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Hui LL, Chan MMF, Pang SM. An intensely pruritic disseminated skin eruption. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022; 51:62-63. [PMID: 35091734 DOI: 10.47102/annals-acadmedsg.2020640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Laura Ly Hui
- Department of Dermatology, Singapore General Hospital, Singapore
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Zhilova MB, Gorodnichev PV. Narrow-band phototherapy in the treatment of atopic dermatitis: mechanisms of action, methodology of implementation. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Phototherapy is widely used to treat various chronic skin diseases. One of the most effective methods of treatment is narrow-band medium-wave ultraviolet radiation with a wavelength of 311 nm (UVB-311). UVB-311 is used for such immune-mediated diseases as atopic dermatitis, psoriasis, vitiligo, mycosis fungoides and others. Despite the fact that the method was developed more than 30 years ago, the exact mechanism of its therapeutic action remains insufficiently studied. To date, most of the effects of UVB-311 are explained by its effect on the immune cells of the skin. This review examines data on the effects on the main molecular targets, including T-lymphocytes, keratinocytes, Langerhans cells, cytokine profile, epidermal barrier proteins. Data on the features of the pathogenetic effect of UVB-311 on the immune mechanisms of pathogenesis in atopic dermatitis were obtained. The issues of dosing by determining the minimum erythemic dose (MED) or skin phototype, methodology of procedures are discussed. Prospects for further study of photobiological aspects of UVB-311 action are determined.
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Onishi-Sakamoto S, Makishi K, Takami K, Asahina R, Maeda S, Nagata M, Moore PF, Ide K, Nishifuji K. Narrow-band ultraviolet B therapy attenuates cutaneous T-cell responses in hapten-induced, experimental contact dermatitis in beagles. Vet Dermatol 2021; 32:605-e161. [PMID: 34796565 DOI: 10.1111/vde.13035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND In human medicine, narrow-band ultraviolet B (NB-UVB) phototherapy has been used to treat various T-cell-mediated skin diseases. However, the effect of NB-UVB on inflamed canine skin remains uncertain. OBJECTIVES To investigate the effect of NB-UVB phototherapy on the skin of dogs with hapten-induced contact dermatitis. ANIMALS Seven healthy beagles without skin problems. METHODS AND MATERIALS Dogs were irradiated with varying doses of NB-UVB to determine the minimal erythema dose (MED). After determining the MEDs of six dogs (excluding one of the seven whose skin did not show a visible reaction), we investigated the effect of NB-UVB on their inflamed skin by topically applying 2,4-dinitrochlorobenzene (DNCB), which causes type 1 helper T cell (Th1)- and cytotoxic T-cell (Tc)1-induced skin inflammation. We then irradiated the skin with NB-UVB. We analysed the treated skin samples via histopathological and immunohistochemical methods, and TdT-mediated dUTP nick-end labelling (TUNEL) to demonstrate apoptotic cells. We also analysed the cytokine gene transcription via real-time quantitative reverse transcription PCR. RESULTS The NB-UVB MEDs caused mild inflammatory changes yet no severe epidermal exfoliations in the irradiated skin. In DNCB-treated skin irradiated by the NB-UVB MEDs, TUNEL-positive dermal apoptotic cells were increased significantly compared with those of DNCB-treated, nonirradiated skin. INF-γ and TNF-α transcription levels in DNCB-treated, irradiated skin were significantly lower than those in the DNCB-treated, nonirradiated skin. CONCLUSION AND CLINICAL RELEVANCE Phototherapy using NB-UVB MEDs attenuated cutaneous Th1 and Tc1 cytokine responses with minimal skin damage in a canine model of hapten-induced contact dermatitis.
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Affiliation(s)
- Saki Onishi-Sakamoto
- Laboratory of Veterinary Internal Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Kiichi Makishi
- Laboratory of Veterinary Internal Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | | | - Ryota Asahina
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sadatoshi Maeda
- Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan
| | | | - Peter F Moore
- School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Kaori Ide
- Laboratory of Veterinary Internal Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Koji Nishifuji
- Laboratory of Veterinary Internal Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
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Liu J, Liang Y, Yan S, Chen D, Miao S, Wang W. Narrowband ultraviolet-B persistent luminescence from (Y,Gd) 3Ga 5O 12:Bi 3+ phosphors for optical tagging application. Dalton Trans 2021; 50:15413-15421. [PMID: 34652360 DOI: 10.1039/d1dt02568f] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Luminescent materials that emit in the narrowband ultraviolet-B (NB-UVB; 310-313 nm) spectral region have attracted considerable attention due to their unique spectral features, which endow them with great potential applications in the fields of photochemistry and photomedicine. However, NB-UVB persistent luminescent materials are relatively lacking, especially materials that are excitable by natural sunlight. Here we report the NB-UVB persistent luminescence of Gd3+ in (Y,Gd)3Ga5O12:Bi3+ garnets by making use of the persistent energy transfer from Bi3+ to Gd3+. The optimal Bi3+ and Gd3+ concentrations for the maximum energy transfer efficiency are determined and persistent NB-UVB light emission with a peak wavelength at 313 nm and an afterglow time of more than 24 h is successfully achieved in the (Y,Gd)3Ga5O12:Bi3+ phosphor. More importantly, the as-synthesized NB-UVB persistent phosphors are also excitable by the widely available natural sunlight and exhibit exceptional NB-UVB persistent luminescence performance. Benefitting from the visible-blind emission feature, interference-free capability from indoor ambient light and self-sustained optical characteristic, the developed sunlight-excitable NB-UVB persistent phosphors here not only hold great promise for covert optical tagging applications, but also open new opportunities for optical data storage in a bright indoor environment.
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Affiliation(s)
- Jingwei Liu
- Key Laboratory for Liquid-Solid Structure Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China.
| | - Yanjie Liang
- Key Laboratory for Liquid-Solid Structure Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China.
| | - Shao Yan
- Key Laboratory for Liquid-Solid Structure Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China.
| | - Dongxun Chen
- Key Laboratory for Liquid-Solid Structure Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China.
| | - Shihai Miao
- Key Laboratory for Liquid-Solid Structure Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China.
| | - Weili Wang
- Key Laboratory for Liquid-Solid Structure Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China.
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Grandi V, Fava P, Rupoli S, Alberti Violetti S, Canafoglia L, Quaglino P, Berti E, Pimpinelli N. Standardization of regimens in Narrowband UVB and PUVA in early stage mycosis fungoides: position paper from the Italian Task Force for Cutaneous Lymphomas. J Eur Acad Dermatol Venereol 2018; 32:683-691. [DOI: 10.1111/jdv.14668] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 10/16/2017] [Indexed: 11/29/2022]
Affiliation(s)
- V. Grandi
- Dermatology Unit; Department of Surgery and Translational Medicine; University of Florence Medical School; Florence Italy
| | - P. Fava
- Department of Medical Sciences; Dermatologic Clinic; University of Turin; Turin Italy
| | - S. Rupoli
- Clinic of Hematology; United Ancona Hospitals; Polytechnic University of Marche; Ancona Italy
| | - S. Alberti Violetti
- Dermatology Unit; IRCCS Ca’ Granda - Ospedale Maggiore Policlinico; Milan Italy
| | - L. Canafoglia
- Clinic of Hematology; United Ancona Hospitals; Polytechnic University of Marche; Ancona Italy
| | - P. Quaglino
- Department of Medical Sciences; Dermatologic Clinic; University of Turin; Turin Italy
| | - E. Berti
- Dermatology Unit; IRCCS Ca’ Granda - Ospedale Maggiore Policlinico; Milan Italy
| | - N. Pimpinelli
- Dermatology Unit; Department of Surgery and Translational Medicine; University of Florence Medical School; Florence Italy
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Martini E, Wikén M, Cheuk S, Gallais Sérézal I, Baharom F, Ståhle M, Smed-Sörensen A, Eidsmo L. Dynamic Changes in Resident and Infiltrating Epidermal Dendritic Cells in Active and Resolved Psoriasis. J Invest Dermatol 2016; 137:865-873. [PMID: 28011143 DOI: 10.1016/j.jid.2016.11.033] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 11/07/2016] [Accepted: 11/17/2016] [Indexed: 12/24/2022]
Abstract
Epidermal Langerhans cells (LCs) are spatially separated from dermal dendritic cells (DCs) in healthy human skin. In active psoriasis, maintained by local production of IL-23 and IL-17, inflammatory DCs infiltrate both skin compartments. Here we show that CCR2+ epidermal DCs (eDCs) were confined to lesional psoriasis and phenotypically distinct from dermal DCs. The eDCs exceeded the number of LCs and displayed high expression of genes involved in neutrophil recruitment and the activation of keratinocytes and T cells. Resident LCs responded to toll-like receptor 4 and toll-like receptor 7/8 activation with increased IL-23 production, whereas eDCs additionally produced IL-1β together with IL-23 and tumor necrosis factor. Psoriasis typically recur in fixed skin lesions. eDCs were absent from resolved psoriasis. Instead, LCs from anti-tumor necrosis factor-treated lesions retained high IL23A expression and responded to toll-like receptor stimulation by producing IL-23. Our results reveal phenotypic and functional properties of eDCs and resident LCs in different clinical phases of psoriasis, and the capacity of these cells to amplify the epidermal microenvironment through the secretion of IL-17 polarizing cytokines.
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Affiliation(s)
- Elisa Martini
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Maria Wikén
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Stanley Cheuk
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Irène Gallais Sérézal
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Faezzah Baharom
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Mona Ståhle
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | | | - Liv Eidsmo
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
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Sokolova A, Lee A, D Smith S. The Safety and Efficacy of Narrow Band Ultraviolet B Treatment in Dermatology: A Review. Am J Clin Dermatol 2015; 16:501-31. [PMID: 26369540 DOI: 10.1007/s40257-015-0151-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Narrow-band ultraviolet B (NBUVB) phototherapy is an important treatment modality in dermatology. The most common dermatological indications for NBUVB include psoriasis, atopic dermatitis and vitiligo; however, it has been found to be an effective and well-tolerated treatment option in various other dermatoses. The efficacy of NBUVB phototherapy compares favorably with other available photo(chemo)therapy options and its efficacy is further augmented by a number of topical and systemic adjuncts. The long-term safety of NBUVB phototherapy remains to be fully elucidated; however, available data now suggest that it is safe and well-tolerated. The objective of this review was to summarize the current understanding of the safety and efficacy of NBUVB phototherapy in dermatology.
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Affiliation(s)
- Anna Sokolova
- Westmead Hospital, Cnr Hawkesbury Road and Darcy Road, Westmead, NSW, 2145, Australia
| | - Andrew Lee
- Department of Dermatology, Royal North Shore Hospital, Reserve Road, St Leonards, NSW, 2065, Australia.
- Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.
| | - Saxon D Smith
- Department of Dermatology, Royal North Shore Hospital, Reserve Road, St Leonards, NSW, 2065, Australia
- Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
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Resolución de granuloma anular diseminado con fototerapia UVB de banda estrecha. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:240-1. [DOI: 10.1016/j.ad.2014.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 08/03/2014] [Accepted: 08/31/2014] [Indexed: 11/21/2022] Open
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Solano-López G, Concha-Garzón M, de Argila D, Daudén E. Successful Treatment of Disseminated Granuloma Annulare With Narrowband UV-B Phototherapy. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2015.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Bafteh PR, Siegesmund M, Kuerten V, Neumann NJ. Phototoxicity of narrowband ultraviolet (UV) B (311 nm) compared with broadband UVB in the photo hen's egg test. Br J Dermatol 2014; 172:462-6. [PMID: 24975088 DOI: 10.1111/bjd.13221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Broadband ultraviolet B (BB-UVB) is a well-established treatment option in dermatology. However, during the last decade BB-UVB has increasingly been replaced by narrowband UVB 311 nm (NB-UVB), especially in the therapy of psoriasis, atopic eczema and vitiligo. Several studies have indicated a better therapeutic response for almost all indications compared with BB-UVB. OBJECTIVES The aim of our study was to investigate the phototoxic effects of NB-UVB in comparison with BB-UVB in vivo. METHODS Therefore, we employed the photo hen's egg test (PHET), an established phototoxic model, based on the yolk sac blood vessel system of incubated hen's eggs. NB-UVB and BB-UVB dosages increasing from 30 up to 1200 mJ cm(-2) were applied on 17 test groups (each n = 12 eggs) and two unirradiated test groups served as controls. Twenty-four hours after irradiation we observed the following test parameters: lethality, membrane discoloration and haemorrhages. RESULTS Following our results, the lethal half dose (LD50) was 60 and 720 mJ cm(-2) for BB-UVB and NB-UVB, respectively. These LD50 dosages provoked severe membrane discoloration and haemorrhaging. Summarizing our results, the LD50 of NB-UVB was 12-fold higher than BB-UVB. CONCLUSIONS Interestingly, these findings are in good accordance with the literature, where the minimal erythema dose (MED) of NB-UVB in human skin is up to 14 times higher than the MED of BB-UVB. These results show that the PHET is a valid test model to evaluate the phototoxic effects of various UVB wavelengths. Moreover, our results indicate that regarding the investigation of phototoxic effects the PHET might serve as a model representative for human skin, which might reduce the extent of photoprovocation in humans in the future.
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Affiliation(s)
- P R Bafteh
- Department of Dermatology, Porphyria Specialist Center, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
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Effect of Narrow Band Ultraviolet B Therapy versus Methotrexate on Serum Levels of Interleukin-17 and Interleukin-23 in Egyptian Patients with Severe Psoriasis. Dermatol Res Pract 2013; 2013:618269. [PMID: 24489536 PMCID: PMC3893776 DOI: 10.1155/2013/618269] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 10/04/2013] [Accepted: 10/07/2013] [Indexed: 11/18/2022] Open
Abstract
Background. There is raised interest in the involvement of interleukin-(IL-)23/T-helper 17 cells (Th17) axis in the pathogenesis of psoriasis. Objectives. To compare the effect of narrow band ultraviolet B (NB-UVB) and methotrexate (MTX) therapy on serum levels of IL-17 and IL-23 in psoriatic patients. Methods. Thirty patients with severe plaque psoriasis were included: 15 patients received NB-UVB three times weekly (group I) and 15 patients received MTX 0.3 mg/kg per week (group II), both for 8 weeks. Before and after treatment, serum levels of IL-17 and IL-23 were investigated by ELISA technique and psoriasis area and severity index (PASI) was calculated. Results. After treatment, all patients showed a reduction in their PASI score, IL-17 and IL-23
serum levels with a nonsignificant difference between both therapeutic modalities (P value >0.05). A positive correlation was detected between the percent of reduction of IL-17, IL-23 and the percent of reduction of PASI score for patients receiving both treatments. No
correlation was found between the percent of reduction of IL-17, IL-23 and duration of disease or age of all patients in this study. Conclusion. Interleukin-17 and IL-23 serum level may serve as a potential biomarker for predicting the prognosis and therapeutic response of NB-UVB or MTX in treating psoriasis.
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Reich A, Mędrek K. Effects of narrow band UVB (311 nm) irradiation on epidermal cells. Int J Mol Sci 2013; 14:8456-66. [PMID: 23594996 PMCID: PMC3645754 DOI: 10.3390/ijms14048456] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 04/09/2013] [Accepted: 04/09/2013] [Indexed: 01/02/2023] Open
Abstract
Ultraviolet radiation (UVR) is known to be one of the most important environmental hazards acting on the skin. It was revealed that chronic exposure to UVR accelerates skin aging, induces immunosuppression and may lead to the development of skin cancers. On the other hand, UVR has been shown to be effective in the treatment of numerous skin diseases and thus, various phototherapy modalities have been developed to date. Narrow-band ultraviolet B (NB-UVB) emitting a light with a peak around 311 nm has been demonstrated to be effective in the treatment of various skin disorders; currently it is one of the most commonly used phototherapy devices. Despite NB-UVB has been developed more than 30 years ago, the exact mechanism of its therapeutic action remains poorly understood. To date, most of NB-UVB effects were attributed to its influence on immune cells; however, nearly 90% of NB-UVB irradiation is absorbed by epidermis and keratinocytes seem to be important players in mediating NB-UVB biological activity. Here, we have reviewed the current data about the influence of NB-UVB on epidermal cells, with a special emphasis on cell proliferation and death.
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Affiliation(s)
- Adam Reich
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chałubińskiego 1, Wrocław 50-368, Poland.
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Liu Z, Guo Z, Zhuang Z, Zhai J, Xiong H, Zeng C. Quantitative optical coherence tomography of skin lesions induced by different ultraviolet B sources. Phys Med Biol 2010; 55:6175-85. [DOI: 10.1088/0031-9155/55/20/009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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AIHARA M, HASEGAWA T, OKUYAMA Y, HIRUMA M, IKEDA S. Langerhans cell histiocytosis treated with narrow-band ultraviolet B. J Dermatol 2010; 38:151-4. [DOI: 10.1111/j.1346-8138.2010.00959.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Effective narrow-band UVB radiation therapy suppresses the IL-23/IL-17 axis in normalized psoriasis plaques. J Invest Dermatol 2010; 130:2654-63. [PMID: 20555351 DOI: 10.1038/jid.2010.166] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Narrow-band UVB radiation (NB-UVB) therapy offers a well-established treatment modality for psoriasis. However, despite the common use of this form of treatment, the mechanism of action of NB-UVB is not well understood. We studied a group of 14 patients with moderate-to-severe psoriasis treated with carefully titrated and monitored NB-UVB for 6 weeks. Lesional plaques were classified as normalized (n=8) or nonresponsive (n=6) based on their histological improvement and normalization. We characterized lesional myeloid dendritic cells (DCs) and T cells and their inflammatory mediators using immunohistochemistry and real-time PCR. NB-UVB suppressed multiple parameters of the IL-23/IL-17 pathway in normalized plaques, but not in nonresponsive plaques. NB-UVB decreased the numbers of CD11c(+) DCs, specifically CD1c(-)CD11c(+) "inflammatory" DCs, and their products, IL-20, inducible nitric oxide synthase, IL-12/23p40, and IL-23p19. Furthermore, effective NB-UVB suppressed IL-17 and IL-22 mRNAs, which strongly correlated with lesion resolution. Therefore, in addition to its known role in suppressing IFN-γ production, NB-UVB radiation therapy can also target the IL-17 pathway to resolve psoriatic inflammation.JID JOURNAL CLUB ARTICLE: For questions, answers, and open discussion about this article, please go to http://www.nature.com/jid/journalclub.
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La photothérapie UVB à spectre étroit dans le psoriasis vulgaire : utilisation pratique et préconisations de la Société Française de Photodermatologie. Ann Dermatol Venereol 2010; 137:21-31. [DOI: 10.1016/j.annder.2009.12.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Kleinpenning M, Smits T, Boezeman J, van de Kerkhof P, Evers A, Gerritsen M. Narrowband ultraviolet B therapy in psoriasis: randomized double-blind comparison of high-dose and low-dose irradiation regimens. Br J Dermatol 2009; 161:1351-6. [DOI: 10.1111/j.1365-2133.2009.09212.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Evers A, Kleinpenning M, Smits T, Boezeman J, van de Kerkhof P, Kraaimaat F, Gerritsen M. Itch and scratching as predictors of time to clearance of psoriasis with narrow-band ultraviolet B therapy. Br J Dermatol 2009; 161:542-6. [DOI: 10.1111/j.1365-2133.2009.09236.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Reich A, Meurer M, Viehweg A, Muller DJ. Narrow-band UVB-induced externalization of selected nuclear antigens in keratinocytes: implications for lupus erythematosus pathogenesis. Photochem Photobiol 2008; 85:1-7. [PMID: 19076311 DOI: 10.1111/j.1751-1097.2008.00480.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study was to analyze whether sera obtained from patients with lupus erythematosus (LE) react with membrane structures found on keratinocytes irradiated with narrow-band ultraviolet B (NB-UVB). We applied atomic force microscopy (AFM) to visualize cell surface structures expressing nuclear antigens upon apoptosis following NB-UVB irradiation. Immortalized human keratinocytes (HaCaT) were cultured under standard conditions, irradiated with 800 mJ cm(-2) NB-UVB light and imaged by AFM mounted on an inverted optical microscope. It was observed that NB-UVB irradiation provoked significant alterations of the keratinocyte morphology and led to the membrane expression of antigens recognized by anti-La and anti-Ro 60 kDa sera but not by antidouble-strand DNA sera. The presence of La and Ro 60 kDa antigens on keratinocyte surfaces after NB-UVB irradiation was limited mainly to the small bleb-like protrusions found on the keratinocytes by AFM. A closer investigation by AFM also revealed that some structures positively stained with anti-Ro 60 kDa serum were also located submembranously. We hypothesize that the externalization of some nuclear antigens because of NB-UVB exposure might be responsible for exacerbation of skin symptoms in patients suffering from LE.
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Affiliation(s)
- Adam Reich
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland.
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Lee PL, van Weelden H, Bruijnzeel PLB. Neutrophil Infiltration in Normal Human Skin After Exposure to Different Ultraviolet Radiation Sources. Photochem Photobiol 2008; 84:1528-34. [DOI: 10.1111/j.1751-1097.2008.00380.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Reich A, Lehmann B, Meurer M, Muller DJ. Structural alterations provoked by narrow-band ultraviolet B in immortalized keratinocytes: assessment by atomic force microscopy. Exp Dermatol 2008; 16:1007-15. [PMID: 18031460 DOI: 10.1111/j.1600-0625.2007.00623.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We applied atomic force microscopy (AFM) to visualize ultrastructural changes of the keratinocyte morphology after narrow-band ultraviolet B (NB-UVB) irradiation. Immortalized human keratinocytes were cultured under standard conditions, irradiated with NB-UVB light at doses ranging from 50 to 800 mJ/cm2 and imaged by AFM mounted on an inverted optical microscope. It was observed, that NB-UVB irradiation provoked dose-dependent alterations of the keratinocyte morphology. While the surface of non-irradiated cells exhibited homogenously distributed crest-like shaped protrusions (height 0.16 +/- 0.05 microm), cells irradiated with a dose of 800 mJ/cm2 in addition showed round shaped protrusions (height 0.14 +/- 0.06 microm) distributed predominantly around the nucleus and bleb-like protrusions irregularly distributed on the cell surface (height 0.95 +/- 0.29 microm). These irradiated cells easily detached from the supporting glass surface, showed impaired contact with adjacent keratinocytes and significantly rearranged their cytoskeleton network. We hypothesize that these structural and functional alterations reflect ongoing apoptosis in UVB treated cells.
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Affiliation(s)
- Adam Reich
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.
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Carrascosa JM, Tapia G, Bielsa I, Fuente MJ, Ferrandiz C. Effects of narrowband UV-B on pharmacodynamic markers of response to therapy: an immunohistochemical study over sequential samples. J Cutan Pathol 2007; 34:769-76. [PMID: 17880582 DOI: 10.1111/j.1600-0560.2006.00694.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND To evaluate the effects of narrow-band UV-B (NBUVB) on the immunohistochemical markers of cellular and cytokine activation as well as of abnormal epidermal differentiation and proliferation--pharmacodynamic markers of response to therapy (PMT)--in psoriatic lesions. METHODS Clinical assessments and immunohistological staining of formalin-fixed paraffin sections of biopsies from psoriatic skin were done at baseline and at the end of the treatment period. RESULTS Ten patients with chronic plaque-type psoriasis were included. After treatment with NBUVB, the total number of CD3+, CD4+ and CD8+ T cells was reduced by an average of 86.6%, 86% and 85% in the epidermis and 70.3%, 70% and 62% in the dermis, respectively. Only the decrease in the number of epidermal CD4+ cells was statistically related with long-lasting remissions. The mean reduction in the expression of keratinocyte proliferation markers after NBUVB was 62%, 68% and 81% for Ki-67, cyclin A and cyclin B, respectively. Expression of suprabasal keratin 16 and filaggrin was almost normalized in most cases. All patients in whom expression of keratin16 remained after finishing UV-B therapy had an early relapse. CONCLUSIONS NBUVB is associated with changes in PMT close to those seen after remittive therapies. The normalization of immunohistochemical parameters of differentiation and the reduction/depletion in epidermal CD4+ cells was the most important markers of long-lasting remissions.
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Affiliation(s)
- Jose-Manuel Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
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23
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Kuwano Y, Watanabe R, Fujimoto M, Komine M, Asahina A, Tsukada N, Tamaki K. Treatment of HIV-associated eosinophilic pustular folliculitis with narrow-band UVB. Int J Dermatol 2007; 45:1265-7. [PMID: 17040467 DOI: 10.1111/j.1365-4632.2006.03072.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Erkin G, Uğur Y, Gürer CK, Aşan E, Korkusuz P, Sahin S, Kölemen F. Effect of PUVA, narrow-band UVB and cyclosporin on inflammatory cells of the psoriatic plaque. J Cutan Pathol 2007; 34:213-9. [PMID: 17302604 DOI: 10.1111/j.1600-0560.2006.00591.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Because antigen presenting is necessary for T-cell activation, antigen-presenting cells should be involved in the pathogenesis of psoriasis. In this study, our purpose was to evaluate and compare effects of PUVA, cyclosporine A and narrow-band UVB on dendritic cells and activated lymphocytes in the psoriatic lesions. METHODS Forty-five volunteered patients (15 patients in each treatment group as PUVA, cyclosporin A and narrow-band UVB) were enrolled in this study. Lesional skin biopsies were taken from each patient before and after treatments. Fresh frozen biopsies were studied for the expressions of CD1a, CD68, CD86, CD4, CD8 and HLA-DR proteins by immunohistochemistry. RESULTS There was no correlation between severity of the lesions and expressions of the antigens. Only PUVA significantly decreased CD1a+ epidermal Langerhans cells' (LCs) counts. Treatment modalities decreased expression of costimulator CD86, and most of them decrease antigen-presenting capacity of skin by decreasing HLA class-II expression. CONCLUSIONS All treatment modalities equally reduce lymphocytes, macrophages and dendritic cells. PUVA is the only treatment that decreases epidermal LCs. All treatments effectively diminish expression of CD86 and inhibit this step of inflammation.
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Affiliation(s)
- Gul Erkin
- Department of Dermatology, Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey.
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25
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El Mofty M, Mostafa W, Esmat S, Youssef R, Azzam O, Hunter N, El Hanafi G, Fawzi M. Narrow band Ultraviolet B 311 nm in the treatment of vitiligo: two right-left comparison studies. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2006; 22:6-11. [PMID: 16436175 DOI: 10.1111/j.1600-0781.2006.00189.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AIM Evaluation of narrow band ultraviolet B (NB UVB 311 nm) in the treatment of vitiligo by two independent studies. The first study compared NB UVB with a well-established therapeutic modality, psoralen ultraviolet A (PUVA), and the second study was conducted to find out whether psoralen might add to its efficacy. METHODS In the first study, 15 patients were exposed on the left half of their body to UVB 311 nm and then exposed on their right half to UVA after ingestion of psoralen. In the second study, 20 patients were exposed to UVB 311 nm on the left side of the body, followed by ingestion of psoralen and exposure to NB UVB 311 nm 90 min later to the right side of the body. In both studies, while exposing one side, the other was protected by an UV-proof gown. Thus two right-left comparative studies were carried out simultaneously, namely: UVB 311 nm vs. PUVA and UVB 311 nm vs. PUVB 311 nm. RESULTS In the first study, comparison of PUVA and NB UVB 311 nm showed no difference either in the degree of response or in the incidence of complications. In the second study, comparison of PUVB and UVB showed equal clinical improvement on both sides. The cumulative dose needed to achieve the same response on the PUVB side was lower than that on the UVB side, but the difference was not statistically significant. The incidence of phototoxic reactions was significantly higher on the PUVB treated body half. CONCLUSION NB UVB 311 nm has similar repigmentary effects as PUVA. The addition of psoralen does not increase its efficacy.
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Affiliation(s)
- M El Mofty
- Phototherapy Unit, Faculty of Medicine, Cairo University, Cairo, Egypt.
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26
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Jasim ZF, Lioe TF, McKenna KE, Robson T, Ouhtit A. The effect of ultra violet B (TL-01) phototherapy on epidermal expression of p53 protein in psoriatic plaques. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2006; 22:12-7. [PMID: 16436176 DOI: 10.1111/j.1600-0781.2006.00197.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Psoriasis is a genetically determined inflammatory skin disease. It is now recognized that narrow band TL-01 phototherapy is an effective treatment for psoriasis. However, ultraviolet (UV) exposure induces p53 mutations in keratinocytes and repeated exposure of skin to UV radiation results in clonal expansion of these initiated p53-mutant cells within the epidermis. AIM The present study aims to examine epidermal p53 expression in the skin of psoriatic patients at different time points following TL-01 phototherapy. METHODS Skin samples from patients suffering from plaque-type psoriasis, collected before, during and at the final stages of TL-01 phototherapy were examined for p53 expression by immunohistochemistry. RESULTS/CONCLUSION Our results showed an increase in p53 expressing keratinocytes following TL-01 phototherapy. Some of these cells were arranged spatially, as conical clones arising from putative stem cell compartments, suggesting that the chronic TL-01 treatment might have triggered cell growth and clonal expansion, an important step in initiating skin carcinogenesis.
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Affiliation(s)
- Z F Jasim
- Department of Dermatology, Belfast City Hospital, Belfast, UK
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27
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Tjioe M, Vissers WHPM, Gerritsen MJP. Topical macrolide immunomodulators: a role in the treatment of vitiligo? Am J Clin Dermatol 2006; 7:7-12. [PMID: 16489839 DOI: 10.2165/00128071-200607010-00002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Recently, topical macrolide immunomodulators have been successfully introduced in the treatment of atopic dermatitis. With the growing interest in this new line of topical immunosuppressants, research into the efficacy of these medicines in other T-cell-mediated skin diseases, such as psoriasis, lichen planus, and even vitiligo, is expanding rapidly. It is generally accepted that autoimmune factors play an important role in vitiligo. In this article, the possible use and mechanism of topical macrolide immunomodulators in the treatment of vitiligo are discussed, together with the current state of clinical studies and case reports. These limited reports indicate that topical macrolide immunomodulators may play a role in the treatment of vitiligo, particularly in areas where use of potent corticosteroids is contraindicated.
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Affiliation(s)
- Milan Tjioe
- Department of Dermatology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands.
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28
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Berneburg M, Brod C, Benedix F, Röcken M. [New and established indications for phototherapy with narrowband UVB]. J Dtsch Dermatol Ges 2005; 3:874-82. [PMID: 16232274 DOI: 10.1111/j.1610-0387.2005.05072.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Phototherapy with ultraviolet (UV) irradiation of wavelengths between 280 and 320 nm (UV-B) is a safe and effective treatment for a variety of inflammatory skin diseases. In addition to standard broad band UVB, narrow band phototherapy with fluorescent bulbs emitting near monochromatic UV between 310-315 nm has become an important treatment for diseases such as psoriasis, atopic dermatitis or vitiligo. Other diseases respond favorably to narrow band UV-B phototherapy, the number of potential indications for such phototherapy is continuously growing. The differential effects of narrow band UV-B phototherapy in comparison to other UV phototherapies, as well as new and established indications for this treatment modality are reviewed.
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Affiliation(s)
- Mark Berneburg
- Universitäts-Hautklinik, Eberhard-Karls-Universität Tübingen, Liebermeisterstrasse 25, D-72076 Tübingen, Germany.
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29
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Inui S, Nishida Y, Itami S, Katayama I. Disseminated granuloma annulare responsive to narrowband ultraviolet B therapy. J Am Acad Dermatol 2005; 53:533-4. [PMID: 16112374 DOI: 10.1016/j.jaad.2005.02.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2005] [Revised: 02/08/2005] [Accepted: 02/16/2005] [Indexed: 10/25/2022]
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