Incidence and profile of skin cancers in patients following ultraviolet phototherapy without psoralens: A retrospective cohort study

BACKGROUND

Psoralen + ultraviolet-A (PUVA) is associated with photocarcinogenesis. However, carcinogenic risk with other ultraviolet phototherapies remains unclear.

OBJECTIVE

Evaluate whether phototherapy without psoralens increases skin cancer risk.

METHODS

Retrospective cohort study of patients treated at a teaching-hospital phototherapy center (1977-2018). Skin cancer records were validated against pathology reports. Age-standardized incidence rates (ASIRs) of skin cancer were evaluated for gender, skin phototype, diagnosis, ultraviolet modality, anatomical site; and compared to provincial population incidence rates (2003).

RESULTS

In total, 3506 patients treated with broadband-ultraviolet-B, narrowband-UVB and/or combined UVAB were assessed with a mean follow-up of 7.3 years. Majority of patients had psoriasis (60.9%) or eczema (26.4%). Median number of treatments was 43 (1-3598). Overall, 170 skin cancers (17 melanoma, 33 squamous cell carcinoma and 120 basal cell carcinoma) occurred in 79 patients. Patient-based and tumor-based ASIR of skin cancer was 149 (95% CI: 112-187)/100,000 and 264 (219-309)/100,000 person-years, respectively. There was no significant difference between tumor-based ASIRs for melanoma, squamous cell carcinoma, and basal cell carcinoma compared to the general population; or in phototherapy patients with-psoriasis or eczema; or immunosuppressants. No cumulative dose-response correlation between UVB and skin cancer was seen.

LIMITATIONS

Treatment and follow-up duration.

CONCLUSION

No increased risk of melanoma and keratinocyte cancer was found with phototherapy.

Association of sunlight exposure with visual impairment in an Indian fishing community

Purpose

Indian fishermen belong to a marginalized population and are continuously exposed to extreme occupational hazards and sunlight. A high prevalence of visual impairment (VI) is reported in the coastal fishing community. We aimed to investigate the association between VI and sunlight exposure measurement (SEM).

Methods

In this cross-sectional observational study, 270 eyes of 135 participants were enrolled from a coastal fishing village. Participants underwent a comprehensive ophthalmic examination, which included best-corrected visual acuity (BCVA), and anterior and posterior segment examination. Ocular Surface Disease Index (OSDI) and SEM questionnaire were administered to estimate the level of dry eye and ultraviolet-B (UV-B) exposure, respectively. VI was defined as presenting visual acuity worse than 6/12 (logarithm of the minimum angle of resolution [logMAR] > 0.3).

Results

The mean age and spherical equivalent were 50.56 ± 11.72 years (range: 18-80 years) and 0.36 ± 1.68 diopters (D) (range: -7.0 to +3.0 D), respectively. Age, SEM, OSDI, fishing as an occupation, and cataract were significantly associated with higher odds of VI in univariate analysis. Refraction, gender, education level, smoking status, amblyopia, systematic, and other ocular diseases were not significantly associated with VI. In the multivariate analysis, age, SEM, and presence of cataract remained significantly associated with a higher risk for VI. The area under the receiver operating characteristic curve values for age and SEM scores demonstrate a fair index of discrimination for the detection of VI.

Conclusion

SEM level is directly associated with a higher risk of VI among fishermen. The fishing community might benefit from regular eye examinations and awareness about the harmful effects of sunlight exposure and preventive measures.

Abscisic Acid Inhibits Cortical Microtubules Reorganization and Enhances Ultraviolet-B Tolerance in Arabidopsis thaliana

Ultraviolet-B (UV-B) radiation is one of the important environmental factors limiting plant growth. Both abscisic acid (ABA) and microtubules have been previously reported to be involved in plant response to UV-B. However, whether there is a potential link between ABA and microtubules and the consequent signal transduction mechanism underlying plant response to UV-B radiation remains largely unclear. Here, by using sad2-2 mutant plants (sensitive to ABA and drought) and exogenous application of ABA, we saw that ABA strengthens the adaptive response to UV-B stress in Arabidopsis thaliana (A. thaliana). The abnormal swelling root tips of ABA-deficient aba3 mutants demonstrated that ABA deficiency aggravated the growth retardation imposed by UV-B radiation. In addition, the cortical microtubule arrays of the transition zones of the roots were examined in the aba3 and sad2-2 mutants with or without UV-B radiation. The observation revealed that UV-B remodels cortical microtubules, and high endogenous ABA can stabilize the microtubules and reduce their UV-B-induced reorganization. To further confirm the role of ABA on microtubule arrays, root growth and cortical microtubules were evaluated after exogenous ABA, taxol, and oryzalin feeding. The results suggested that ABA can promote root elongation by stabilizing the transverse cortical microtubules under UV-B stress conditions. We thus uncovered an important role of ABA, which bridges UV-B and plants' adaptive response by remodeling the rearrangement of the cortical microtubules.

Mechanisms underlying the impact and interaction of temperature and UV-B on the hatching of spider mite and phytoseiid mite eggs

BACKGROUND

A spider mite control method using night-time ultraviolet (UV)-B irradiation was recently developed for strawberry greenhouses (UV method). The control effect of this UV method is negatively affected by increasing temperature. Tetranychus urticae eggs are more resistant to a single dose of UV-B irradiation than Neoseiulus californicus eggs. By contrast, N. californicus can better survive nightly UV-B irradiation with the UV method compared with T. urticae. To elucidate the mechanism underlying these phenomena, we explored the hypotheses that higher temperature promotes photoenzymatic repair (PER) and that mortality is determined by UV-B susceptibility in the embryonic stage exposed to UV-B.

RESULTS

PER efficacy was not promoted by increasing temperature. The lowest hatchability (around zero) of T. urticae eggs after a single dose of UV-B irradiation (0.288 and 0.432 kJ m^-2 ) without photoreactivation was seen in the morphogenesis stages between "cleavage ended" and "eye points became colored". Based on these results, we developed a linear function of daily UV-B irradiance and deviation of cumulative irradiance during vulnerable embryonic developmental phases from 50% lethal dose (LD₅₀ ) after a single dose of UV-B irradiation. The difference between T. urticae and N. californicus and changes in UV-B vulnerability due to temperature could be explained by this simple relationship.

CONCLUSION

Slower development in T. urticae than N. californicus in nature and developmental delay under low temperatures increase the ovicidal effects of the UV method. This shows the advantage of the simultaneous use of the UV method and biological control, contributing to the development of integrated pest management. © 2022 Society of Chemical Industry.

Growth and Biosynthesis of Phenolic Compounds of Canola (Brassica napus L.) to Different Ultraviolet (UV)-B Wavelengths in a Plant Factory with Artificial Light

The application of ultraviolet-B (UV-B) irradiation to supplement visible light as an elicitor to increase bioactive compounds under controlled conditions is increasing. This study aimed to evaluate the effects of UV-B dose and wavelength region (280−300 and 300−320 nm) on the morphological, physiological, and biochemical responses of canola plants (Brassica napus L.). Canola plants (17 days after sowing) were subjected to various UV-B intensities (i.e., 0.3, 0.6, and 0.9 W m−2) and were divided into cut and non-cut treatments for each UV treatment. Plant growth parameters exhibited different trends based on the treated UV irradiation intensity. Plant growth gradually decreased as the UV irradiation intensity and exposure time increased. Despite the same UV irradiation intensity, plant response varied significantly depending on the presence or absence of a short-wavelength cut filter (<300 nm). Canola plants suffered more leaf damage in nonfilter treatments containing shorter wavelengths (280−300 nm). UV treatment effectively activates the expression of secondary metabolite biosynthetic genes, differing depending on the UV irradiation intensity. Our results suggest that both UV irradiation intensity and wavelength should be considered when enhancing antioxidant phytochemicals without inhibiting plant growth in a plant factory with artificial light.

Physiological Responses and Metabonomics Analysis of Male and Female Sargassum thunbergii Macroalgae Exposed to Ultraviolet-B Stress

Ultraviolet-B (UV-B) radiation is a major environmental stress that suppresses or activates defense responses in organisms. UV-B radiation affecting growth and development in intertidal species have been researched for a long time, but a series of unknown knowledge remain in the male and female macroalgae comparison. To compare the different responses of male and female Sargassum thunbergii macroalgae under UV-B radiation, PSII photochemical efficiency determination, metabolomic analysis, and main carbon-based metabolites (including soluble sugar, total amino acid, and lipid) content measuring have been performed in our experiments. Results showed that males have significantly superiority performance in the chlorophyll fluorescence parameters of F _v/F _m, Y(II), and Y(NO) either low or high UV-B radiation treatments. Metabolomics analysis revealed that carbon and nitrogen metabolism pathways in male and female S. thunbergii were significant components responding to enhanced UV-B radiation. Based on measuring, female S. thunbergii lipid content expressed higher than males without any stimulation. Additionally, under low UV-B radiation stimulation, females total amino acid content shown significantly higher than control group and their lipid content also significantly higher than males. Under high UV-B radiation, males soluble sugar, total amino acid, and lipid content significantly varied from females, which meant that enhancing UV-B stress might altered mainly carbon-based metabolites flowing directions. The present study elucidated the potential role of enhanced UV-B radiation in regulating macroalgae physiological responses, metabolites changing, and reflecting differences between male and female S. thunbergii, contributing to understanding of brown-macroalgae diecious adopting mechanisms in defending intertidal UV-B stresses.

Persistency of Indigenous and Exotic Entomopathogenic Fungi Isolates under Ultraviolet B (UV-B) Irradiation to Enhance Field Application Efficacy and Obtain Sustainable Control of the Red Palm Weevil

The red palm weevil Rhynchophorus ferrugineus Olivier (Coleoptera: Dryophthoridae) has become a key invasive pest and major threat to the palm tree worldwide. Several entomopathogenic fungi are used in insect biological control programs. In the present study, persistency of different local and exotic fungal isolates of Beauveria bassiana and Metarhizium anisopliae was evaluated under UV-B irradiation with different exposure intervals. Several factors, including ultraviolet (UV) light, significantly decrease germination rate of fungi, as UV penetrates and damages their DNA. Several studies have investigated that UV-resistant conidia germinate better under harsh environmental conditions. Seven local and exotic fungi isolates ("BbSA-1", "BbSA-2", "BbSA-3", "MaSA-1", "BbIDN-1", "MaIDN-1", and "MaIDN-2") were tested in the current study under UV-B irradiation having different UV exposure times (i.e., 15, 30, 60, 120, 180, 240, and 300 min). The colony-forming unit (CFU) in each isolate was used to calculate the survival rate. Results indicated that survival rate of all the isolates decreased under UV-B irradiation for all exposure times compared to no exposure to UV-B irradiation. The CFU number decreased as the exposure time increased. Fungi isolates "MaSA-1", "BbSA-1", "BbSA-2", "MaIDN-1", and "MaIDN-2" could persist after 300 min exposure to UV-B, while the remaining isolates, such as "BbIDN-1", and "BbSA-3", could not persist after 300 min exposure to UV-B. The ultimate objective of the present research was to explore an ultraviolet-tolerant fungal isolate that might be useful in the field application for the sustainable management of the red palm weevil, which has become a key invasive pest in many regions rather than its native range. Most of the fungus isolates studied in the present work were collected from Saudi Arabia's Al-Qatif region, where the red palm weevil has infested more than ten thousand trees, worth millions of riyals.

Radiofrequency Irradiation Mitigated UV-B-Induced Skin Pigmentation by Increasing Lymphangiogenesis

Dermal macrophages containing melanin increase skin pigmentation since dermal melanin removal is slower than epidermal melanin removal. Lymphatic vessels are also involved in melanin clearance. We evaluated whether radiofrequency (RF) irradiation induced an increase in HSP90, which promotes lymphangiogenesis by activating the BRAF/MEK/ERK pathway and decreasing tyrosinase activity, in the UV-B exposed animal model. The HSP90/BRAF/MEK/ERK pathway was upregulated by RF. Tyrosinase activity and the VEGF-C/VEGFR 3/PI3K/pAKT1/2/pERK1/2 pathway, which increase lymphangiogenesis, as well as the expression of the lymphatic endothelial marker LYVE-1, were increased by RF. Additionally, the number of melanin-containing dermal macrophages, the melanin content in the lymph nodes, and melanin deposition in the skin were decreased by RF. In conclusion, RF increased HSP90/BRAF/MEK/ERK expression, which decreased tyrosinase activity and increased lymphangiogenesis to eventually promote the clearance of dermal melanin-containing macrophages, thereby decreasing skin pigmentation.

Photoprotective Effects of a Hyperoside-Enriched Fraction Prepared from Houttuynia cordata Thunb. on Ultraviolet B-Induced Skin Aging in Human Fibroblasts through the MAPK Signaling Pathway

Ultraviolet-B (UVB) irradiation causes skin damage via deleterious effects including oxidative stress, inflammation, and collagen degradation. The photoprotective effects of a hyperoside-enriched fraction obtained from Houttuynia cordata Thunb. (H. cordata) on the attenuation of UVB-induced skin aging in human fibroblasts were investigated. The solvent-partition technique was used to establish the hyperoside-enriched fraction of H. cordata (HcEA). The active compounds identified in the H. cordata extracts were hyperoside, quercitrin, chlorogenic acid, and rutin. With regard to the photoprotective effects of H. cordata on UVB-irradiated dermal fibroblasts, HcEA and hyperoside inhibited intracellular ROS production and inflammatory cytokine secretions (IL-6 and IL-8), while increasing collagen type I synthesis along with downregulating MMP-1 gene and protein expressions. Mechanistically, the hyperoside-enriched fraction obtained from H. cordata inhibited UVB-irradiated skin aging through regulation of the MAPK signaling pathway by attenuating the activation of JNK/ERK/c-Jun in human dermal fibroblasts. The hyperoside-enriched fraction of H. cordata exerted potent anti-skin aging properties against UVB exposure. The findings of this study can be applied in the cosmetics industry, as H. cordata extract can potentially be used in pharmaceutical or cosmetic formulations as a photoprotective or anti-skin aging agent.

Genome-Wide Association Study for Ultraviolet-B Resistance in Soybean (Glycine max L.)

The depletion of the stratospheric ozone layer is a major environmental issue and has increased the dosage of ultraviolet-B (UV-B) radiation reaching the Earth’s surface. Organisms are negatively affected by enhanced UV-B radiation, and especially in crop plants this may lead to severe yield losses. Soybean (Glycine max L.), a major legume crop, is sensitive to UV-B radiation, and therefore, it is required to breed the UV-B-resistant soybean cultivar. In this study, 688 soybean germplasms were phenotyped for two categories, Damage of Leaf Chlorosis (DLC) and Damage of Leaf Shape (DLS), after supplementary UV-B irradiation for 14 days. About 5% of the germplasms showed strong UV-B resistance, and GCS731 was the most resistant genotype. Their phenotypic distributions showed similar patterns to the normal, suggesting UV-B resistance as a quantitative trait governed by polygenes. A total of 688 soybean germplasms were genotyped using the Axiom^® Soya 180K SNP array, and a genome-wide association study (GWAS) was conducted to identify SNPs significantly associated with the two traits, DLC and DLS. Five peaks on chromosomes 2, 6, 10, and 11 were significantly associated with either DLC or DLS, and the five adjacent genes were selected as candidate genes responsible for UV-B resistance. Among those candidate genes, Glyma.02g017500 and Glyma.06g103200 encode cryptochrome (CRY) and cryptochrome 1 (CRY1), respectively, and are known to play a role in DNA repair during photoreactivation. Real-time quantitative RT-PCR (qRT-PCR) results revealed that CRY1 was expressed significantly higher in the UV-B-resistant soybean compared to the susceptible soybean after 6 h of UV-B irradiation. This study is the first GWAS report on UV-B resistance in soybean, and the results will provide valuable information for breeding UV-B-resistant soybeans in preparation for climate change.

Hormonal Regulation in Different Varieties of Chenopodium quinoa Willd. Exposed to Short Acute UV-B Irradiation

Increased ultraviolet-B (UV-B) due to global change can affect plant development and metabolism. Quinoa tolerates extreme conditions including high UV levels. However, the physiological mechanisms behind its abiotic stress tolerance are unclear, especially those related to UV-B. We previously demonstrated that 9.12 kJ m⁻² d⁻¹ may induce UV-B-specific signaling while 18.24 kJ m⁻² d⁻¹ promotes a UV-B-independent response. Here, we explored the effects of these UV-B doses on hormonal regulation linked to plant morphology and defense among diverse varieties. Changes in fluorescence parameters of photosystem II, flavonoids and hormones (indoleacetic acid (IAA), jasmonic acid (JA), abscisic acid (ABA) and salicylic acid (SA)) were surveyed under controlled conditions. Here, we showed that the sensitivity to short acute UV-B doses in varieties from different habitats is influenced by their parental lines and breeding time. UV-B sensitivity does not necessarily correlate with quinoa’s geographical distribution. The role of flavonoids in the UV-B response seems to be different depending on varieties. Moreover, we found that the extent of changes in JA and SA correlate with UV-B tolerance, while the increase of ABA was mainly related to UV-B stress.

Matrix Metalloproteinase-2 Activated by Ultraviolet-B Degrades Human Ciliary Zonules In Vitro

The ciliary zonules, also known as the zonules of Zinn, help to control the thickness of the lens during focusing. The ciliary zonules are composed of oxytalan fibers, which are synthesized by human nonpigmented ciliary epithelial cells (HNPCEC). The ciliary zonules are exposed to ultraviolet (UV), especially UV-A and UV-B, throughout life. We previously demonstrated that UV-B, but not UV-A, degrades fibrillin-1- and fibrillin-2-positive oxytalan fibers. However, the mechanism by which UV-B degrades oxytalan fibers remains unknown. In this study, we investigate the involvement of matrix metalloproteinase-2 (MMP-2) in the UV-B-induced degradation of fibrillin-1- and fibrillin-2-positive oxytalan fibers in cultured HNPCECs. Enzyme-linked immunosorbent assay revealed that UV-B irradiation at levels of 100 and 150 mJ/cm² significantly increased the level of active MMP-2. Notably, MMP-2 inhibitors completely suppressed the degradation of fibrillin-1- and fibrillin-2-positive oxytalan fibers. In addition, we show that UV-B activates MMP-2 via stress-responsive kinase p38. Taken together, the results suggest that UV-B activates a production of active type of MMP-2 via the p38 pathway, and subsequently, an active-type MMP-2 degrades the fibrillin-1- and fibrillin-2-positive oxytalan fibers in cultured HNPCECs.

Ultraviolet Radiation From a Plant Perspective: The Plant-Microorganism Context

Ultraviolet (UV) radiation directly affects plants and microorganisms, but also alters the species-specific interactions between them. The distinct bands of UV radiation, UV-A, UV-B, and UV-C have different effects on plants and their associated microorganisms. While UV-A and UV-B mainly affect morphogenesis and phototropism, UV-B and UV-C strongly trigger secondary metabolite production. Short wave (<350 nm) UV radiation negatively affects plant pathogens in direct and indirect ways. Direct effects can be ascribed to DNA damage, protein polymerization, enzyme inactivation and increased cell membrane permeability. UV-C is the most energetic radiation and is thus more effective at lower doses to kill microorganisms, but by consequence also often causes plant damage. Indirect effects can be ascribed to UV-B specific pathways such as the UVR8-dependent upregulated defense responses in plants, UV-B and UV-C upregulated ROS accumulation, and secondary metabolite production such as phenolic compounds. In this review, we summarize the physiological and molecular effects of UV radiation on plants, microorganisms and their interactions. Considerations for the use of UV radiation to control microorganisms, pathogenic as well as non-pathogenic, are listed. Effects can be indirect by increasing specialized metabolites with plant pre-treatment, or by directly affecting microorganisms.

Degradation of the transcription factors PIF4 and PIF5 under UV-B promotes UVR8-mediated inhibition of hypocotyl growth in Arabidopsis

Inhibition of hypocotyl growth is a well-established UV-B-induced photomorphogenic response that is mediated by the UV-B photoreceptor UV RESISTANCE LOCUS 8 (UVR8). However, the molecular mechanism by which UVR8 signaling triggers inhibition of hypocotyl growth is poorly understood. The bZIP protein ELONGATED HYPOCOTYL 5 (HY5) functions as the main positive regulatory transcription factor in the UVR8 signaling pathway, with HY5-HOMOLOG (HYH) playing a minor role. However, here we demonstrate that hy5 hyh double mutants maintain significant UVR8-dependent hypocotyl growth inhibition. We identify UVR8-dependent inhibition of the activities of bHLH transcription factors PHYTOCHROME INTERACTING FACTOR 4 (PIF4) and PIF5 as part of the UVR8 signaling pathway, which results in inhibition of hypocotyl growth. The UVR8-mediated repression of several hypocotyl elongation-related genes is independent of HY5 and HYH but largely associated with UVR8-dependent degradation of PIF4 and PIF5, a process that consequently diminishes PIF4/5 target promoter occupancy. Taken together, our data indicate that UVR8-mediated inhibition of hypocotyl growth involves degradation of PIF4 and PIF5. These findings contribute to our mechanistic understanding of UVR8-induced photomorphogenesis and further support the function of PIFs as integrators of different photoreceptor signaling pathways.

Protective effects of Belamcandae Rhizoma against skin damage by ameliorating ultraviolet-B-induced apoptosis and collagen degradation in keratinocytes

Ultraviolet-B light (UV-B) is a major cause of skin photoaging, inducing cell death and extracellular matrix collapse by generating reactive oxygen species (ROS). Belamcandae Rhizoma (BR), the rhizome of Belamcanda chinensis Leman, exhibits antioxidant properties, but it remains unknown whether BR extract ameliorates UV-B-induced skin damage. In this study, we evaluated the effects of a standardized BR extract on UV-B-induced apoptosis and collagen degradation in HaCaT cells. BR was extracted using four different methods. We used radical-scavenging assays to compare the antioxidative activities of the four extracts. Cells were irradiated with UV-B and treated with BR boiled in 70% (vol/vol) ethanol (BBE). We measured cell viability, intracellular ROS levels, the expression levels of antioxidative enzymes, and apoptosis-related and collagen degradation-related proteins. The irisflorentin and tectorigenin levels were measured via high-performance liquid chromatography. BBE exhibited the best radical-scavenging and cell protective effects of the four BR extracts. BBE inhibited intracellular ROS generation and induced the synthesis of antioxidative enzymes such as catalase and glutathione. BBE attenuated apoptosis by reducing the level of caspase-3 and increasing the Bcl-2/Bax ratio. BBE reduced the level of matrix metalloproteinase-1 and increased that of type I collagen. The irisflorentin and tectorigenin contents were 0.23% and 0.015%, respectively. From these results, BBE ameliorated UV-B-induced apoptosis and collagen degradation by enhancing the expression of antioxidative enzymes. It may be a useful treatment for UV-B-induced skin damage.

Netrin-1 plays a critical role in regulating capacities of epidermal stem cells upon ultraviolet-B (UV-B) irradiation

Loss of the capacities of epidermal stem cells (ESCs) induced by ultraviolet-B (UV-B) irradiation has been widely associated with various skin diseases. Netrin-1, a member of the axonal guidance protein family, has displayed diverse biological functions in different types of cells and tissues, mediated by its specific receptor UNC-5 homolog B (UNC5b). In this study, we examined the physiological functions of netrin-1 and UNC5b in ESCs upon UV-B exposure. Our results indicate that UNC5b is expressed in ESCs, and its expression is upregulated in response to UV-B radiation. We found that treatment with netrin-1 prevented UV-B radiation-induced oxidative stress by reducing the generation of reactive oxygen species (ROS) and expression of NADPH oxidase 4 (NOX-4). Additionally, treatment with netrin-1 improved UV-B radiation-induced mitochondrial dysfunction by increasing mitochondrial membrane potential (MMP) levels and adenosine triphosphate (ATP) production. The presence of netrin-1 attenuated UV-B radiation-induced lactic dehydrogenase (LDH) release. UV-B exposure resulted in the loss of the capacities of ESCs by reducing the expressions of integrin β1 and Krt19, the two major ESC markers. Importantly, this process was prevented by netrin-1. Silencing of UNC5b abolished the effects of netrin-1 on the expression of integrin β1 and Krt19, suggesting that the effects of netrin-1 in maintaining the capacities of ESCs are dependent on UNC5b. Mechanistically, we found that the Wnt/β-catenin signalling may be involved. Our findings suggest that netrin-1 may serve as a therapeutic agent for the treatment of skin diseases.

Protective Effect of Sulfated Polysaccharides from Celluclast-Assisted Extract of Hizikia fusiforme Against Ultraviolet B-Induced Skin Damage by Regulating NF-κB, AP-1, and MAPKs Signaling Pathways In Vitro in Human Dermal Fibroblasts

Our previous study evaluated the antioxidant activities of sulfated polysaccharides from Celluclast-assisted extract of Hizikia fusiforme (HFPS) in vitro in Vero cells and in vivo in zebrafish. The results showed that HFPS possesses strong antioxidant activity and suggested the potential photo-protective activities of HFPS. Hence, in the present study, we investigated the protective effects of HFPS against ultraviolet (UV) B-induced skin damage in vitro in human dermal fibroblasts (HDF cells). The results indicate that HFPS significantly reduced intracellular reactive oxygen species (ROS) level and improved the viability of UVB-irradiated HDF cells in a dose-dependent manner. Furthermore, HFPS significantly inhibited intracellular collagenase and elastase activities, remarkably protected collagen synthesis, and reduced matrix metalloproteinases (MMPs) expression by regulating nuclear factor kappa B (NF-κB), activator protein 1 (AP-1), and mitogen-activated protein kinases (MAPKs) signaling pathways in UVB-irradiated HDF cells. These results suggest that HFPS possesses strong UV protective effect, and can be a potential ingredient in the pharmaceutical and cosmetic industries.

Enzyme-Treated Asparagus Extract (ETAS) Facilitates the Turnover of UV-B-Irradiated Keratinocytes

Enzyme-treated asparagus extract (ETAS) is prepared from the lower, residual parts of asparagus, and some functionalities, such as anti-oxidative and neuroprotective activities, have been suggested. The purpose of the present study was to investigate the effects of ETAS on photoaging in the epidermal layer of the skin using cultured keratinocytes. Normal human epidermal keratinocytes were irradiated or left unirradiated with UV-B (10 mJ/cm²) and incubated with ETAS (0.5 or 2 mg/mL) or vehicle. After 3 or 13 h, molecular examinations were performed, and after 24 or 48 h, cell viabilities were determined by a CCK-8 assay. ETAS addition may induce keratinocyte migration and proliferation as well as apoptosis under molecular examination. These results suggest that ETAS might accelerate turnover of keratinocytes.

Partial or entire: Distinct responses of two types of chloroplast autophagy

Autophagy carries out intracellular degradation of cytoplasmic components, which is important for the removal of dysfunctional organelles and for efficient nutrient recycling in eukaryotic cells. Most proteins in plant green tissues are found in chloroplasts, mainly as photosynthetic proteins that constantly accumulate damage caused by sunlight. Our recent study investigated the involvement of autophagy in the turnover of damaged chloroplasts and found that entire photodamaged chloroplasts are transported into the vacuole for degradation via an autophagy process termed chlorophagy. Our previous studies also established that autophagy can also degrade chloroplast components piecemeal: chloroplast stroma is transported for degradation via autophagy vesicles termed Rubisco-containing bodies (RCB). During sugar starvation-induced senescence in darkened leaves, the RCB pathway is preferentially active. By contrast, we observed active chlorophagy without prior induction of RCB production in photodamaged leaves. These distinct responses between the RCB pathway and chlorophagy support the notion that the induction of the partial-type and entire-organelle-type chloroplast autophagy are differentially regulated by individual upstream molecules. This finding further suggests that the two types of autophagy are coordinated to achieve the controlled chloroplast turnover in response to specific conditions.

Inhibition effect of curcumin on UVB-induced secretion of pro-inflammatory cytokines from corneal limbus epithelial cells

AIM

To study the effects of curcumin on the secretion of interleukin (IL)-6 and IL-8 by corneal limbus epithelial cells.

METHODS

Human corneal limbus epithelial cells were isolated and cultured from donor eyes and irradiated by UVB at different dosages with or without curcumin. MTT test was used for studying the effects of UVB and curcumin on the cell viability. The role of mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-κB) pathways on the UVB-induced secretion of IL-6 and IL-8 were tested by addition of their inhibitors to the culture with or without UVB-radiation. Levels of various signal pathways, IL-6 and IL-8 in the cells and in the conditioned culture medium were measured by ELISA analysis.

RESULTS

UVB at 20 mJ/cm² or less and curcumin at 20 µmol/L or less did not affect the cell viability of cultured limbus epithelial cells (P>0.05). UVB irradiation at 10 and 20 mJ/cm² induced a significant increase of secretion of IL-6 and IL-8 and upregulated NF-κB and phosphorylated MAPK pathways of cultured limbus epithelial cells (P<0.05). Various signal pathway inhibitors, including SP600125 (JNK inhibitor), SB203580 (p38 MAPK inhibitor) and BAY11-7082 (NF-κB inhibitor) significantly decreased the UVB-induced secretion of IL-6 and IL-8 secretion (P<0.05). Curcumin at 5-20 µmol/L significantly inhibited UVB-induced secretion of IL-6 and IL-8 by limbus epithelial cells in a dose-dependent manner; while curcumin alone did not affect the secretion of IL-6 and IL-8. The upregulation of NF-κB and MAPK pathways induced by UVB treatment was significantly inhibited by curcumin, suggesting that NF-κB and MAPK pathways are involved in the inhibitory effect of curcumin on UVB-induced production of IL-6 and IL-8.

CONCLUSION

Curcumin may be a promising agent to be explored for the prevention and treatment of pterygium.

Expression of the UVR8 photoreceptor in different tissues reveals tissue-autonomous features of UV-B signalling

The Arabidopsis UV-B photoreceptor UV RESISTANCE LOCUS 8 (UVR8) orchestrates the expression of hundreds of genes, many of which can be associated with UV-B tolerance. UV-B does not efficiently penetrate into tissues, yet UV-B regulates complex growth and developmental responses. To unravel to what extent and how UVR8 located in different tissues contributes to UV-B-induced responses, we expressed UVR8 fused to the YELLOW FLUORESCENT PROTEIN (YFP) under the control of tissue-specific promoters in a uvr8 null mutant background. We show that (1) UVR8 localized in the epidermis plays a major role in regulating cotyledon expansion, and (2) expression of UVR8 in the mesophyll is important to protect adult plants from the damaging effects of UV-B. We found that UV-B induces transcription of selected genes, including the key transcriptional regulator ELONGATED HYPOCOTYL 5 (HY5), only in tissues that express UVR8. Thus, we suggest that tissue-autonomous and simultaneous UVR8 signalling in different tissues mediates, at least partly, developmental and defence responses to UV-B.

NaCl Induces Flavonoid Biosynthesis through a Putative Novel Pathway in Post-harvest Ginkgo Leaves

The flavonoids in the extracts of Ginkgo leaves have been shown to have great medical value: thus, a method to increase the flavonoid contents in these extracts is of significant importance for human health. In the present study, we investigated the changes in flavonoid contents and the corresponding gene expression levels in post-harvest Ginkgo leaves after various treatments. We found that both ultraviolet-B and NaCl treatment induced flavonoid accumulation. However, gene expression analysis showed that the increases in flavonoid contents were achieved by different pathways. Furthermore, post-harvest Ginkgo leaves responded differently to NaCl treatment compared with naturally grown leaves in both flavonoid contents and corresponding gene expression. In addition, combined treatment with ultraviolet-B and NaCl did not further increase the flavonoid contents compared with ultraviolet-B or NaCl treatment alone. Our results indicate the existence of a novel mechanism in response to NaCl treatment in post-harvest Ginkgo leaves, and provide a technique to increase flavonoid content in the pharmaceutical industry.

Vacuolar digestion of entire damaged chloroplasts in Arabidopsis thaliana is accomplished by chlorophagy

In yeast and mammals, selective vacuolar delivery and degradation of whole mitochondria, or mitophagy, represents an important quality control system and is achieved by a cargo recognition mechanism enabling selective elimination of dysfunctional mitochondria. As photosynthetic organelles that need light for energy production, plant chloroplasts accumulate sunlight-induced damage. Plants have evolved multiple mechanisms to avoid, relieve, or repair chloroplast photodamage. Our recent study showed that vacuolar degradation of entire chloroplasts, termed chlorophagy, is induced to degrade chloroplasts that are collapsed due to photodamage. Our results underscore the involvement of autophagy in the quality control of endosymbiotic, energy-converting organelles in eukaryotes.

Differential responses to high- and low-dose ultraviolet-B stress in tobacco Bright Yellow-2 cells

Ultraviolet (UV)-B irradiation leads to DNA damage, cell cycle arrest, growth inhibition, and cell death. To evaluate the UV-B stress-induced changes in plant cells, we developed a model system based on tobacco Bright Yellow-2 (BY-2) cells. Both low-dose UV-B (low UV-B: 740 J m(-2)) and high-dose UV-B (high UV-B: 2960 J m(-2)) inhibited cell proliferation and induced cell death; these effects were more pronounced at high UV-B. Flow cytometry showed cell cycle arrest within 1 day after UV-B irradiation; neither low- nor high-UV-B-irradiated cells entered mitosis within 12 h. Cell cycle progression was gradually restored in low-UV-B-irradiated cells but not in high-UV-B-irradiated cells. UV-A irradiation, which activates cyclobutane pyrimidine dimer (CPD) photolyase, reduced inhibition of cell proliferation by low but not high UV-B and suppressed high-UV-B-induced cell death. UV-B induced CPD formation in a dose-dependent manner. The amounts of CPDs decreased gradually within 3 days in low-UV-B-irradiated cells, but remained elevated after 3 days in high-UV-B-irradiated cells. Low UV-B slightly increased the number of DNA single-strand breaks detected by the comet assay at 1 day after irradiation, and then decreased at 2 and 3 days after irradiation. High UV-B increased DNA fragmentation detected by the terminal deoxynucleotidyl transferase dUTP nick end labeling assay 1 and 3 days after irradiation. Caffeine, an inhibitor of ataxia telangiectasia mutated (ATM) and ataxia telangiectasia and Rad3-related (ATR) checkpoint kinases, reduced the rate of cell death in high-UV-B-irradiated cells. Our data suggest that low-UV-B-induced CPDs and/or DNA strand-breaks inhibit DNA replication and proliferation of BY-2 cells, whereas larger contents of high-UV-B-induced CPDs and/or DNA strand-breaks lead to cell death.

Autism prevalence in the United States with respect to solar UV-B doses: An ecological study

Evidence is mounting that vitamin D deficiency is intimately involved in autism. We report on autism prevalence by US state for those aged 6–17 y in 2010 with respect to indices of solar UV-B (UVB) doses. We calculated autism prevalence rates for white, black and Asian Americans by using total prevalence and relative populations of minors for each ethnic group by state. Analyses omit AK and HI (considered extreme cases), WY (no data), along with AZ and ND for black Americans (low numbers) and DC, ME, MT, ND and SD for Asian Americans (low numbers). For white Americans, the regression coefficient for solar UVB doses and autism prevalence ranged from -0.52 in January to -0.57 in October. For black Americans, the regression coefficient for latitude was 0.61, whereas those for solar UVB ranged from -0.55 to -0.61. For Asian Americans, the values for solar UVB ranged from -0.28 to -0.38. The inverse correlation between solar UVB and autism prevalence is similar to that for many types of cancer in the US. The journal literature indicates that adverse effects on fetal brain development during pregnancy due to vitamin D deficiency can explain these findings. However, we cannot rule out a role of vitamin D deficiency in early life. These results add to the evidence that vitamin D deficiency may be an important risk factor for autism and suggest that pregnant women and autistic individuals raise their serum 25-hydroxyvitamin D concentrations above 30 ng/ml.

Acute exposure to ultraviolet-B radiation modulates sex steroid hormones and receptor expression in the skin and may contribute to the sex bias of melanoma in a fish model

Using the Xiphophorus fish melanoma model, we show a strong male bias for sunlight-induced malignant melanoma, consistent with that seen in the human population. To examine underlying factors, we exposed adult X. couchianus fish to a single, sublethal dose of UVB and measured circulating sex steroid hormones and expression of associated hormone receptor genes over a 24-h period. We found that a single exposure had profound effects on circulating levels of steroid hormones with significant decreases for all free sex steroids at 6 and 24 h and increases in conjugated 2-estradiol and 11-ketotestosterone at 6 and 24 h, respectively. Whereas ARα expression increased in male and female skin, neither ARβ nor either of the ERs showed significant responses to UVB in either sex. The rapid response of male androgens and their receptors in the skin after UVB irradiation implicates hormones in the male bias of skin cancer and suggests that the photoendocrine response immediately after UV exposure may be relevant to melanomagenesis.

Constitutively active UVR8 photoreceptor variant in Arabidopsis

Arabidopsis thaliana UV RESISTANCE LOCUS 8 (UVR8) is a UV-B photoreceptor that initiates photomorphogenic responses underlying acclimation and UV-B tolerance in plants. UVR8 is a homodimer in its ground state, and UV-B exposure results in its instantaneous monomerization followed by interaction with CONSTITUTIVELY PHOTOMORPHOGENIC 1 (COP1), a major factor in UV-B signaling. UV-B photoreception by UVR8 is based on intrinsic tryptophan aromatic amino acid residues, with tryptophan-285 as the main chromophore. We generated transgenic plants expressing UVR8 with a single amino acid change of tryptophan-285 to alanine. UVR8(W285A) appears monomeric and shows UV-B-independent interaction with COP1. Phenotypically, the plants expressing UVR8(W285A) exhibit constitutive photomorphogenesis associated with constitutive activation of target genes, elevated levels of anthocyanins, and enhanced, acclimation-independent UV-B tolerance. Moreover, we have identified COP1, REPRESSOR OF UV-B PHOTOMORPHOGENESIS 1 and 2 (RUP1 and RUP2), and the SUPPRESSOR OF PHYA-105 (SPA) family as proteins copurifying with UVR8(W285A). Whereas COP1, RUP1, and RUP2 are known to directly interact with UVR8, we show that SPA1 interacts with UVR8 indirectly through COP1. We conclude that UVR8(W285A) is a constitutively active UVR8 photoreceptor variant in Arabidopsis, as is consistent with the crucial importance of monomer formation and COP1 binding for UVR8 activity.

An ecological study of cancer mortality rates in California, 1950-64, with respect to solar UVB and smoking indices

<u>

PURPOSE

</u> This paper addresses whether nonmelanoma skin cancer (NMSC) mortality rates can serve as a useful index of population ultraviolet-B (UVB) irradiance and vitamin D production in a manner that affects the risk of internal cancers <u>

METHODS

</u> This analysis uses the ecological study approach with cancer mortality rate data from 19 state economic areas in California. This paper uses age-adjusted data for those aged 40 y or older. Two additional indices for solar UVB doses were also used: latitude and surface UVB doses for July 1992 from the total ozone mapping spectrometer. Lung cancer mortality rates served as the index of the health effects of smoking<u>

RESULTS

</u> Significant inverse correlations with NMSC mortality rate in multiple linear regression analyses were found during the period 1950-64 for eight types of cancer for males: bladder, brain, colon, gastric, prostate, and rectal cancer; multiple myeloma; and non-Hodgkin lymphoma. No similar results emerged for females with respect to all three UVB indices. Their NMSC mortality rates averaged 60% lower than those for males. Lung cancer mortality rates were directly correlated with three types of cancer for males: laryngeal, oral, and renal. No significant correlations with NMSC mortality rates appeared for later periods<u>

CONCLUSIONS

</u> NMSC mortality rates were found inversely correlated with internal cancers for males in the period 1950-64. After that period, no further such correlations were found. The reasons may hypothetically include reduced NMSC mortality rates, high immigration rates, movement from rural to urban locations and reduced solar UVB irradiance.

Role of solar UVB irradiance and smoking in cancer as inferred from cancer incidence rates by occupation in Nordic countries

A large body of evidence indicates that solar ultraviolet-B (UVB) irradiance and vitamin D reduce the risk of incidence and death for many types of cancer. However, most of that evidence comes from midlatitude regions, where solar UVB doses are generally high in summer. Data on cancer standardized incidence ratios (SIRs) by sex and 54 occupation categories based on 1.4 million male and 1.36 million female cancer cases for 1961–2005 in the five Nordic countries provide the basis for an ecological study of the role of solar UVB in the risk of many types of cancer at high latitudes. Lip cancer SIRs less lung cancer SIRs for men was the best index of solar UVB dose, which was weakly inversely correlated with both melanoma and nonmelanoma skin cancer (NMSC) SIRs. Lung cancer SIRs were used as the index of the effects of smoking. For men, the UVB index was significantly inversely correlated with 14 types of internal cancer—bladder, breast, colon, gallbladder, kidney, laryngeal, liver, lung, oral, pancreatic, pharyngeal, prostate, rectal and small intestine cancer. For women, the same UVB index was inversely correlated with bladder, breast and colon cancer. These results generally agree with findings from other studies. These results provide more support for the UVB-vitamin D-cancer hypothesis and suggest that widespread fear of chronic solar ultraviolet (UV) irradiance may be misplaced.

Differences in vitamin D status may account for unexplained disparities in cancer survival rates between African and white Americans

Considerable disparities in cancer survival rates exist between African Americans (AAs) and white Americans (WAs). Various factors such as differences in socioeconomic status (SES), cancer stage at time of diagnosis, and treatment—which this analysis considers primary explanatory factors—have accounted for many of these differences. An additional factor not usually considered is vitamin D. Previous studies have inversely correlated higher solar ultraviolet-B (UVB) doses and serum 25-hydroxyvitamin D (25(OH)D) concentrations with incidence and/or mortality rates for about 20 types of cancer and improved survival rates for eight types of cancer. Because of darker skin pigmentation, AAs have 40% lower serum 25(OH)D concentrations than WAs. This study reviews the literature on disparities in cancer survival between AAs and WAs. The journal literature indicates that there are disparities for 13 types of cancer after consideration of SES, stage at diagnosis and treatment: bladder, breast, colon, endometrial, lung, ovarian, pancreatic, prostate, rectal, testicular, and vaginal cancer; Hodgkin lymphoma and melanoma. Solar UVB doses and/or serum 25(OH)D concentrations have been reported inversely correlated with incidence and/or mortality rates for all of these cancers. This finding suggests that future studies should consider serum 25(OH)D concentrations in addressing cancer survival disparities through both measurements of serum 25(OH)D concentrations and increasing serum 25(OH)D concentrations of those diagnosed with cancer, leading to improved survival rates and reduced disparities.

Vitamin D: Its role in disease prevention

Evidence that vitamin D reduces the risk of many types of disease is increasing exponentially. In 2011, 3,100 publications with "vitamin D" in the title or abstract were published, up from 2,606 in 2010, 1,303 in 2005, and 796 in 2000. A committee operating under the auspices of the Institute of Medicine (IOM) of the US National Academies reviewed the evidence for beneficial effects of vitamin D. Their report, issued at the end of 2010,(1) found what they considered to be strong evidence for only one health outcome: skeletal health. They considered beneficial evidence only from published randomized controlled trials (RCTs) focused mainly on skeletal health. In contrast, to justify concern about higher vitamin D intake and serum 25(OH)D concentrations, they used data from nested case-control studies reporting U-shaped outcomes of prediagnostic serum 25-hydroxyvitamin D [25(OH)D] for cancer and all-cause mortality rates. They set the daily recommended intake of vitamin D at 600-800 IU for most children and adults and defined vitamin D sufficiency as a serum 25(OH)D level above 20 ng/ml (50 nmol/l). They also set a daily upper intake of 4,000 IU of vitamin D(3) and called for more RCTs to determine nonskeletal health effects. As of this writing, more than 130 journal publications have criticized the IOM report as being too conservative. One summarized the problems succinctly: "The IOM recommendations for vitamin D fail in a major way on logic, on science, and on effective public health guidance. Moreover, by failing to use a physiological referent, the IOM approach constitutes precisely the wrong model for development of nutritional policy."(2).

Effect of follow-up time on the relation between prediagnostic serum 25-hydroxyvitamin D and all-cause mortality rate

Evidence continues to mount that vitamin D reduces the risk and mortality rates of many types of disease. However, evidence from prospective cohort studies is sometimes weaker than that from case-control and ecological studies. A suggested reason for this discrepancy is that, because serum levels of 25-hydroxyvitamin D [25(OH)D] change over time, a single 25(OH)D concentration measurement taken at study enrollment does not reliably indicate 25(OH)D concentration related to the health outcome. To evaluate this suggestion further, this paper plots results from 12 prospective cohort studies of all-cause mortality rate vs. follow-up time. The regression fit to the hazard ratio per 20-nmol/l increase in serum 25(OH)D concentration vs. time increased from 0.82 (95% CI, 0.67-1.02) for 6 y to 0.96 (95% CI, 0.90-1.01) for 14 y. The value extrapolated for zero follow-up time was 0.72 (95% CI, 0.50-1.03), giving a hazard ratio reduction 3.5 times higher than the standard result from the meta-analysis [0.92 (95% CI, 0.89-0.95)]. Using the example of the Vitamin D Pooling Project of Rarer Cancers, this paper also discusses follow-up time's effect in interpreting prospective cohort studies of cancer outcome. This paper recommends that meta-analyses of prospective cohort studies account for follow-up time and, if possible, that studies measure serum 25(OH)D concentration every 2-4 y.

The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918-1919 influenza pandemic in the United States

Deaths during the 1918-1919 influenza pandemic have been linked to both the influenza virus and secondary bacterial lung infections. Case fatality rates and percentage of influenza cases complicated by pneumonia were available from survey data for twelve United States locations in the 1918-1919 pandemic. This study analyzes case fatality rates and cases complicated by pneumonia with respect to estimated summertime and wintertime solar ultraviolet-B (UVB) doses as indicators of population mean vitamin D status. Substantial correlations were found for associations of July UVB dose with case fatality rates (r = -0.72, p = 0.009) and rates of pneumonia as a complication of influenza (r = -0.77, p = 0.005). Similar results were found for wintertime UVB. Vitamin D upregulates production of human cathelicidin, LL-37, which has both antimicrobial and antiendotoxin activities. Vitamin D also reduces the production of proinflammatory cytokines, which could also explain some of the benefit of vitamin D since H1N1 infection gives rise to a cytokine storm. The potential role of vitamin D status in reducing secondary bacterial infections and loss of life in pandemic influence requires further evaluation.

Effect of interval between serum draw and follow-up period on relative risk of cancer incidence with respect to 25-hydroxyvitamin D level: Implications for meta-analyses and setting vitamin D guidelines

Ecological studies have reported strong inverse correlations between indices of solar ultraviolet-B (UVB) doses and incidence and/or mortality rates for many types of cancer. Case-control studies (CCS) generally find inverse correlations between serum 25-hydroxyvitamin D [25(OH)D] concentration measured at time of diagnosis for cancer incidence, whereas nested case-control studies (NCCS), which involve a several-year follow-up time after serum sampling, generally do not. This paper examines the relation between follow-up interval and relative risk (RR) for breast, colorectal, and prostate cancer. I plot the RR versus serum 25(OH)D data as a function of follow-up time from the literature for each type of cancer. For breast cancer, RRs were significantly reduced only for follow-up periods less than 3 years. For colorectal cancer, RRs were generally significantly reduced for follow-up periods up to 12 years. For prostate cancer, RRs were not statistically significant from 4 years to 28 years. This study included no CCS. Follow-up periods after serum sampling should not be too long for breast cancer because once a tumor reaches a diameter of 1-3 mm, it requires angiogenesis to continue growing, and vitamin D reduces angiogenesis around tumors. Breast cancer diagnoses are more common in spring and fall than in summer or winter, indicating that they can grow rapidly if circulating 25(OH)D drops in the fall or melatonin levels drop in spring. Serum sampling should be conducted during the study, perhaps every 2 years, to overcome the problem of change of 25(OH)D concentration during cohort studies.

A review of the role of solar ultraviolet-B irradiance and vitamin D in reducing risk of dental caries

Large geographical variations in dental health and tooth loss among US adolescents and young adults have been reported since the mid-1800s. Studies in the 1920s and 1930s noted that vitamin D and ultraviolet-B (UVB) irradiance reduced caries formation, the proposed mechanism being improved calcium absorption and metabolism. This paper reviews the history of studies of dental caries with respect to vitamin D, geographical location and available solar UVB doses. In addition, data on mean dental health rank by state for US servicemen from three periods, 1918, 1934 and 1943, were used in regression analyses with respect to summertime solar UVB doses and an index for mottled enamel, a proxy for natural fluoridation of drinking water, for 1935. There was a significant inverse correlation for dental health rank with respect to solar UVB from doses of 4.0 to 6.5 kJ/m(2) with little change thereafter. Adding data for mottled enamel rates for the states with UvB doses <6.6 kJ/m(2) improved the adjusted R(2) from 0.45 to 0.52. The mechanism whereby UVB reduces risk of dental caries is likely through production of vitamin D, followed by induction of cathelicidin and defensins, which have antimicrobial properties. Serum 25-hydroxyvitamin D concentrations at or above 30-40 ng/ml should significantly reduce the formation of dental caries. It is unfortunate that the UVB and vitamin D findings were not given more consideration in the 1950s as a way to reduce the risk of dental caries when water fluoridation was being proposed.

Dr. Frank caldwell garland, june 20, 1950-august 17, 2010

Frank Caldwell Garland, Ph.D., died August 17, 2010 after a year-long battle with cancer. He will be remembered for his seminal work with his brother Cedric F. Garland in proposing the ultraviolet-B (UVB)-vitamin D-cancer hypothesis to explain the geographical variation of colon cancer mortality rates in the United States in 1980. This hypothesis has been extended to about 20 types of cancer using the ecological approach, and supported strongly by observational studies of prediagnostic serum 25-hydroxyvitamin D [25(OH) D] for incidence of breast, colorectal and ovarian cancer, and a randomized controlled trial that used sufficient vitamin D (1,150 IU/day) to and found a strongly beneficial effect on cancer incidence. The UVB-vitamin D-cancer hypothesis is also supported by studies that used as the index of solar UVB irradiance the amount of sunlight exposure in childhood or incidence of non-melanoma skin cancer. Survival after diagnosis was increased for individuals with higher serum 25(OH)D levels at the time of cancer diagnosis for six types of cancer: breast, colorectal, lung and prostate cancer; melanoma and non-Hodgkin's lymphoma. The ecological study approach is ideally suited to studying cancer risk-modifying factors since the lag between cancer initiation and detection or death can be 20-40 years or more, making ordinary observational studies difficult. The impact on vitamin D research by both Frank Garland and Cedric Garland has been immense. Health policy leaders will realize this in the near future, providing a rich legacy for humanity.

An ecological study of cancer mortality rates in the United States with respect to solar ultraviolet-B doses, smoking, alcohol consumption and urban/rural residence

The Cohort Consortium Vitamin D Polling Project of Rarer Cancers (VDPP ) study failed to find a beneficial role of prediagnostic serum 25-hydroxyvitamin D [25(OH)D] levels on risk of seven types of rarer cancer: endometrial, esophageal, gastric, kidney, ovarian and pancreatic cancer and non-Hodgkin's lymphoma (NHL). However, ecological studies and studies of oral vitamin D intake have generally found solar ultraviolet B (UVB) and oral vitamin D inversely correlated with incidence and/or mortality rates of these cancers. To explore the discrepancy, I conducted an ecological study of cancer mortality rates for white Americans in the United States for 1950-1994 with data for 503 state economic areas in multiple linear regression analyses with respect to UVB for July, lung cancer, alcohol consumption and urban/rural residence. UVB was significantly inversely correlated with six types of cancer (not pancreatic cancer) in both periods. However, the adjusted R(2) values were much lower for cancers with lower mortality rates than those in an earlier ecological study that used state-averaged data. This finding suggests that the VDPP study may have had too few cases. Thus, the VDPP study should not be considered as providing strong evidence against the solar UVB-vitamin D-cancer hypothesis.

An ecological study of cancer incidence and mortality rates in France with respect to latitude, an index for vitamin D production

France has unexplained large latitudinal variations in cancer incidence and mortality rates. Studies of cancer rate variations in several other countries, as well as in multicountry studies, have explained such variations primarily in terms of gradients in solar ultraviolet-B (UVB) doses and vitamin D production. To investigate this possibility in France, I obtained data on cancer incidence and mortality rates for 21 continental regions and used this information in regression analyses with respect to latitude. This study also used dietary data. Significant positive correlations with latitude emerged for breast, colorectal, esophageal (males), lung (males), prostate, both uterine cervix and uterine corpus, all and all less lung cancer. Although correlations with latitude were similar for males and females, the regression variance for all and all less lung cancer was about twice as high for males than for females. Lung cancer incidence and mortality rates for females had little latitudinal gradient, indicating that smoking may have also contributed to the latitudinal gradients for males. On the basis of the available dietary factor, micro- and macronutrient data, dietary differences do not significantly affect geographical variation in cancer rates. These results are consistent with solar UVB's reducing the risk of cancer through production of vitamin D. In the context of serum 25-hydroxyvitamin D level-cancer incidence relations, cancer rates could be reduced significantly in France if everyone obtained an additional 1,000 IU/day of vitamin D. Many other benefits of vitamin D exist as well.

Critique of the International Agency for Research on Cancer's meta-analyses of the association of sunbed use with risk of cutaneous malignant melanoma

The International Agency for Research on Cancer (IARC) reported meta-analyses of the association of cutaneous malignant melanoma (CMM), finding significant correlations with ever use of sunbeds and first use of sunbeds prior to age 35 years; it did not claim that the associations showed causal links. However, some observational studies in the meta-analysis included individuals in the UK with skin phenotype at increased genetic risk of CMM without adjustment for skin phenotype. Treating the five UK studies separately from the other 14 corrected this oversight. In the original study, the summary relative risk (RR ) of CMM with respect to sunbed use was 1.15 (95% confidence interval [CI], 1.00-1.31). In this study, the similar RR was 1.20 (95% CI, 1.03-1.38). The RR for the five UK studies was 2.09 (95% CI, 1.14-3.84), whereas the RR for the other 14 studies was 1.09 (95% CI, 0.96-1.24). For first use of sunbeds prior to age 35 years, the IARC found a summary RR of 1.75 (95% CI, 1.35-2.36). This study plotted the RRs versus latitude of each study population, with a linear regression analysis carried out for all but the one UK study. The RR increased at 0.077 per degree of latitude and the regression explained 67% of the variance. It is also argued that factors other than sunbed use explain the increasing worldwide trends in CMM. Because solar-UV-simulating sunbeds induce production of vitamin D, the health benefits of their use greatly outweigh any possible risks.

Epidemiologic evidence supporting the role of maternal vitamin D deficiency as a risk factor for the development of infantile autism

This study examines whether maternal vitamin D deficiency is a risk factor for infantile autism disease (IAD). We used epidemiologic data seasonal variation of birth rates and prevalence of IAD for cohorts born before 1985. For seven studies reporting spring-to-summer excess birth rates for IAD, the season progressed from broad near 30 degrees N latitude, spring/summer in midlatitudes, to winter at the highest latitude. Also, using data from 10 studies, we found a strong effective latitudinal (related to wintertime solar ultraviolet B radiation) increase in IAD prevalence. These findings are consistent with maternal vitamin D deficiency's being a risk factor for IAD, possibly by affecting fetal brain development as well as possibly by affecting maternal immune system status during pregnancy. Further investigation of this hypothesis is warranted.

In defense of the sun: An estimate of changes in mortality rates in the United States if mean serum 25-hydroxyvitamin D levels were raised to 45 ng/mL by solar ultraviolet-B irradiance

Emerging scientific evidence strongly supports the beneficial role of vitamin D in reducing the risk of incidence and death from many chronic and infectious diseases. This study estimates increases in melanoma and nonmelanoma skin cancer mortality rates and decreases in chronic and infectious disease mortality rates in the US from the standpoint of approximately doubling population doses of solar UVB to increase mean serum 25-hydroxyvitamin D levels from 16 ng/mL for black Americans and 25 ng/mL for white Americans to 45 ng/mL. The primary benefits are expected to come from reductions in cancer and cardiovascular diseases. Although a few thousand excess deaths per year might occur from melanoma and skin cancer, the avoided premature death rate could be near 400,000/ year, with most of the avoided deaths coming late in life. While oral sources of vitamin D could be used instead of UVB or when UVB irradiance is not available, public health policies do not yet recommend the 3,000-4,000 IU/day required to raise serum 25-hydroxyvitamin D levels to the levels required for optimal health, which would be required before vitamin D fortification levels in food can be raised. Until then, moderate solar UVB irradiance remains an import source, and the health benefits greatly outweigh the risks.

Solar ultraviolet-B irradiance and vitamin D may reduce the risk of septicemia

The primary features of the epidemiology of septicemia in the United States include highest rates in winter and the Northeast, lowest in fall and in the West; higher rates among African Americans than white Americans; a rapid increase in incidence with age; comorbidity with several chronic and infectious diseases; and a rapid increase in incidence rate starting in the early 1980s. This article reviews the literature on the epidemiology of septicemia in the United States, along with the roles of solar ultraviolet-B (UVB) and vitamin D3 related to the more important features. Solar UVB doses in summer are highest in the Southwest and lowest in the Northeast. Serum 25-hydroxyvitamin D [25(OH)D] levels are highest in summer, lowest in winter. African Americans have much lower 25(OH)D levels than those of white Americans. Serum 25(OH)D levels decline rapidly with advancing age. The risk of diseases comorbid with septicemia are generally inversely correlated with serum 25(OH)D levels. Sun-avoidance messages may have led to lower population levels of 25(OH)D, although prevalence of antibiotic-resistant bacteria may have increased. Previous reports have shown that 1,25-dihydroxyvitamin D upregulates human cathelicidin, LL-37, which has antimicrobial as well as antiendotoxin activity. The general agreement between the epidemiology of septicemia in the United States and the variations of solar UVB and the effects of vitamin D supports the hypothesis that both play important roles in reducing the risk of septicemia. Further study is warranted to evaluate this hypothesis.

Protective actions of Rubus coreanus ethanol extract on collagenous extracellular matrix in ultraviolet-B irradiation-induced human dermal fibroblasts

Solar ultraviolet (UV) irradiation leads to distinct changes in the skin connective tissues by degradation of collagen, which is a major structural component in the extracellular matrix. UV irradiation induces the production of matrix metalloproteinases (MMP) capable of attacking native fibrillar collagen and responsible for inhibiting the construction of collagenous extracellular matrix. In this study, we attempted to investigate the protective actions of Rubus coreanus ethanol extract (RCE) on the MMP production and the consequent procollagen/collagen degradation in UV-B-irradiated human dermal fibroblasts. The analytical data showed that Rubus coreanus ethanol extract was mostly comprised of cyanidin 3-rutinoside. Pre-treatment of fibroblasts with this extract inhibited UV-B-induced production of MMP-1, MMP-8 and MMP-13 in dose-dependent manners. In addition, Western blot analysis and immunocytochemical staining assay revealed that RCE markedly augmented the cellular levels of procollagen/collagen declined in UV-B-exposed dermal fibroblasts. These results demonstrate that RCE blocks UV-B-induced increase of the collagen degradation by inhibiting MMP production. Thus, RCE may act as an agent inhibiting excessive dermal collagen degradation leading to the skin photoaging.

Ultraviolet-B responses of nuclear genes encoding light-harvesting complex II proteins in pea (Pisum sativum) are altered by norflurazon- and photobleaching-induced chloroplast changes

The role of functional and intact chloroplasts in mediating the ultraviolet-B (UV-B, 290-320 nm) regulation of two nuclear genes encoding light-harvesting complex II proteins in pea (Pisum sativum L. cv. Extra Early Alaska) was studied. Plants with chloroplasts lacking or containing carotenoids and functional photosystem II were obtained by growth under dim red light (0.2 µmol m^-2 s^-1 ) in the presence or absence of norflurazon (NF), an inhibitor of carotenoid biosynthesis. The NF-treatment resulted in an increase in AB80 (lhcb1^* 2) mRNA but no substantial change in Cab-8 (lhcb1^* 4) mRNA, indicating that the mRNA accumulations for AB80 and Cab-8 were differently correlated with the presence and absence of carotenoids. The mRNA levels for both Cab-8 and AB80 in the NF-treated plants were reduced to the same extent by partially photobleaching the chloroplasts with 3 h of higher intensity white light (W, 110 µmol m^-2 s^-1 ), suggesting that chloroplast integrity was equally important for transcript accumulation of both genes. The mRNAs of both Cab-8 and AB80 in non-NF-treated control plants were decreased by UV-B irradiation, with the level of AB80 mRNA reduced to a greater extent. The UV-B-induced mRNA reduction of both genes was inhibited by NF. The difference between the UV-B responses of the two genes was unaffected by NF, but was abolished by photobleaching the NF-treated plants prior to the UV-B irradiation. Therefore, the presence of carotenoids enhanced rather than prevented the UV-B down-regulation, and the difference in UV-B responses of the two genes may be dependent on chloroplast integrity.