Narrowband ultraviolet B treatment improves vitamin D balance and alters antimicrobial peptide expression in skin lesions of psoriasis and atopic dermatitis

被引:103
作者
Vahavihu, K. [1 ,2 ]
Ala-Houhala, M. [1 ]
Peric, M. [3 ]
Karisola, P. [4 ]
Kautiainen, H. [5 ]
Hasan, T. [1 ]
Snellman, E. [1 ]
Alenius, H. [4 ]
Schauber, J. [3 ]
Reunala, T. [1 ,2 ]
机构
[1] Tampere Univ Hosp, Dept Dermatol, FIN-33531 Tampere, Finland
[2] Univ Tampere, Sch Med, FIN-33531 Tampere, Finland
[3] Univ Munich, Dept Dermatol & Allergol, Munich, Germany
[4] Finnish Inst Occupat Hlth, Helsinki, Finland
[5] Helsinki & Cent Finland Cent Hosp, Orton Rehabil Unit, Jyvaskyla, Finland
基金
芬兰科学院;
关键词
antimicrobial peptides; atopic dermatitis; calcidiol; psoriasis; ultraviolet B radiation; vitamin D; HYPOVITAMINOSIS-D; DENDRITIC CELLS; D DEFICIENCY; HEALTHY; ADULTS; IMMUNOPATHOGENESIS; KERATINOCYTES; FORTIFICATION; EXPOSURE; THERAPY;
D O I
10.1111/j.1365-2133.2010.09767.x
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
P>Background Narrowband ultraviolet B (NB-UVB) is a routine treatment for psoriasis and atopic dermatitis (AD) but its effect on vitamin D balance is not well studied. Objectives To examine whether NB-UVB treatment in winter improves vitamin D balance in psoriasis and AD, and to study the effects of NB-UVB on antimicrobial peptide and cytokine expression in the skin. Methods Eighteen adult patients with psoriasis, 18 with AD and 15 healthy subjects received a total of 15 NB-UVB exposures on the whole body, given three times a week. Serum calcidiol (25-hydroxyvitamin D) was measured by radioimmunoassay. Antimicrobial peptide and cytokine expression in skin lesions was examined by real-time quantitative polymerase chain reaction. Results At onset 16 (89%) patients with psoriasis, 17 (94%) patients with AD and eight (53%) healthy subjects had vitamin D insufficiency (calcidiol < 50 nmol L-1). NB-UVB treatment significantly increased (P < 0 center dot 001) serum calcidiol. The increase was 59 center dot 9 nmol L-1 (95% confidence interval, CI 53 center dot 5-66 center dot 9) in psoriasis, 68 center dot 2 nmol L-1 (95% CI 55 center dot 4-80 center dot 1) in AD and 90 center dot 7 nmol L-1 (95% CI 63 center dot 8-123 center dot 4) in healthy subjects. Psoriasis Area and Severity Index and SCORAD improved significantly (P < 0 center dot 001) but no correlation to the increase of serum calcidiol was found. Cathelicidin and human beta-defensin 2 (HBD2) expression was high in skin lesions of psoriasis. After six NB-UVB treatments cathelicidin increased further while HBD2 expression decreased. A similar trend was observed in AD lesions. NB-UVB caused a marked but nonsignificant decrease of interleukin (IL)-1 beta and IL-17 in psoriasis lesions. Conclusions The present study shows that in addition to a significant improvement of psoriasis and AD, NB-UVB treatment effectively corrects vitamin D insufficiency. It also increases cathelicidin and decreases HBD2 levels in healing skin lesions of psoriasis and AD. This effect might be mediated by improved vitamin D balance and the local cytokine network.
引用
收藏
页码:321 / 328
页数:8
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