Skin colour and vitamin D: An update

Homo sapiens evolved in East Africa and had dark skin, hair, and eyes, in order to protect against deleterious consequences of intensive UV radiation at equatorial latitudes. Intensive skin pigmentation was thought to bear the risk of inefficient vitamin D3 synthesis in the skin. This initiated the hypothesis that within the past 75 000 years, in which humans migrated to higher latitudes in Asia and Europe, the need for vitamin D3 synthesis served as an evolutionary driver for skin lightening. In this review, we summarize the recent archeogenomic reconstruction of population admixture in Europe and demonstrate that skin lightening happened as late as 5000 years ago through immigration of lighter pigmented populations from western Anatolia and the Russian steppe but not primarily via evolutionary pressure for vitamin D3 synthesis. We show that variations in genes encoding for proteins being responsible for the transport, metabolism and signalling of vitamin D provide alternative mechanisms of adaptation to a life in northern latitudes without suffering from consequences of vitamin D deficiency. This includes hypotheses explaining differences in the vitamin D status and response index of European populations.

[Vitamin D deficiency in Spanish population. Importance of egg on nutritional improvement]

INTRODUCTION

Vitamin D is an essential nutrient whose deficiency has been associated with the risk of various chronic diseases such as osteoporosis, hypertension, cardiovascular disease, diabetes, some types of cancer and even overweight and obesity. Although vitamin D can be synthesized at the skin from exposure to sunlight, this source is not always sufficient to meet the needs. For example, the use of sunscreen or the low exposition to the sunlight limits the syntheses. In fact, studies have found that at least half of the Spanish population has vitamin D deficits. Therefore, the dietary contribution is fundamental. Although there are different foods fortified in this vitamin, few products are natural source of it, as fatty fish and eggs. However, according to different studies carried out in the Spanish population, there is a low consumption of this food group. In this way, it would be advisable to promote egg consumption among the population, since this food, in addition to having many nutrients, contains a high amount of vitamin D, which contributes to avoid the appearance of deficiencies and the consequences health consequences that this implies.

Attenuation of UVR-induced vitamin D3 synthesis in a mouse model deleted for keratinocyte lathosterol 5-desaturase

The lower risk of some internal cancers at lower latitudes has been linked to greater sun exposure and consequent higher levels of ultraviolet radiation (UVR)-produced vitamin D₃ (D₃). To separate the experimental effects of sunlight and of all forms of D₃, a mouse in which UVR does not produce D₃ would be useful. To this end we have generated mice carrying a modified allele of sterol C5-desaturase (Sc5d), the gene encoding the enzyme that converts lathosterol to 7-dehydrocholesterol (7-DHC), such that Sc5d expression can be inactivated using the Cre/lox site-specific recombination system. By crossing to mice with tissue-specific expression of Cre or CreER² (Cre/estrogen receptor), we generated two lines of transgenic mice. One line has constitutive keratinocyte-specific inactivation of Sc5d (Sc5d^k14KO). The other line (Sc5d^k14KOi) has tamoxifen-inducible keratinocyte-specific inactivation of Sc5d. Mice deleted for keratinocyte Sc5d lose the ability to increase circulating D₃ following UVR exposure of the skin. Thus, unlike in control mice, acute UVR exposure did not affect circulating D₃ level in inducible Sc5d^k14KOi mice. Keratinocyte-specific inactivation of Sc5d was proven by sterol measurement in hair - in control animals lathosterol and cholesta-7,24-dien-3β-ol, the target molecules of SC5D in the sterol biosynthetic pathways, together constituted a mean of 10% of total sterols; in the conditional knockout mice these sterols constituted a mean of 56% of total sterols. The constitutive knockout mice had an even greater increase, with lathosterol and cholesta-7,24-dien-3β-ol accounting for 80% of total sterols. In conclusion, the dominant presence of the 7-DHC precursors in hair of conditional animals and the lack of increased circulating D₃ following exposure to UVR reflect attenuated production of the D₃ photochemical precursor 7-DHC and, consequently, of D₃ itself. These animals provide a useful new tool for investigating the role of D₃ in UVR-induced physiological effects and, more broadly, for investigations of the cholesterol synthetic pathway in the skin and other targeted tissues.

Plasma transport of ergocalciferol and cholecalciferol and their 25-hydroxylated metabolites in dairy cows

In cattle, there are 2 significant forms of vitamin D: ergocalciferol (ERG) from fungi on roughage and cholecalciferol (CHO) from vitamin supplements or endogenous synthesis in the skin. The hypothesis of the present study is that vitamin D from the 3 sources is transported in different plasma fractions in the body. This is hypothesized to explain the lower efficiency of ERG compared to CHO in securing a sufficient plasma status of 25-hydroxyvitamin D and explain the inefficient excretion of dietary CHO into milk compared to endogenous CHO. Twenty vitamin D-depleted cows were assigned to 5 treatments: D2, housed indoor and fed 625-μg/d (25.000 IU) ERG; D3, housed indoor and fed 625-μg/d CHO; D2+D3, housed indoor and fed 625-μg/d ERG and 625-μg/d CHO; SUN, let out for daily pasture to facilitate CHO synthesis from sunlight; and D2+SUN, fed 625-μg/d ERG and let out for daily pasture. Blood samples were taken twice weekly and plasma fractionated by ultracentrifugation into 3 fractions: light lipoprotein (LLP), heavy lipoprotein (HLP), and protein and analyzed for content of ERG and CHO and their liver derived metabolites 25-hydroxyergocalciferol (25ERG) and 25-hydroxycholecalciferol (25CHO), respectively. Liver biopsies were taken on the last day of the study to asses gene expression related to vitamin D metabolism. During 4 wk of study, the vitamin D status in plasma increased to 19.3 to 22.8 ng/mL 25ERG in ERG-treated cows with the highest concentration in D2 (P ≤ 0.05) and to 25.0 to 33.4 ng/mL 25CHO in pasture or CHO-treated cows with the highest concentration in SUN (P ≤ 0.01). In plasma fractions, CHO was mainly found in the HLP fraction, whereas 25CHO was almost exclusively found in the protein fraction, probably due to its reported high binding affinity to vitamin D-binding protein. About 70% to 90% of 25ERG was found in the protein fraction and the remaining 25ERG was found in HLP, whereas ERG was found in both HLP and LLP fractions. In liver tissue, the expression of vitamin D-25-hydroxylase was lower in D2+D3 (P ≤ 0.05) and SUN (P ≤ 0.05) than that in the remaining groups, and the vitamin D receptor was expressed in the liver to a larger extent in D2+SUN than that in D2+D3 (P ≤ 0.05) and SUN (P ≤ 0.05). In conclusion, different plasma transport mechanisms may explain the lower physiological efficiency of ERG compared to CHO in securing the vitamin D status in plasma but do not explain the lower efficiency of synthetic CHO compared to endogenous CHO from sunlight or UV light in securing a high CHO content in milk.

Regional and seasonal variations in ultraviolet B irradiation and vitamin D synthesis in India

Evaluation of ultraviolet B index (UVBI) and its impact on vitamin D synthesis is important. We observed the maximum UVBI between 11 am and 1 pm. There was no increase in serum 25(OH)D levels following sun exposure during winter as the UVBI was significantly low, emphasizing the need for vitamin D supplementation during these months.

INTRODUCTION

The amount of vitamin D3 synthesizing UVB irradiation (290-320 nm) reaching the earth's surface at different altitudes and seasons in different parts of India and it's impact on vitamin D synthesis has not been well studied.

METHODS

The hourly UVB index (UVBI) from 10 am to 3 pm everyday for 12 months was measured by a solar meter in 4 different zones (North, Northeast, West and South) of the country. To study the impact of sun light exposure on vitamin D synthesis during winter, healthy school children aged 10-15 years were exposed to sunlight for a period of 30 min per day, between 11 am to 12 noon with 10 % body surface area, for 4 weeks. The main outcome measures were serum 25(OH)D, PTH, calcium, phosphate, and alkaline phosphatase levels before and after sun exposure.

RESULTS

The mean UVBI was highest between 11 am and 1 pm throughout the year in all locations. The highest UVBI was recorded from the North zone (4.5 ± 2.7 μW/Cm(2)), while the least was recorded in the Northeast zone (2.1 ± 1.2 μW/Cm(2)). UVBI readings in the Northeast zone were consistently low throughout the year, while all the other three zones showed significant seasonal fluctuations. Surprisingly, we observed a significant decrease in serum 25(OH)D levels from baseline (6.3 ± 4.6 to 5.1 ± 2.7 ng/mL; p < 0.001) despite sun exposure.

CONCLUSION

The mean UVBI was highest between 11 am and 1 pm throughout the year in all locations. No increase in the serum 25(OH)D levels was observed following sun exposure in winter, emphasizing the need for vitamin D supplementation during these months.

Solar Simulators for Healthy Vitamin D Synthesis

BACKGROUND/AIM

The angular distribution of solar radiance and its spectral characteristics is required for the determination of vitamin D3 production in humans.

MATERIALS AND METHODS

The vitamin D3 weighted exposure can be calculated by integrating the incident solar spectral radiance over all relevant parts of the human body. A novel instrument allowing simultaneous measurements of spectral radiance from more than 100 directions has been developed. A large solar simulator for controlled experiments is described.

RESULTS

In summer it is relatively easy to obtain sufficient vitamin D because sun exposure times are short. In winter solstice vitamin D3 cannot be obtained with realistic clothing even if the exposure were extended to all daylight hours.

CONCLUSION

Improved and controlled experiments to determine vitamin D3 production are required to assess the positive effects of solar UV radiation and to assess its natural variability.

Determination of vitamin D and its metabolites

The demand for analysis of 25-hydroxyvitamin D has increased dramatically throughout the world over the past decade. As a consequence, a number of new automated assays have been introduced for 25-hydroxyvitamin D measurement. Automated assays have shown variable ability to meet the technical challenges associated with 25-hydroxyvitamin D measurement. Assays are able to meet performance goals for precision at high concentrations but fail to do so at low concentrations of 25-hydroxyvitamin D. The overall accuracy of automated methods has improved over recent years and generally shows good overall agreement with reference methods; however, discrepancies persist for individual samples. Liquid chromatography-tandem mass spectrometry is used by some routine laboratories for 25-hydroxyvitamin D analysis but its widespread use is hampered by limited sample throughput. 1,25-Dihydroxyvitamin D is an important analyte in specific clinical situations, which remains in the hands of specialised laboratories using manual analytical methods.

Solar UV doses of young Americans and vitamin D3 production

BACKGROUND

Sunlight contains ultraviolet B (UVB) radiation (290-315 nm) that affects human health in both detrimental (skin cancers) and beneficial (vitamin D3) ways. Serum 25-hydroxyvitamin D concentrations from young Americans (≤ 19 years) show that many have deficient (< 50 nmol/L, 20 ng/mL) or insufficient (< 75 nmol/L, 30 ng/mL) vitamin D levels, indicating that they are not getting enough sun exposure. Those findings are in conflict with some calculated, published values that suggest people make "ample" vitamin D3 (~ 1,000 IU/day) from their "casual," or everyday, outdoor exposures even if they diligently use sunscreens with sun protection factor (SPF) 15.

OBJECTIVE

We estimated how much vitamin D3 young Americans (n = ~ 2,000) produce from their everyday outdoor ultraviolet doses in the North (45°N) and South (35°N) each season of the year with and without vacationing.

METHODS

For these vitamin D3 calculations, we used geometric conversion factors that change planar to whole-body doses, which previous calculations did not incorporate.

RESULTS

Our estimates suggest that American children may not be getting adequate outdoor UVB exposures to satisfy their vitamin D3 needs all year, except some Caucasians during the summer if they do not diligently wear sunscreens except during beach vacations.

CONCLUSION

These estimates suggest that most American children may not be going outside enough to meet their minimal (~ 600 IU/day) or optimal (≥ 1,200 IU/day) vitamin D requirements.

Vitamin D and pregnancy: An old problem revisited

Vitamin D has historically been considered to play a role solely in bone and calcium metabolism. Human disease associations and basic physiological studies suggest that vitamin D deficiency is plausibly implicated in adverse health outcomes including mortality, malignancy, cardiovascular disease, immune functioning and glucose metabolism. There is considerable evidence that low maternal levels of 25 hydroxyvitamin D are associated with adverse outcomes for both mother and fetus in pregnancy as well as the neonate and child. Vitamin D deficiency during pregnancy has been linked with a number of maternal problems including infertility, preeclampsia, gestational diabetes and an increased rate of caesarean section. Likewise, for the child, there is an association with small size, impaired growth and skeletal problems in infancy, neonatal hypocalcaemia and seizures, and an increased risk of HIV transmission. Other childhood disease associations include type 1 diabetes and effects on immune tolerance. The optimal concentration of 25 hydroxyvitamin D is unknown and compounded by difficulties in defining the normal range. Whilst there is suggestive physiological evidence to support a causal role for many of the associations, whether vitamin D deficiency is a marker of poor health or the underlying aetiological problem is unclear. Randomised controlled trials of vitamin D supplementation with an appropriate assessment of a variety of health outcomes are required.

Vitamin D: metabolism

The biologically active metabolite of vitamin D, 1,25(OH)(2)D(3), affects mineral homeostasis and has numerous other diverse physiologic functions including effects on growth of cancer cells and protection against certain immune disorders. This article reviews the role of vitamin D hydroxylases in providing a tightly regulated supply of 1,25(OH)(2)D(3). The role of extrarenal 1alpha(OH)ase in placenta and macrophages is also discussed, as well as regulation of vitamin D hydroxylases in aging and chronic kidney disease. Understanding specific factors involved in regulating the hydroxylases may lead to the design of drugs that can selectively modulate the hydroxylases. The ability to alter levels of these enzymes would have therapeutic potential for the treatment of various diseases, including bone loss disorders and certain immune diseases.

Comparison of biologically effective spectra for erythema and pre-vitamin D3 synthesis

The short wavelength cut-off (lambdac), the wavelength of the maximum spectral UV (lambdaMax) of spectral pre-vitamin D3 effective solar UV irradiance (UVD3), and the spectral erythemal UV (UVEry) were compared at 5-min intervals over a 6-month period at solar zenith angles (SZA) ranging from 4.7 degrees to 80 degrees. Averaged over the entire period, lambdac for UVD3 is higher by 1.05 nm than that for UVEry. The lambdaMax is higher for UVD3 compared to UVEry for SZA<approximately 50 degrees. For higher SZA (>55 degrees), the ratio of lambdaMax for UVD3 to that for UVEry is less than 1. As the erythemal action spectrum extends into the UVA, the ratio of UVD3 to UVEry irradiances decreases with increasing SZA, along with a decrease in the ratio of lambdaMax for UVD3 compared to UVEry. The changes in lambdac and lambdaMax influence both personal UVD3 and UVEry exposure and, to take this into account, a dual calibration technique for polysulphone dosimeters has been developed to simultaneously provide measurements of both types of exposure.

[Adequate level of vitamin D is essential for maintaining good health]

The high prevalence of vitamin D deficiency and insufficiency in the human population results from its inadequate cutaneous production and low dietary intake. Vitamin D status in the organism is determined by circulating levels of 25-hydroxycholecalciferol [25(OH)D3]. 25(OH)D3 is metabolized by a renal 25-hydroxyvitamin D-1alpha-hydroxylase (CYP27B1) into the vitamin D hormone 1,25 dihydroxycholecalciferol (calcitriol), which generates a wide range of biological responses via both the regulation of gene transcription and nongenomic pathways. Most of the circulating metabolite originates from cholecalciferol, which is synthesized in the skin upon exposure to the UVB spectrum of sunlight. The dietary source of vitamin D is extraordinarily low (10%) compared with endogenous production (90%). Recent epidemiological data demonstrated a strong association between poor vitamin D status (i.e. serum 25(OH)D3 levels below 50 nmol/l) and increased risk for chronic illnesses of various etiology. It is now recognized that maintaining a serum 25(OH)D3 level of 80 nmol/l (32 ng/ml) or greater is beneficial in the prevention of osteoporosis, cardiovascular diseases, certain autoimmune diseases, and some forms of cancer. It seems that sensible sun exposure and the use of supplements are the most effective ways of preventing vitamin D deficiency. The aim of the present article is to review new developments related to vitamin D deficiency and insufficiency and their consequences.

Darkness at noon: sunscreens and vitamin D3

We are assured by responsible scientific and governmental organizations that sunscreens should be routinely worn to reduce skin cancer risk. We are also advised that wearing sunscreens will not hinder our ability to produce sufficient previtamin D3 (preD3) from casual sunlight exposure. We report the examination of a series of 166 solar spectra, obtained on different days throughout a year, evaluated for erythemic and preD3 effectiveness and the relative effects of recommended Sun protection factor (SPF) 15 sunscreen. The results show that the sunscreen is much more effective in blocking the formation of preD3, than its labeled SPF for preventing sunburn. In fact with sunscreen applied only miniscule amounts of preD3 are predicted to be made outdoors even with extensive exposure. This raises important questions regarding the safest way to use sunlight exposure to promote healthy vitamin D3 levels and suggests the need to modify the public safety "Safe Sun" messages.

The UVB-induced synthesis of vitamin D3 and 1alpha,25-dihydroxyvitamin D3 (calcitriol) in organotypic cultures of keratinocytes: effectiveness of the narrowband Philips TL-01 lamp (311 nm)

Both calcitriol and UVB radiation exert potent antipsoriatic effects. We hypothesize that the therapeutical effect of UVB radiation may be attributed at least in part to UVB-triggered cutaneous synthesis of calcitriol. The optimum wavelength for initiation of the vitamin D(3) pathway was found to be in the range of 300+/-5 nm in vitro and in vivo. The narrowband Philips TL-01 lamp which is commonly used as UVB source for phototherapy of psoriasis has maximum spectral irradiance at around 311 nm which is presumed to be, however, of lesser importance in photochemical activation of the vitamin D(3) pathway. The aim of this study was to compare the vitamin D(3) and calcitriol-inducing potential of UVB from the TL-01 lamp with that of monochromatic UVB at 300+/-2.5 nm and 310+/-2.5 nm in organotypic cultures of keratinocytes supplemented with 25 microM 7-DHC. We found that maximum calcitriol-generating capacity of the TL-01 lamp at 500 mJ/cm(2) and 16 h after irradiation still amounts up to 44% of that found after monochromatic irradiation at 300+/-2.5 nm and 30 mJ/cm(2). Thus, the antipsoriatic effect of UVB emitted from the TL-01 lamp may, at least in part, based on the antiproliferative and prodifferentiative action of newly synthesized calcitriol on epidermal keratinocytes.

An evaluation of the vitamin D3 content in fish: Is the vitamin D content adequate to satisfy the dietary requirement for vitamin D?

It has been suggested that the major source of vitamin D should come from dietary sources and not sun exposure. However, the major fortified dietary source of vitamin D is milk which often does not contain at least 80% of what is stated on the label. Fish has been touted as an excellent source of vitamin D especially oily fish including salmon and mackerel. Little is known about the effect of various cooking conditions on the vitamin D content in fish. We initiated a study and evaluated the vitamin D content in several species of fish and also evaluated the effect of baking and frying on the vitamin D content. Surprisingly, farmed salmon had approximately 25% of the vitamin D content as wild salmon had. The vitamin D content in fish varied widely even within species. These data suggest that the tables that list the vitamin D content are out-of-date and need to be re-evaluated.

Decitabine and vitamin D3 differentially affect hematopoietic transcription factors to induce monocytic differentiation

Standard chemotherapy is not curative for many patients with acute myeloid leukemia (AML). New treatment strategies combining demethylating agents, such as decitabine, and drugs that induce myelomonocytic differentiation (i.e. Vitamin D3) may re-establish functional hematopoiesis in these patients. We studied the effects of decitabine alone or in combination with Vitamin D3 (VD3) on U937 cells and AML blasts. Preincubation with decitabine (0.1-1 microM) and subsequent exposure to VD3 (3 nM) synergistically induced monocytic differentiation. To elucidate the mechanisms of decitabine- and VD3-induced monocytic differentiation, we investigated the effects of the two drugs on transcription factors implicated in monocytic differentiation. Northern and Western blotting showed that decitabine induced transcription of c-jun but not PU.1, while VD3 increased PU.1, IRF8, and C/EBPbeta but not c-jun. Using electromobility shift assays, we demonstrated increased DNA binding of nuclear proteins from decitabine- and VD3-induced U937 cells to the CD11b promoter. In addition, we investigated whether the myeloid transcription factor Sp1 played a role in decitabine- and VD3-induced CD14 expression. Indeed, we found that mithramycin A, a specific inhibitor of Sp1, inhibited both VD3- and decitabine-induced upregulation of CD14, which is in line with previous data showing that Sp1 is critical for CD14 promoter activity. Induction of CD11b and/or CD14 by decitabine and/or VD3 was confirmed in primary AML patient samples at the time of diagnosis. In conclusion, decitabine synergizes with Vitamin D3 to induce CD11b and CD14 expression, likely by enhancing PU.1/c-jun and Sp1 transcriptional activity.

The solar UV radiation level needed for cutaneous production of vitamin D3 in the face. A study conducted among subjects living at a high latitude (68° N)

Populations at high latitudes experience several winter months with insufficient UV solar radiation to induce a significant cutaneous production of vitamin D. This unique study was designed to pursue an in vivo threshold of UV radiation needed for cutaneous production of vitamin D to take place if only the face was exposed to UV radiation. The vitamin D status were measured by analyzing blood samples weekly from a study group of 15 subjects over a period of 2 months during late winter, when UV radiation can be expected to increase substantially from rising solar elevations. Statistical analysis showed no significant positive association between the mean UV radiation dose and the mean 25(OH)D (25-hydroxy vitamin D) for the group. On an individual basis, however, we found indications that subjects with very low initial concentration of 25(OH)D (<30 nmol l(-1)) seemed to respond to UV radiation as early as in the beginning of March. For other individuals diet seemed to be the dominant controlling factor for 25(OH)D levels.

Vitamine D : Métabolisme, régulation et maladies associées

Vitamin D is well known as a hormone involved in mineral metabolism and bone growth. Conversion into the active metabolite 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) from the precursor is effected by cytochrome P450 enzymes in the liver (CYP27A1 and CYP2R1) and the kidney (CYP27B1). CYP27A1 has been shown to be transcriptionally regulated by nuclear receptors (PPARalpha, gamma, HNF-4alpha and SHP) which are ligand-dependent transcription factors. CYP27B1 is tightly regulated by the plasma levels of calcium, phosphate, parathyroid hormone (PTH) and 1,25(OH)2D3 itself. In vitamin D target organs, inactivation of vitamin D is attributed to CYP24A1 which is transcriptionally induced by 1,25(OH)2D3 whose action is mediated by binding to its cognate nuclear receptor, the vitamin D receptor (VDR). Diseases associated to Vitamin D deficiency (rickets in children, and osteomalacia or osteoporosis in adults) and autosomal recessive forms of inherited rickets illustrate the key role of vitamin D in calcium homeostasis and bone metabolism. Recently, discovery of 1,25(OH)2D3 new biological actions that include antiproliferative, prodifferentiating effect on many cell types and immunoregulatory properties creates a growing interest for this vitamin. In this way, a best understanding of various actors implicated in vitamin D metabolism and its regulation is of a major importance to optimise the use of vitamin D in disease prevention.

Barriers to optimizing vitamin D3 intake for the elderly

Available data on metabolic utilization of vitamin D3 indicate a total daily requirement of approximately 4000 international units (iu) (100 microg) or twice the current tolerable upper intake level (UL). In young individuals, most of this comes from the skin. However, cutaneous vitamin D3 synthesis declines with age, creating a need for increasing oral intake to maintain optimal serum 25-hydroxyvitamin D [25(OH)D] concentrations. Estimates of the population distribution of serum 25(OH)D values, coupled with available dose-response data, indicate that it would require input of an additional 2600 iu/d (65 microg/d) of oral vitamin D3 to ensure that 97.5% of older women have 25(OH)D values at or above desirable levels. The age-related decline in cutaneous input, taken together with the UL, creates a substantial barrier to the deployment of public health strategies to optimize vitamin D status in the elderly.

The vitamin D epidemic and its health consequences

Vitamin D deficiency is now recognized as an epidemic in the United States. The major source of vitamin D for both children and adults is from sensible sun exposure. In the absence of sun exposure 1000 IU of cholecalciferol is required daily for both children and adults. Vitamin D deficiency causes poor mineralization of the collagen matrix in young children's bones leading to growth retardation and bone deformities known as rickets. In adults, vitamin D deficiency induces secondary hyperparathyroidism, which causes a loss of matrix and minerals, thus increasing the risk of osteoporosis and fractures. In addition, the poor mineralization of newly laid down bone matrix in adult bone results in the painful bone disease of osteomalacia. Vitamin D deficiency causes muscle weakness, increasing the risk of falling and fractures. Vitamin D deficiency also has other serious consequences on overall health and well-being. There is mounting scientific evidence that implicates vitamin D deficiency with an increased risk of type I diabetes, multiple sclerosis, rheumatoid arthritis, hypertension, cardiovascular heart disease, and many common deadly cancers. Vigilance of one's vitamin D status by the yearly measurement of 25-hydroxyvitamin D should be part of an annual physical examination.

Vitamin D effective ultraviolet wavelengths due to scattering in shade

Solar UVB radiation (280-320 nm) is an initiator of Vitamin D3 production in the human skin. While numerous studies have been conducted in relation to the biological impact of UV exposure in full sun, less research has investigated the irradiances in shade. The purpose of this study was to determine the levels of UV radiation in relation to Vitamin D3 induction with six commonly encountered shade environments for the larger solar zenith angles observed during autumn and winter. Spectral UV irradiance measurements were made under relatively clear sky conditions at a sub-tropical Southern Hemisphere site for six specific shade environments and solar zenith angle between 35 degrees and 60 degrees to investigate the biologically effective UV irradiances for pre-Vitamin D3 production. Data from this research indicates that pre-Vitamin D3 effective UV wavelengths in the shade were most significant for tree shade and a shade umbrella. Compared to that in full sun, pre-Vitamin D3 effective UV wavelengths were at levels of approximately 52 and 55%, respectively, beneath the shade umbrella and in tree shade. UVB irradiance levels in the shade of a northern facing covered veranda and in a car with windows closed were significantly less than those beneath the shade umbrella, with levels of approximately 11 and 0%, respectively, of those in full sun. Shade is important as a UV minimisation strategy; however, it may also play an important role in providing the human body with adequate levels of UVB radiation for pre-Vitamin D3 production without experiencing the relatively higher levels of UVA irradiances present in full sun.

Solar radiation, vitamin D and survival rate of colon cancer in Norway

Solar radiation contributes significantly to the status of serum calcidiol (25-hydroxyvitamin D3, 25-(OH)D3) in humans, even at the high latitudes of northern Norway. Thus, in late summer the serum concentration of calcidiol is roughly 50% larger than that in late winter, when the solar radiation in Norway contains too little ultraviolet radiation to induce any synthesis of vitamin D3 in human skin. This seems to influence the prognosis of colon cancer. We here report that the survival rate of colon cancer in men and women, assessed 18 months after diagnosis, is dependent on the season of diagnosis. A high serum concentration of calcidiol at the time of diagnosis, i.e. at the start of conventional therapy, seems to give an increased survival rate. This agrees with cell and animal experiments reported in the literature, as well as with epidemiological data from some countries relating colon cancer survival with latitude and vitamin D3 synthesis in skin. One possible interpretation of the present data is that, the level of calcidiol, or its derivative calcitriol (1alpha,25-dihydroxyvitamin D3, 1alpha,25-(OH)2D3), may act positively in concert with conventional therapies of colon cancer.

Overview of general physiologic features and functions of vitamin D

Vitamin D3 is a prohormone produced in skin through ultraviolet irradiation of 7-dehydrocholesterol. It is biologically inert and must be metabolized to 25-hydroxyvitamin D3 in the liver and then to 1alpha,25-dihydroxyvitamin D3 in the kidney before function. The hormonal form of vitamin D3, ie, 1alpha,25-dihydroxyvitamin D3, acts through a nuclear receptor to carry out its many functions, including calcium absorption, phosphate absorption in the intestine, calcium mobilization in bone, and calcium reabsorption in the kidney. It also has several noncalcemic functions in the body. This overview provides a brief description of the physiologic, endocrinologic, and molecular biologic characteristics of vitamin D. It also provides information on new selective analogs of 1alpha,25-dihydroyvitamin D3 for therapy.

Vitamin D and skin: new aspects for dermatology

It has been shown that epidermal keratinocytes have the capacity for the UVB-induced photochemical conversion of 7-dehydrocholesterol to vitamin D3, and also for the enzymatically controlled hydroxylation of the photolysis product. This metabolic loop results in the formation of the biologically active final product 1alpha,25-dihydroxyvitamin D3 (1alpha,25(OH)2D3, calcitriol). The epidermal synthesis of calcitriol is of fundamental relevance because calcitriol regulates important cellular functions in keratinocytes and immunocompetent cells. Because of their anti-proliferative and prodifferentiating effects, calcitriol and other vitamin D analogs are highly efficient in the treatment of psoriasis vulgaris. In addition, the known therapeutic effect of UVB light therapy in the treatment of psoriasis may, at least in part, be mediated via UVB-induced synthesis of calcitriol. Increasing evidence now indicates that cutaneous vitamin D synthesis is of great importance for the prevention of a broad variety of diseases, including various malignancies. It has been postulated that cancer mortality could be reduced via careful UV exposure or, more safely, via oral substitution with vitamin D. These new findings must be taken into account when establishing new sun protection guidelines for the prevention of skin cancer. In addition, better understanding of the metabolism of vitamin D in the skin has opened up new perspectives for the therapeutic application of vitamin D analogs, e.g. in inflammatory skin diseases.

Vitamin D3from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway)

OBJECTIVE

To investigate whether prognosis of breast-, colon- and prostate cancer may be related to vitamin D(3), induced from solar ultra-violet (UV) radiation, through studies on geographical and seasonal variations in UV radiation.

METHODS

This study includes 115,096 cases of breast-, colon- or prostate cancer, diagnosed between 1964 and 1992. Among these, 45,667 deaths due to the cancer were registered. On the basis of a north-south gradient in solar UV radiation and geographical climatic differences, Norway was divided into eight residential regions. According to seasonal variations in UV radiation, four periods of diagnosis during the year were used. Case fatality according to residential region and to season of diagnosis was estimated using Cox regression. The effects of occupational sun exposure, childbearing pattern and educational level were also evaluated.

RESULTS

No geographic variation in case fatality was observed for the three cancer types studied. A significant variation in prognosis by season of diagnosis was observed. Diagnoses during summer and fall, the seasons with the highest level of vitamin D(3), revealed the lowest risk of cancer death.

CONCLUSION

The results suggest that a high level of vitamin D(3) at the time of diagnosis, and thus, during cancer treatment, may improve prognosis of the three cancer types studied.

Do panther chameleons bask to regulate endogenous vitamin D3 production?

Basking by ectothermic vertebrates is thought to have evolved for thermoregulation. However, another beneficial effect of sunlight exposure, specifically the ultraviolet B (UV-B) component, includes endogenous production of vitamin D(3). In the laboratory, panther chameleons exhibited a positive phototaxis to greater visible, ultraviolet A (UV-A) and UV-B light. However, with equivalent high irradiances of UV-A or UV-B, their response to UV-B was significantly greater than it was to UV-A. Exposure of in vitro skin patches of panther chameleons to high UV-B (90 microW/cm(2)) for 1 h significantly enhanced vitamin D(3) concentration. Voluntary exposure to higher UV-B irradiance (70 vs. 1 microW/cm(2)) resulted in greater circulating 25-hydroxyvitamin D(3) in female panther chameleons (604 vs. 92 ng/mL). Depending on dietary intake of vitamin D(3), chameleons adjusted their exposure time to UV-B irradiation as if regulating their endogenous production of this vital hormone. When dietary intake was low (1-3 IU/g), they exposed themselves to significantly more UV-producing light; when intake was high (9-129 IU/g), they exposed themselves to less. Vitamin D(3) photoregulation seems to be an important additional component of the function of basking.

UVB-induced conversion of 7-dehydrocholesterol to 1alpha,25-dihydroxyvitamin D3 in an in vitro human skin equivalent model

We have previously shown that keratinocytes in vitro can convert biologically inactive vitamin D3 to the hormone calcitriol (1alpha,25-dihydroxyvitamin D3). This study was initiated to test whether the ultraviolet-B-induced photolysis of provitamin D3 (7-dehydrocholesterol), which results in the formation of vitamin D3, can generate calcitriol in an in vivo-like human skin equivalent model made of fibroblasts in a collagen matrix as the dermal component and keratinocytes as the epidermal component. Cultures were preincubated with increasing concentrations of 7-dehydrocholesterol (0.53-5.94 nmol per cm2 human skin equivalent) at 37 degrees C and irradiated with monochromatic ultraviolet B at wavelengths ranging from 285 to 315 nm (effective ultraviolet doses 7.5-45 mJ per cm2). In our in vitro model irradiation with ultraviolet B resulted in a sequential metabolic process with generation of previtamin D3 followed by the time-dependent formation of vitamin D3, 25-hydroxyvitamin D3, and ultimately calcitriol in the femtomolar range. Unirradiated cultures and irradiated cultures without keratinocytes generated no calcitriol. Irradiation of skin equivalents at wavelengths > 315 nm generated no or only trace amounts of calcitriol. The ultraviolet-B-triggered conversion of 7-dehydrocholesterol to calcitriol was strongly inhibited by ketoconazole indicating the involvement of P450 mixed function oxidases. The amount of calcitriol generated was dependent on the 7-dehydrocholesterol concentration, on wavelength, and on ultraviolet B dose. Hence, keratinocytes in the presence of physiologic concentrations of 7-dehydrocholesterol and irradiated with therapeutic doses of ultraviolet B may be a potential source of biologically active calcitriol within the epidermis.

A human skin equivalent model that mimics the photoproduction of vitamin D3 in human skin

A human skin equivalent was prepared by culturing human keratinocytes on the surface of nylon filtration meshes containing human skin fibroblasts and by growing the epidermal cells at the air-liquid interface. This human skin equivalent model was used to mimic the photoproduction of vitamin D3 in human skin. It was found that the concentration of 7-dehydrocholesterol and its photoconversion to previtamin D3 and its subsequent thermal isomerization to vitamin D3 in the human skin equivalent was essentially identical to that of human skin. The 7-dehydrocholesterol content in the skin equivalent and human skin was 2187 +/- 296 and 2352 +/- 320 ng/cm2, respectively. The percentage of the major photoproducts of 7-dehydrocholesterol in the skin equivalent following ultraviolet B radiation (0.5 J/cm2) was 35% pre-vitamin D3, 29% lumisterol, and 6% tachysterol; 30% remained as 7-dehydrocholesterol. Similarly, in human skin they were 36%, 29%, 7%, and 28%, respectively. After incubation at 37 degrees C for 30 min, 11% and 12% of the previtamin D3 had thermally isomerized to vitamin D3 in the skin equivalent and human skin. In conclusion, compared with cultured keratinocytes or fibroblasts, the human skin equivalent model provides a superior in vitro system that better mimics the physiology and biochemistry of the photosynthesis of vitamin D3 in human skin.

A liposomal model that mimics the cutaneous production of vitamin D3. Studies of the mechanism of the membrane-enhanced thermal isomerization of previtamin D3 to vitamin D3

We reported previously that the rate of previtamin D3 (preD3) <==> vitamin D3 isomerization was enhanced by about 10 times in the skin compared with that in organic solvents. To elucidate the mechanism by which the rate of this reaction is enhanced in the skin, we developed a liposomal model that mimicked the enhanced isomerization of preD3 to vitamin D3 that was described in human skin. Using this model we studied the effect of changing the polarity of preD3 as well as changing the chain length and the degree of saturation of liposomal phospholipids on the kinetics of preD3 <==> vitamin D3 isomerization. We found that a decrease in the hydrophilic interaction of the preD3 with liposomal phospholipids by an esterification of the 3beta-hydroxy of preD3 (previtamin D3-3beta-acetate) reduced the rate of the isomerization by 67%. The addition of a hydroxyl on C-25 of the hydrophobic side chain (25-hydroxyprevitamin D3), which decreased the hydrophobic interaction of preD3 with the phospholipids, reduced the rate by 87%. In contrast, in an isotropic n-hexane solution, there was little difference among the rates of the conversion of preD3, its 3beta-acetate, and 25-hydroxy derivatives to their corresponding vitamin D3 compounds. We also determined rate constants (k) of preD3 <==> vitamin D3 isomerization in liposomes containing phosphatidylcholines with different carbon chain lengths. The rates of the reaction were found to be enhanced as the number of carbons (Cn) in the hydrocarbon chain of the phospholipids increased from 10 to 18. In conclusion, these results support our hypothesis that amphipathic interactions between preD3 and membrane phospholipids stabilize preD3 in its "cholesterol like" cZc-conformer, the only conformer of preD3 that can convert to vitamin D3. The stronger these interactions were, the more preD3 was likely in its cZc conformation at any moment and the faster was the rate of its conversion to vitamin D3.

Ultraviolet B suppresses vitamin D receptor gene expression in keratinocytes

Keratinocytes not only produce vitamin D3 in response to ultraviolet B light (UVB) and convert 25-hydroxyvitamin D3 to 1 alpha, 25-dihydroxyvitamin D3 (1,25(OH)2D) but also possess the vitamin D receptor (VDR) and respond to 1,25(OH)2D. We characterized the regulation of the expression of the VDR gene in primary human keratinocytes following UVB irradiation. We report a marked dose-dependent down-regulation of the VDR mRNA and protein within a few hours after irradiation. This occurs independently of de novo protein synthesis and is not due to a change in the half-life of the VDR mRNA. Interestingly, treatment of the cells with sodium salicylate, caffeic acid phenethyl ester and tosylphenylchloromethylketone inhibited this down-regulation. Our results strongly suggest the existence of a feedback mechanism in that UVB initiates vitamin D synthesis in keratinocytes and at the same time limits VDR abundance. They also provide a rational explanation for the reported lack of any additive effect between 1,25(OH)2D and UVB phototherapy in the treatment of psoriasis.

[Adverse effects of sunlight on the skin]

Many people consider a summer's day pleasant: warm and bright. The sun's ultraviolet rays do not contribute to the pleasure, and are biologically mainly harmful. As UV radiation does not penetrate any deeper than our skin, this organ has to be particularly well adapted to the UV exposure. The skin exploits the UV radiation for the synthesis of vitamin D3. Our day-to-day exposure suffices for this beneficial UV effect. Excessive exposure, as in sunbathing, only contributes to the adverse effects, like sunburn and suppression of cellular immunity in the short term, and 'photoaging' and skin cancer in the long term. The UVB radiation in sunlight is mainly responsible for these harmful effects, the UVA radiation to a far lesser extent (10-20% contribution). The UVA radiation from modern tanning equipment does not differ from that in sunlight, but UVA radiation does not lead to vitamin D3 production; it rather degrades vitamin D3 and a tan offers insufficient protection against the UVB radiation in full sunlight.

Vitamin D3 in Tilapia mossambica: relevance of photochemical synthesis

The capability of fish to synthesize vitamin D on exposure to ultraviolet (UV) light was examined. Purposeful exposure of the freshwater fish Tilapia mossambica (Tilapia) to artificial UV light (300 nm) resulted in a significant increase of vitamin D3 with a concomitant decrease in provitamin D3 [7-dehydrocholesterol (7-DHC)], indicating that provitamin D3 was converted to vitamin D3. However, only 0.13% of the intraperitoneally injected 4-14C cholesterol was recovered in the vitamin D3 and 25-hydroxyvitamin D3 (25-OH-D3) fractions after 15 h of irradiation. Thus, although fish is capable of photosynthesizing vitamin D through constant, prolonged exposure to UV light of appropriate wavelength, the contribution of this mode of synthesis is unlikely to be of any significance in its natural habitat.

The effect of season and latitude on in vitro vitamin D formation by sunlight in South Africa

AIMS

To assess the effect of season and latitude on the in vitro formation of previtamin D3 and vitamin D3 from 7-dehydrocholesterol (7-DHC) by sunlight in two cities in South Africa, Cape Town and Johannesburg.

METHODS

An in vitro study utilising vials containing 7-DHC, which were exposed to sunlight for a period of 1 hour between 8:00 and 17:00 on 1 day a month for a year. Previtamin D3 and vitamin D3 were separated from 7-DHC by high-performance liquid chromatography, and the amounts formed were calculated with the use of external standards.

RESULTS

A marked seasonal variation in vitamin D3 production was noted in Cape Town, with very little being formed during the winter months of April through September. In Johannesburg, in vitro formation changed little throughout the year, and was similar to that found in Cape Town during the summer. During sunlit hours, vitamin D3 production was maximal at midday and small quantities were still being formed between 8:00 and 9:00, and between 16:00 and 17:00 during the summer. During winter in Cape Town, peak formation at midday was less than one-third of that in Johannesburg, and negligible amounts were formed before 10:00 and after 15:00.

CONCLUSIONS

The previously documented seasonal variation in serum 25-hydroxyvitamin D recorded in patients in Johannesburg is probably a consequence of the increased clothing worn and the decreased time spent out of doors during winter, rather than decreased ultraviolet radiation reaching the earth. The limited in vitro formation of vitamin D3 during winter in Cape Town may have clinical implications insofar as the management of metabolic bone diseases like rickets and osteoporosis is concerned. Breast-fed infants resident in the area are likely to suffer from vitamin D deficiency rickets unless vitamin D supplements are provided, or the mothers are encouraged to take their children out of doors.

Evolutionary importance for the membrane enhancement of the production of vitamin D3 in the skin of poikilothermic animals

The photoproduction of vitamin D in the skin was essential for the evolutionary development of terrestrial vertebrates. During exposure to sunlight, previtamin D3 formed in the skin is isomerized to vitamin D3 (calciol) by a temperature-dependent process. Since early land vertebrates were poikilothermic, the relatively slow conversion of previtamin D3 to vitamin D3 at ambient temperature put them at serious risk for developing vitamin D deficiency, thus leading to a poorly mineralized skeleton that could have ultimately halted further evolutionary development of vertebrates on land. We evaluated the rate of isomerization of previtamin D3 to vitamin D3 in the skin of iguanas and found the isomerization rate was enhanced by 1100% and 1700% at 25 degrees C and 5 degrees C, respectively. It is likely that the membrane entrapment of previtamin D3 in its s-cis,s-cis conformation is responsible for the markedly enhanced conversion of previtamin D3 to vitamin D3. The membrane-enhanced production of vitamin D3 ensures the critical supply of vitamin D3 to poikilothermic animals such as iguanas.

Solar ultraviolet B radiation and photoproduction of vitamin D3 in central and southern areas of Argentina

The incidence of nutritional rickets in the southern part of Argentina is 8-12 times higher than in the rest of the country. Winter 25(OH)D serum levels in normal population of southern areas are lower than in central and northern areas. To elucidate these differences, we compared the photoconversion of provitamin D3 (7-DHC) to previtamin D3 in two cities: Ushuaia (latitude 55 degrees S) and Buenos Aires (34 degrees S). Ampules containing 7-DHC were exposed to sunlight one day in the middle of each month either from 10:30 a.m. to 2:30 p.m. or from 8:00 a.m. to 5:00 p.m. The percentages of photoproducts formed were determined by high performance liquid chromatography (HPLC). Previous studies have proved that this is a valid model to assess "in vitro" the photoproduction of vitamin D3 in human skin. Previtamin D3 + vitamin D3 formed in Ushuaia were less (p < 0.02) than those found in Buenos Aires during all seasons: summer, (X +/- SEM) 6.4 +/- 0.8% vs. 13.2 +/- 1.8%; autumn, 1.2 +/- 0.7% vs. 6.3 +/- 1.3%; winter, 0.8 +/- 0.7% vs. 3.6 +/- 0.7%; spring, 3.4 +/- 0.5% vs. 9.1 +/- 1.1%. The photoproducts produced from 10:30 a.m. to 2:30 p.m. were similar for each month and latitude to those formed when the ampules were exposed from 8:00 a.m. to 5:00 p.m. We conclude that in Ushuaia there is a prolonged "vitamin D winter" during which cutaneous synthesis of vitamin D is absent, leading to lower serum values of 25(OH)D and contributing to the higher incidence of rickets.

Dietary vitamin D dependence of cat and dog due to inadequate cutaneous synthesis of vitamin D

As in herbivores and omnivores, the biosynthesis of vitamin D3 in the skin exposed to ultraviolet (uv) light is generally expected to also occur in the dog and the cat. The purpose of this in vitro study was to measure the concentrations of vitamin D3 and its precursor 7-dehydrocholesterol (7DHC) in dog and cat skin before and after a quantitatively and qualitatively standardized exposure to uv light. The results are compared to those obtained by the same method in the skin of the rat. The efficiency of extracting 7DHC and vitamin D3 from skin was 72 +/- 8% and 67 +/- 3%, respectively. In dog and cat skin the concentrations of nonesterified 7DHC were below the detection limit of the HPLC system. Therefore, skin extracts were saponified and total 7DHC and vitamin D3 concentrations were measured by normal-phase HPLC. Before irradiation with uv-B light the total concentrations of 7DHC were 1858 +/- 183, 1958 +/- 204, and 17,620 +/- 2345 ng/cm2 skin (mean +/- SEM; n = 5) for the dog, the cat, and the rat, respectively. The corresponding concentrations of vitamin D3 were 211 +/- 44, 193 +/- 18, and 161 +/- 32 ng/cm2 skin for the dog, the cat, and the rat, respectively. Irradiation of standard solutions of 7DHC with 0.15 J uv-B light/min resulted in a time-dependent decrease in 7DHC and a concomitant increase in previtamin D3.(ABSTRACT TRUNCATED AT 250 WORDS)

Clothing prevents ultraviolet-B radiation-dependent photosynthesis of vitamin D3

Photoprotection of the skin is mainly a function of clothing, although the effectiveness of the latter against UV-B solar radiation (wavelengths 290-320 nm) has not been measured in vivo. Since UV-B mediates the cutaneous formation of vitamin D3, we examined the attenuation of that photosynthetic reaction by the commonly used fabrics cotton, wool, and polyester in black and white colors. Direct transmission of UV-B was attenuated the most by black wool (98.6% of incident irradiance) and the least by white cotton (47.7%). None of the fabrics allowed the photoproduction of previtamin D3 from 7-dehydrocholesterol irradiated in vitro with up to 40 min of simulated sunlight or the elevation of serum vitamin D3 after irradiation with approximately one minimal erythema dose (MED) of UV-B in volunteers wearing jogging garments made of these fabrics. Increasing the whole body irradiation dose to six MEDs still failed to produce a serum vitamin D3 response in garment-clad subjects. Regular (seasonal) street clothing also prevented an elevation of the vitamin D3 in response to UV-B radiation. We conclude that clothing prevents or significantly impairs the formation of vitamin D3 after photostimulation with up to six MEDs of UV-B.

Racial pigmentation and the cutaneous synthesis of vitamin D

The varying epidermal melanin content that produces racial pigmentation determines the number of photons that reach the lower (malpighian) cellular layers, where vitamin D3 synthesis takes place. We investigated the effect of racial pigmentation on vitamin D3 formation, stimulating the process with a fixed dose of UVB radiation (wavelengths, 290 to 320 nm). Vitamin D nutritional status was further assessed measuring serum 25-hydroxyvitamin D and the most active serum metabolite, 1,25-dihydroxyvitamin D. Experimental subjects were young (third decade of life) and healthy, representing the white, Oriental (East Asian), Indian (South Asian), and black races. Basal serum vitamin D3 levels were similar among groups, ranging from 2.3 +/- 0.6 nmol/L (mean +/- SEM) for blacks to 3.4 +/- 1.0 nmol/L for Indians. Following whole-body exposure to 27 mJ/cm2 of UVB, there was a significant racial group effect on serum vitamin D3 levels. Post-UVB levels were significantly higher in whites (31.4 +/- 4.4 nmol/L) than in Indians or blacks (12.8 +/- 2.9 and 9.1 +/- 2.1 nmol/L, respectively), while the levels in Orientals (27.8 +/- 4.4 nmol/L) differed significantly from those in blacks and Indians but not in whites. Race had only a marginal effect on serum 25-hydroxyvitamin D, with higher levels in whites than in blacks (69.9 +/- 12.7 vs 29.7 +/- 6.2 nmol/L). Serum 1,25-dihydroxyvitamin D and vitamin D binding protein levels were similar in all groups. We conclude that while racial pigmentation has a photoprotective effect, it does not prevent the generation of normal levels of active vitamin D metabolites.

Suntanning and cutaneous synthesis of vitamin D3

Skin tanning is the melanization of the epidermis induced by excessive sunlight exposure. Since melanin absorbs preferentially the wavelengths around 300 nm and the cutaneous synthesis of vitamin D3 is stimulated by the same wavelengths (290 to 320 nm, ultraviolet light B [UVB]), we investigated the effect of tanning on vitamin D3 formation. Vitamin D3 and 25 hydroxyvitamin D (25-OH-D) serum levels were measured during midwinter (untanned state) in seven healthy subjects. Blood was obtained immediately before whole body exposure to UVB in a phototherapy unit, and again 24 hours later. The study was repeated in the same subjects during midsummer (tanned state) using the same UVB dose. Serum vitamin D3 increased in the untanned state from 1.7 +/- 0.4 ng/ml (mean +/- SE) to 11 +/- 1.5 ng/ml following UVB (p less than 0.001). In the tanned state, basal serum vitamin D3 was significantly higher: 9.6 +/- 2.8 ng/ml (p less than 0.04 basal untanned versus basal tanned), and exhibited minimal rise after UVB to 14.3 +/- 4.1 ng/ml (p greater than 0.1 for tanned basal versus post UVB tanned). Tanning was also associated with significantly higher serum 25-OH-D levels: 22.5 +/- 2.9 ng/ml (untanned) versus 36.9 +/- 4.7 ng/ml (tanned) (p less than 0.02). Thus excessive solar exposure produces, besides erythema and tanning, the resetting of the vitamin D3 synthetic mechanism with blunting of the response to UVB.

Use of topical sunscreen for the evaluation of regional synthesis of vitamin D3

Sunscreens absorb solar radiation and block the cutaneous synthesis of vitamin D3. Because of this property, we tested sunscreens as a research tool for photodependent reactions. The concept was evaluated by determining the segmental body contributions to vitamin D3 production. Twenty-seven healthy, untanned white persons with skin type III applied a sunscreening agent to selected body areas (head and neck, arms, trunk, or legs) to block UVB absorption. Control groups comprised subjects who either covered the whole body with, or did not apply, sunscreen. Serum vitamin D3 was determined 1 hour before and 24 hours after exposure to a suberythemic dose of UVB light (27 millijoule/cm2). Basal vitamin D3 levels were similar among the different groups (mean +/- standard error for the entire population: 2.8 +/- 0.7 ng/ml). Segmental contribution to the UVB-stimulated cutaneous synthesis of vitamin D3 appeared to be largely a function of surface area. Serum vitamin D3 increased significantly (p less than 0.05) in subjects exposing the trunk (13.7 +/- 3.2 ng/ml), legs (11.2 +/- 3.2 ng/ml), and entire body (12.6 +/- 2.8 ng/ml). In subjects exposing the head and neck or arms, the post-UVB vitamin D3 level was higher than the basal level (5.8 +/- 4.0 and 4.5 +/- 2.2 ng/ml), but the difference was not significant (p greater than 0.5). Whole body application of sunscreen completely blocks the vitamin D3 response to UVB. We conclude that short-term (single) application of sunscreens may be used as a simple complementary technique for the evaluation of photodependent reactions in physiologic and pathologic conditions.

In vivo threshold for cutaneous synthesis of vitamin D3

Cutaneous vitamin D3 synthesis and release into the circulation is promoted by skin exposure to ultraviolet B radiation (UVB, spectrum 290 to 320 nm). To determine the relation between UVB energy level and cutaneous vitamin D synthetic response, we delivered graded increases of UVB suberythemic radiant energy (3 to 27 millijoules/cm2 [mJ/cm2]) to 32 untanned young white subjects with skin type III (Fitzpatrick-Pathak classification). Serum vitamin D3 was determined 1 hour before (basal value) and 24 hours after a single whole body exposure to UVB in a phototherapy unit. The basal vitamin D3 concentration was similar in all individuals (mean +/- SEM for whole group, 1.6 +/- 0.2 ng/ml). UVB irradiances were followed by proportional rises in serum vitamin D3 (at 27 mJ/cm2, 14.3 +/- 3.7 ng/ml), and the overall correlation between UVB radiation and consequent serum vitamin D3 response (r = 0.81; p less than 0.02) was best described by an exponential function. The minimal UVB radiation level that produced a significant increase in serum vitamin D3 was 18 mJ/cm2, a value similar to the lowest solar broadband UVB irradiance that generates previtamin D3 in vitro from the precursor 7-dehydrocholesterol (20 mJ/cm2). Because in the northern United States winter UVB irradiance does not generally reach this threshold level, we conclude that individuals living at extreme northern (or southern) latitudes may have higher dependence on body stores and dietary supply to meet their vitamin D requirements during winter.

Sunlight regulates the cutaneous production of vitamin D3 by causing its photodegradation

Exposure to sunlight initiates the formation of vitamin D3 in skin as the UV B radiation in the solar spectrum causes the photoconversion of 7-dehydrocholesterol to previtamin D3. A heat-induced isomerization then converts previtamin D3 to vitamin D3 over a period of days. A number of irradiation products of vitamin D3 are known to form upon irradiation with high intensity UV radiation, but the effect of subsequent exposures to sunlight on the vitamin D3 formed in skin is not known. To investigate this phenomenon, human skin containing vitamin D3 was exposed to sunlight in Boston. A model system of [3H]vitamin D3 in methanol was also used to study the effects of sunlight on vitamin D3 throughout the year. Vitamin D3 proved to be exquisitely sensitive to sunlight, and once formed in the skin, exposure to sunlight resulted in its rapid photodegradation to a variety of photoproducts, including 5,6-transvitamin D3, suprasterol I, and suprasterol II.