Psoralens, UVA (PUVA) and photocarcinogenesis

Revisiting carotenoids as dietary antioxidants for human health and disease prevention

Humans are unique indiscriminate carotenoid accumulators, so the human body accumulates a wide range of dietary carotenoids of different types and to varying concentrations. Carotenoids were once recognized as physiological antioxidants because of their ability to quench singlet molecular oxygen (1O2). In the 1990s, large-scale intervention studies failed to demonstrate that supplementary β-carotene intake reduces the incidence of lung cancer, although its antioxidant activity was supposed to contribute to the prevention of oxidative stress-induced carcinogenesis. Nevertheless, the antioxidant activity of carotenoids has attracted renewed attention as the pathophysiological role of 1O2 has emerged, and as the ability of dietary carotenoids to induce antioxidant enzymes has been revealed. This review focuses on six major carotenoids from fruit and vegetables and revisits their physiological functions as biological antioxidants from the standpoint of health promotion and disease prevention. β-Carotene 9',10'-oxygenase-derived oxidative metabolites trigger increases in the activities of antioxidant enzymes. Lutein and zeaxanthin selectively accumulate in human macular cells to protect against light-induced macular impairment by acting as antioxidants. Lycopene accumulates exclusively and to high concentrations in the testis, where its antioxidant activity may help to eliminate oxidative damage. Dietary carotenoids appear to exert their antioxidant activity in photo-irradiated skin after their persistent deposition in the skin. An acceptable level of dietary carotenoids for disease prevention should be established because they can have deleterious effects as prooxidants if they accumulate to excess levels. Finally, it is expected that the reason why humans are indiscriminate carotenoid accumulators will be understood soon.

Tanning accelerators: prevalence, predictors of use, and adverse effects

BACKGROUND

Tanning accelerators are topical products used by indoor tanners to augment and hasten the tanning process. These products contain tyrosine, psoralens, and/or other chemicals.

OBJECTIVE

We sought to better define the population using accelerators, identify predictors of their use, and describe any related adverse effects.

METHODS

This cross-sectional study surveyed 200 indoor tanners about their tanning practices and accelerator use. Primary analysis compared accelerator users with nonusers with respect to questionnaire variables. Descriptive statistics and χ(2) contingency tables were applied to identify statistically significant variables.

RESULTS

Of respondents, 53% used accelerators; 97% were female and 3% were male with a median age of 22 years (range: 19-67). Users were more likely to spray tan, tan frequently, and be addicted to tanning. Acne and rashes were more common in accelerator users. Adverse reactions to accelerators prevented their further use 31% of the time.

LIMITATIONS

A limited adult population was evaluated; exact accelerator ingredients were not examined.

CONCLUSIONS

Tanning accelerator users are high-risk indoor tanners who tan more frequently and who are more likely addicted to tanning. Acne and rashes are more common with these products and act as only mild deterrents to continued use. Additional research should investigate accelerators' longer-term health effects.

Growth inhibition of mammalian cells by synthetic and natural photosensitising agents

Amammalian cell line, J774, was susceptible to both synthetic and natural photosensitising agents after irradiation with long-wave ultraviolet light. Both UV-A light and psoralen did not affect cell growth individually; a reduction invisual confluency was achieved only when psoralen and UV-A light were used in combination. The maximum visual confluency decreased by 55% when 50 ppm psoralen was added to a growing culture and irradiated with UV light for 3 min. Decreasing the UV-A exposure times from 3min to 3 s did not greatly affect the maximum total visual confluence reached using different synthetic psoralen concentrations, but did affect the rate at which cell death occurred. The 3 min exposure time resulted in a rapid decrease in cell numbers in comparison to 3s exposure time. Synthetic psoralen was found to have an increasing photosensitising activity with increasing concentration using a logarithmic shift between 0.5 ppm and 50 ppm. A visual confluency of 45 % was achieved using concentrations of 50 ppm psoralen, and 70% visual confluency using 0.5 ppm. Natural mixtures of furanocoumarins containing psoralens, obtained from two separate parsley sources, were found to have greater efficacy at inhibiting the growth cycle of the cells when compared to the synthetic psoralen.

A novel group of ovarian toxicants: the psoralens

The psoralens are naturally occurring metabolites found in many crop plants; synthetic forms of 5-methoxypsoralen (bergapten) and 8-methoxypsoralen (xanthotoxin) are widely used in skin photochemotherapy. Our previous research documented that dietary bergapten and xanthotoxin reduced birthrates in female rats when males and females were exposed to these chemicals. The present study was designed to determine the cause of this reduced birthrate and whether this resulted from direct impact on the females. The study demonstrates that bergapten and xanthotoxin administered, either alone or in combination to female rats (mated to undosed males), significantly reduced the number of implantation sites, pups, and corpora lutea in dosed females compared with control animals. Additionally, full uterine weight and empty uterine weight were significantly reduced. These compounds also significantly reduced circulating estrogen levels in a dose-dependent manner. Interestingly, the psoralens significantly induced mRNAs of liver enzymes typically induced by polycyclic aromatic hydrocarbons, CYP1A1 and UGT1A6; the higher the dose, the greater the induction. UGT 2B1 mRNA, typically induced by phenobarbital-like compounds, was not significantly affected. Thus, enhanced oxidative metabolism and conjugation of estrogens in psoralen-treated animals may provide a partial explanation for the effects observed. These findings are also consistent with psoralen-induced reduction in ovarian follicular function and ovulation.

Phototoxicity and photoallergy

Photosensitivity may be phototoxic or photoallergic. Phototoxicity is much more common. There are 2 types of phototoxicity: photodynamic, which requires oxygen, and nonphotodynamic, which does not. Reactions induced by porphyrin molecules, coal tar derivatives, and many drugs are photodynamic. The reaction induced by psoralens, for the most part, is nonphotodynamic. Acute phototoxic reactions are characterized by erythema and edema followed by hyperpigmentation. Long-term ultraviolet phototoxicity results in chronic sun damage and skin cancer formation. Also, certain chemicals such as psoralen molecules and coal tar are photocarcinogenic. Phototoxic reactions to certain drugs produce unusual clinical patterns, that is lichenoid eruptions, dyschromia, photo-onycholysis, and pseudoporphyria. Photoallergy is an uncommon acquired altered reactivity dependent on an immediate antibody or a delayed cell mediated reaction. Solar urticaria is an example of the former, whereas photoallergy to exogenous chemicals is an example of the latter. Photoallergy to systemic drugs does occur but is difficult to characterize. The action spectrum for photoreactions to exogenous agents usually at least includes the ultraviolet A rays for both phototoxicity and photoallergy.

The unusual UVA-dependent antiviral properties of the furoisocoumarin, coriandrin

The novel furoisocoumarin, coriandrin, which was found recently to possess an interesting combination of photobiological properties, was investigated for antiviral activity in the presence and absence of UVA (long-wavelength ultraviolet radiation). In contrast to results obtained with other antiviral furocoumarins, such as 8-MOP (8-methoxypsoralen), coriandrin was much more phototoxic to the RNA-virus Sindbis virus than to the DNA-virus murine cytomegalovirus, although both viruses were substantially more sensitive to this compound than they were to 8-MOP. Human immunodeficiency virus, HIV-1, was also susceptible to coriandrin + UVA. Another unexpected finding was that viruses without membranes were completely resistant to coriandrin. This suggests that a membrane component was a target for the compound. The antiviral activity of coriadrin was profoundly inhibited by serum components in the reaction mixtures, which suggests that the compound may have a strong affinity for certain protein or lipid materials, although maximal interference was only obtained when all components of the reaction mixture, virus, coriandrin and serum, were irradiated simultaneously. Thus it appears that coriandrin has unusual antiviral properties that would not be predicted from its chemical similarity to furocoumarins.

Transient absorption spectra and quenching of coumarin excited states by nucleic acid bases

Triplet-triplet absorption spectra of coumarin show different profiles and maxima in ethanol from those in water, which are very similar to those reported in benzene. Long-lived transient species other than triplet states were generated as initial photoproducts between coumarins and nucleic acid bases. The excited singlet and triplet states of coumarins were quenched by nucleic acid bases. Adenine base quenched the excited singlet state of coumarins more efficiently than thymine base. However, photocycloadducts of furocoumarins are formed predominantly with thymine, and not with adenine. Moreover, it is reported that the poly[dA-dT].poly[dA-dT] sequence region is the most favourable site for the photocycloaddition reaction of furocoumarins. The results imply that adenine contributes to singlet-state photocycloaddition reaction of furocoumarins with thymine, probably through an adenine-furocoumarin-thymine termolecular interaction.

Therapeutic potential of plant photosensitizers

Many bioactive phytochemicals have been shown in recent years to be photosensitizers, i.e. their toxic activities against viruses, micro-organisms, insects or cells are dependent on or are augmented by light of certain wavelengths. These activities are often selective, and this has led to the concept of therapeutic prospects in the control of infectious diseases, pests and cancer. Reaction mechanisms commonly involve singlet oxygen and radicals, which are thought to cause photodamage to membranes or macromolecules. The main classes of plant photosensitizers reviewed here are polyyines (acetylenes, thiophenes and related compounds); furanyl compounds; beta-carbolines and other alkaloids; and complex quinones. We propose that within each group of phytochemicals there are several representatives that merit further study for therapeutic abilities in appropriate animal models.

Mutagenic effects photoinduced in normal human lymphoblasts by a monofunctional pyridopsoralen in comparison to 8-methoxypsoralen

The photobiological effects induced by the monofuctional 7-methylpyrido[3,4-c]psoralen (MePyPs) in comparison to the bifunctional furocoumarin 8-methoxypsoralen (8-MOP) have been studied in a human lymphoblast cell line TK6. We report that, in human lymphoblasts, the cytotoxic effect of MePyPs plus UVA (365 nm) is much higher than that of 8-MOP plus 365-nm irradiation. The dose-modifying factor at the 37% survival level between the 2 compounds equals 120. Mutation induction by photoactivated MePyPs and 8-MOP has been studied in 2 genetic loci, hypoxanthine phosphoribosyl transferase (HPRT) and Na+/K+ ATPase. For equal UVA doses, the mutagenic effectiveness of MePyPs was higher than that of 8-MOP. However at equal survival levels, the mononfuctional psoralen MePyPs was less efficient than the bifunctional 8-MOP. In other words, compared to 8-MOP, the monofunctional agent MePyPs is more cytotoxic than mutagenic. This higher phototoxic and mutagenic efficiency of MePyPs in comparison to 8-MOP is likely to be related to the chemical nature of MePyPs-induced lesions which may be responsible for a reduced recognition and/or accessibility of the repair enzymes to damaged DNA.

Plant photosensitizers with antiviral properties

Many antiviral compounds obtained from plants are photosensitizers, i.e., their biological properties are dependent upon or augmented by light of specific wavelengths, commonly long wave ultraviolet, UVA. Three groups of chemically distinct plant photosensitizers have been investigated in some detail in regard to antiviral properties. These are (a) thiophenes and polyacetylenes; (b) furyl compounds; (c) certain alkaloids. Some of the thiophenes and their acetylenic derivatives possess extremely potent phototoxic activities toward membrane-containing viruses. These activities are markedly affected by the chemical structures of these compounds. Inactivated virus retains its integrity, however, and penetrates cells, but does not replicate. Their mechanism of action is believed to occur via singlet-oxygen damage to the membranes, although other targets cannot be ruled out. In contrast, the antiviral activities of plant furyl compounds (such as psoralens and furanochromones) appear to depend on UVA-mediated covalent adduct formation with the viral genomes. Some of the photoactive beta-carboline alkaloids also have impressive antiviral activities, especially against viruses with single-stranded genomes. These and other types of alkaloids appear to work by mechanisms that do not require covalent bonding to nucleic acids, and may also involve other target molecules as well. Some of these compounds have potent antiviral activities at concentrations well below cytotoxic levels, and accordingly should be tested in animal models.

Psoralen photochemotherapy

Psoralens and sunlight have been used by the Egyptians and Indians for hundreds of years for the treatment of vitiligo. The combination of oral psoralens and artificial ultraviolet A (PUVA) therapy was approved for the management of severe psoriasis by the Food and Drug Administration in 1982. Since then PUVA therapy has been found to be an effective modality in the treatment of many cutaneous conditions. When properly administered, the major short-term side effects are minimal. The long-term side effects may include an increased risk of squamous cell carcinoma, atypical cutaneous pigmentation, accelerated skin aging, and ophthalmologic abnormalities. By careful patient selection and limiting the cumulative UVA dosage and frequency by using combinations or alternative therapies, these side effects may be reduced. Continued reporting of carefully carried out long-term prospective studies will provide us with more knowledge of the long-term side effects of PUVA. In the meantime, for each patient on PUVA therapy the risk/benefit ratio should be carefully considered.

DNA photobinding of 7-methylpyrido[3,4-c]psoralen and 8-methoxypsoralen. Effects on macromolecular synthesis, repair and survival in cultured human cells

The photobinding to DNA of tritiated 7-methylpyrido[3,4-c]psoralen (MPP), a recently synthesized monofunctional compound of therapeutical interest, and of 8-methoxypsoralen (8-MOP) was determined in cultured normal human fibroblasts. Employing compounds at 10(-6) M, MPP photobinds approximately 11 times more efficiently than 8-MOP: one molecule is fixed respectively per 7.5 X 10(4) or 8.1 X 10(5) base pairs/kJ . m-2 of 365-nm radiation (UVA). Removal of bound material from DNA is slow and limited in 48-72 h of post-treatment incubation to 30-40% of initial adducts formed by MPP and to 50-60% of those of 8-MOP. For equivalent photobinding MPP and 8-MOP induce similar inhibitions of DNA synthesis. However, the recovery of DNA synthesis during post-treatment incubation is lower after photoaddition of MPP than after that of 8-MOP. MPP also exerts a much higher lethal effect than 8-MOP: one lethal hit corresponds to about 4400 and to 19,900 adducts per cell respectively. Alkaline elution experiments confirmed the monofunctional nature of MPP and indicated that in MPP-damaged cells DNA breaks accumulate with time of post-treatment incubation. In contrast, after photoaddition of 3-carbethoxypsoralen (3-CPs), another monofunctional furocoumarin, or irradiation with 254-nm UV, DNA breaks are induced only transiently. In 8-MOP-treated cells, DNA cross-links appear to be partially repaired. In conclusion, MPP monoadducts turn out to constitute more cytotoxic lesions than 8-MOP mono- and bi-adducts.

Genotoxic effects and DNA photoadducts induced in Chinese hamster V79 cells by 5-methoxypsoralen and 8-methoxypsoralen

The induction of lethal effects and 6-thioguanine-resistant (6-TGr) mutants were studied in Chinese hamster V79 cells after treatment with the two bifunctional furocoumarins 5- and 8-methoxypsoralens (5-MOP, 8-MOP) in the presence of 365-nm radiation (UVA). The in vivo DNA-photobinding capacity of these two compounds was measured and in parallel the cross-linking capacities of 5-MOP and 8-MOP were determined using the alkaline elution technique. The results show that 5-MOP plus UVA was about 2.5 times more effective than 8-MOP plus UVA for inhibiting cell survival and for inducing the same frequency of 6-TGr mutants (10(-4]. The total number of photoinduced lesions by 5-MOP plus UVA was about 6 times higher than that induced by 8-MOP plus UVA. However, the cross-linking capacities of 5-MOP and 8-MOP were found to be within the same range at equal doses of UVA. At equal number of DNA photoadducts produced, the lesions induced by 5-MOP appeared to be less genetically active than those induced by 8-MOP. The apparently weaker genotoxicity of 5-MOP-induced lesions is likely to be due to the induction of a lower proportion of cross-links by 5-MOP at a given number of photoadducts.

Lethal and mutagenic effects photoinduced in haploid yeast (Saccharomyces cerevisiae) by two new monofunctional pyridopsoralens compared to 3-carbethoxypsoralen and 8-methoxypsoralen

The photobiological effects of two monofunctional pyridopsoralens (PPs), pyrido[3,4-c]psoralen and pyrido[3,4-c]-7-methylpsoralen were studied and compared to those of 3-carbethoxypsoralen (3-CPs) and 8-methoxypsoralen (8-MOP) in a haploid wild-type strain of yeast (Saccharomyces cerevisiae). The capacity of PPs to photoinduce lethal effects in the presence of 365-nm radiation was not only higher than that of the monofunctional compound 3-CPs, but also higher than that of the bifunctional compound 8-MOP. This activity was apparently independent of oxygen, and it was found that it was probably due to the induction of monoadducts in DNA. A high effectiveness of PPs on the induction of cytoplasmic 'petite' mutations was observed suggesting a high photoaffinity towards mitochondrial DNA. In contrast to 8-MOP, the strong cell killing activity of PPs was not accompanied by a strong inducing effect on nuclear mutations (HIS+ reversions or canR forward mutations). For these endpoints, PPs were less effective per unit dose of 365-nm radiation and also less efficient per viable cell than 8-MOP. From this, it appears that the lesions photoinduced by the former compounds show a more lethal than (nuclear) mutagenic potential. Furthermore, the fact that PPs were even less mutagenic (nuclear) per viable cell than the monofunctional compound 3-CPs suggests that the activity of these agents may differ in frequency and nature of lesions induced. The photobiological activity of PPs in haploid yeast appears to be in line with the recent proposition for their use in photochemotherapy.

Induction in human skin fibroblasts of sister-chromatid exchanges (SCEs) by photoaddition of two new monofunctional pyridopsoralens in comparison to 3-carbethoxypsoralen and 8-methoxypsoralen

The induction of SCEs in human fibroblasts by photoaddition of a pyrido[3,4-c]psoralen (PyPs) and its 7-methyl derivative (MePyPs), two newly synthesized monofunctional agents proposed for photochemotherapeutic use, was compared to that of another monofunctional agent, 3-carbethoxypsoralen (3-CPs) and to the bifunctional compound, 8-methoxypsoralen (8-MOP). The yield of SCEs/cell and of SCEs/chromosome was determined at equimolar concentrations (10(-6) M) of all the drugs with increasing doses of 365 nm radiation (UVA). In the dark, the drugs alone had either no effect (8-MOP, PyPs) or a very slight effect (3-CPs, MePyPs). Nor did UVA alone demonstrate at inducing action (14.4 kJ/m2). With all the agents the average frequencies of SCE increased with increasing UVA doses, reaching a plateau level for the monofunctional compounds. The order of effectiveness for the linear part of the induction curves was MePyPs greater than PyPs greater than 8-MOP much greater than 3-CPs, whereas at the maximal level the order was 8-MOP greater than PyPs greater than MePyPs greater than 3-CPs. Determination of the frequencies of 2nd generation mitosis indicates that MePyPs is the most cytotoxic. The results focus the attention on the importance of the structure of psoralen monoadducts which, for certain genetic endpoints, might be as efficient as cross-links.

Mutagenic effects of 3-carbethoxypsoralen and 8-methoxypsoralen plus 365-nm irradiation in mammalian cells

Cell survival, i.e. colony-forming ability, and the induction of 6-thioguanine-resistant (6-TGr) mutants were determined in Chinese hamster V79 cells by using two photoreactive furocoumarins of photochemotherapeutic interest: the bifunctional compound 8-methoxypsoralen (8-MOP) and the monofunctional compound 3-carbethoxypsoralen (3-CPs). To quantify the mutation induction in V79 cells mutants deficient in the enzyme hypoxanthine-guanine phosphoribosyl transferase (HGPRT) were selected with the purine analogue 6-thioguanine (6-TG). The effects of the compounds alone at 50 microM in the absence of light and those of 365-nm radiation (UVA) at doses of up to 6 kJm-2 were negligible. When exposed to equimolar concentrations of the compounds together with UVA, V79 cells were about 8 times more sensitive to 8-MOP-plus-UVA than to 3-CPs-plus-UVA. Per unit dose of UVA, 8-MOP was about 7 times more effective than 3-CPs for the induction of 6-TGr mutants. The induction followed about one-hit kinetics for 3-CPs and about two-hit kinetics for 8-MOP. At 50% survival the frequency of 6-TGr mutants induced by 8-MOP plus UVA and 3-CPs plus UVA differed by a factor of about 3.5. These results show a marked concordance with those obtained in the yeast Saccharomyces cerevisiae: both compound exhibited lethal and mutagenic activities but the monofunctional compound 3-CPs was less lethal and mutagenic than the bifunctional compound 8-MOP.

Photocarcinogenesis, skin cancer, and aging

Nonmelanoma skin cancers, like most malignancies, increase in incidence with increasing age. However, in general they are not due to the aging process but are primarily due to solar radiation. Clinically, squamous cell carcinomas and basal cell epitheliomas are the most common cancers that occur in the Caucasian population in the United States. The role of radiation from the sun was suggested by a number of astute clinical observations reported around 1900 and subsequently has been established by epidemiologic and experimental studies. Action spectrum evaluations indicate that the ultraviolet B (UVB) rays are the most carcinogenic. However, recent studies indicate that the UVA rays can augment the cancer-producing effects of UVB rays. Other physical stimuli, including heat and wind, can also accelerate UVB carcinogenesis. Chemicals such as the polycyclic hydrocarbons, the nitrosoureas, and nitrogen mustard have an additive carcinogenic effect with UVB radiation. Also, some chemicals such as croton oil, the phorbol ester--TPA, and all-trans-retinoic (RA) acid can promote UVB-initiated carcinogenesis. RA can also inhibit UVB-induced cancer formation. The role of the immune status has received a great deal of attention. Both in experimental and clinical situations, nonspecific immune suppression results in increased cancer formation. Also, recent studies indicate that a specific T cell suppressor population can be induced in experimental animals with UVB which will inhibit rejection of tumors produced by UVB radiation. Finally, damage to DNA by UVB radiation is well established. Studies with the genetic disease xeroderma pigmentosum support the concept that such damage, if not repaired, will lead to cancer formation. It also has been suggested that unrepaired damage to deoxyribonucleic (DNA) and other macromolecules is at least in part responsible for the aging process in general.

Position paper--PUVA therapy. American Academy of Dermatology

PUVA, the combination of psoralen (P) and long-wave ultraviolet radiation (UVA), is being used increasingly in the management of psoriasis and several other dermatologic disorders. While the acute toxicity of this modality, which includes erythema and blistering of the skin, can be avoided with careful monitoring of the dosimetry of the administered radiation, the potential chronic toxicity remains a source of concern. Since psoralens and UVA are clearly mutagenic, carcinogenic, cataractogenic, and may have as yet poorly understood effects on the immune system, it is imperative that all patients treated with this modality be carefully monitored for the development of neoplasia and cataracts. PUVA therapy should only be administered using specialized equipment that can be accurately monitored for its spectral irradiance by physicians thoroughly familiar with the risks and benefits of the modality.

Photobiological studies with dictamnine, a furoquinoline alkaloid

Dictamnine, a naturally occurring furoquinoline, produces bacterial frameshift mutations in the dark. It does not form DNA interstrand crosslinks in bacterial cells in the presence of near-ultraviolet light (300-380 nm). It is more active than angelicin but slightly less active than 8-MOP as a phototoxic agent with E. coli. It is however a more active mutagen than 8-MOP at equivalent concentration. Dictamnine is slightly more potent than the same concentration of angelicin in producing photosensitized lethality in Chinese hamster cells. It does, however, produce almost twice as many sister-chromatid exchanges per lethal event than angelicin. The concept of 'unit dose' relating the observable photoinduced damage by the photosensitizer and the total irradiation appears to apply reasonably well to the actions of dictamnine in killing bacterial and mammalian cells, in the formation of sister-chromatid exchanges, but not to the induction of bacterial mutations.

Ultrastructural changes in the nucleus of a human epithelial cell line exposed to cytotoxic agents. The effect of PUVA and cadmium

An established human epithelial cell line was exposed to cytotoxic doses of photo-activated 8-methoxy psoralen (PUVA) and to cadmium (Cd++) and the cells' nuclear ultrastructure were compared with controls. PUVA and Cd++ have some common biological features. Both substances induced nuclear indentations and cytoplasmic invaginations, while only PUVA caused an increase in nuclear bodies. After cadmium exposure, clusters of large-sized perichromatin granules (PG) were seen as well as an increase in chromatin margination. After PUVA, an increase in singularly distributed PGs was observed. The nuclear envelope was not affected by PUVA while Cd caused extensive disruption of this membrane. A strain of the epithelial cell line was made resistant to 100 mumol Cd/l and its nuclear ultrastructure was examined. An increase in chromatin margination was seen compared with its parent line. When this Cd resistant cell strain was exposed to 200 mumol Cd/l no ultrastructural changes took place. An attempt to produce a PUVA resistant epithelial cell strain was unsuccessful. Some functional aspects of the different morphological parameters observed are discussed.