen H, Snellman E, Karisola P, Dombrowski Y, Schauber J, Saha H, Reunala T. Narrow-band ultraviolet B exposure increases serum vitamin D levels in haemodialysis patients. Nephrol Dial Transplant 2011; 27:2435-40. [PMID: 22180542 DOI: 10.1093/ndt/gfr700] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) patients are especially prone to vitamin D insufficiency. Narrow-band ultraviolet B (NB-UVB) treatment increases serum 25-hydroxyvitamin D [25(OH)D] in dermatological patients, and we studied whether it also improves vitamin D balance in CKD patients on haemodialysis. METHODS Fifteen dialysis patients (mean age 48.3 years) and 12 healthy subjects (mean age 43.6 years) received nine NB-UVB exposures on the upper body. Serum 25(OH)D and 1,25(OH)(2)D were measured before and after the exposures. From skin biopsy specimen messenger RNA (mRNA) expression levels of CYP24A1 and CYP27B1, two enzymes needed for hydroxylation of vitamin D into its active metabolites, and of antimicrobial peptide cathelicidin, were examined. RESULTS Before NB-UVB, mean serum 25(OH)D was 32.5 ± 10.2 nmol/L in the dialysis patients and 60.2 ± 18.0 nmol/L in the healthy subjects (P < 0.001). After eight NB-UVB exposures, serum 25(OH)D increased by 13.8 nmol/L (43%; P < 0.001) and serum 1,25(OH)(2)D by 3.3 pmol/L (27%; P = 0.002) in the dialysis patients. After NB-UVB exposures, CYP27B1 mRNA was increased (P = 0.04), whereas cathelicidin mRNA was decreased (P < 0.0001) compared to non-treated healthy subjects. One and 2 months after NB-UVB exposure, serum 25(OH)D was still 10% higher than initially in the dialysis patients. CONCLUSIONS The present study shows that a short course of NB-UVB exposure increases significantly serum 25(OH)D and 1,25(OH)(2)D in dialysis patients. The effect is, however, short lasting suggesting that the patients need cyclic NB-UVB exposure to maintain their improved vitamin D concentration.
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Affiliation(s)
- Meri J Ala-Houhala
- Department of Dermatology, Tampere University Hospital, Tampere, Finland.
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25
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Vähävihu K, Ylianttila L, Kautiainen H, Tuohimaa P, Reunala T, Snellman E. Spore film dosimeters are feasible for UV dose monitoring during heliotherapy. Photochem Photobiol 2011; 86:1174-8. [PMID: 20573044 DOI: 10.1111/j.1751-1097.2010.00769.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objective of the study was to compare Bacillus subtilis spore film dosimeters with a Robertson Berger UV meter (RB meter) and diary records for assessing personal UV-B doses during a 13-day heliotherapy (HT) for atopic dermatitis (AD). In addition, the relationship between the personal UV-B dose and change in serum 25-hydroxyvitamin D (25(OH)D) was studied. Altogether 21 adult patients with AD completed the study arranged in the Canary Islands, either in January or March 2005. The spore film dosimeters were used throughout the day during the HT. Serum 25(OH)D was analyzed using radioimmunoassay. The mean personal UV-B dose measured with the dosimeters was 75 SED in January and 131 SED in March. The respective results gained from the RB meter combined with diary records were 63 SED and 119 SED showing a close correlation with the dosimeter results. Serum 25(OH)D concentration increased by 9.7nmol L(-1) in January and by 26.0 7nmol L(-1) in March. The increase in serum 25(OH)D correlated with the UV-B dose received. The patients complied well to use the dosimeters. We conclude spore films to be a feasible and reliable personal UV dosimeter in vivo in field conditions.
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Affiliation(s)
- Katja Vähävihu
- Department of Dermatology, Päijät-Häme Central Hospital, Lahti, Finland.
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26
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Diffey BL. Is casual exposure to summer sunlight effective at maintaining adequate vitamin D status? PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2010; 26:172-6. [PMID: 20626818 DOI: 10.1111/j.1600-0781.2010.00518.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND/PURPOSE The advice that an adequate vitamin D status can be achieved by short, casual exposure to summer sunlight is ubiquitous. This review will examine the value of this advice. METHODS The results of experimental studies on changes in serum 25-hydroxyvitamin D [25(OH)D] concentrations following ultraviolet exposure are interpreted in the context of human exposure to sunlight. RESULTS It is shown that current advice about modest sun exposure during the summer months does little in the way of boosting overall 25(OH)D levels, while sufficient sun exposure that could achieve a worthwhile benefit would compromise skin health. CONCLUSIONS Failure to understand the nature of human exposure to sunlight has led to misguided advice concerning the sun exposure necessary for an adequate vitamin D status.
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Affiliation(s)
- Brian L Diffey
- Department of Dermatological Sciences, Institute of Cellular Medicine, University of Newcastle, Newcastle Upon Tyne, UK.
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27
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Vähävihu K, Ala-Houhala M, Peric M, Karisola P, Kautiainen H, Hasan T, Snellman E, Alenius H, Schauber J, Reunala T. Narrowband ultraviolet B treatment improves vitamin D balance and alters antimicrobial peptide expression in skin lesions of psoriasis and atopic dermatitis. Br J Dermatol 2010; 163:321-8. [PMID: 20331450 DOI: 10.1111/j.1365-2133.2010.09767.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Narrowband ultraviolet B (NB-UVB) is a routine treatment for psoriasis and atopic dermatitis (AD) but its effect on vitamin D balance is not well studied. OBJECTIVES To examine whether NB-UVB treatment in winter improves vitamin D balance in psoriasis and AD, and to study the effects of NB-UVB on antimicrobial peptide and cytokine expression in the skin. METHODS Eighteen adult patients with psoriasis, 18 with AD and 15 healthy subjects received a total of 15 NB-UVB exposures on the whole body, given three times a week. Serum calcidiol (25-hydroxyvitamin D) was measured by radioimmunoassay. Antimicrobial peptide and cytokine expression in skin lesions was examined by real-time quantitative polymerase chain reaction. RESULTS At onset 16 (89%) patients with psoriasis, 17 (94%) patients with AD and eight (53%) healthy subjects had vitamin D insufficiency (calcidiol < 50 nmol L(-1)). NB-UVB treatment significantly increased (P < 0.001) serum calcidiol. The increase was 59.9 nmol L(-1) (95% confidence interval, CI 53.5-66.9) in psoriasis, 68.2 nmol L(-1) (95% CI 55.4-80.1) in AD and 90.7 nmol L(-1) (95% CI 63.8-123.4) in healthy subjects. Psoriasis Area and Severity Index and SCORAD improved significantly (P < 0.001) but no correlation to the increase of serum calcidiol was found. Cathelicidin and human beta-defensin 2 (HBD2) expression was high in skin lesions of psoriasis. After six NB-UVB treatments cathelicidin increased further while HBD2 expression decreased. A similar trend was observed in AD lesions. NB-UVB caused a marked but nonsignificant decrease of interleukin (IL)-1beta and IL-17 in psoriasis lesions. CONCLUSIONS The present study shows that in addition to a significant improvement of psoriasis and AD, NB-UVB treatment effectively corrects vitamin D insufficiency. It also increases cathelicidin and decreases HBD2 levels in healing skin lesions of psoriasis and AD. This effect might be mediated by improved vitamin D balance and the local cytokine network.
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Affiliation(s)
- K Vähävihu
- Department of Dermatology, Tampere University Hospital, PO Box 2000, FIN-33531 Tampere, Finland.
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