Narrowband UVB Treatment Research Articles

NOD2 expression in psoriasis before and after treatment with Narrowband Ultraviolet B phototherapy.

Psoriasis is a chronic inflammatory skin condition characterized by hyperproliferation of keratinocytes and immune dysregulation. Narrow band ultraviolet B (NB-UVB) phototherapy is a common treatment for psoriasis due to its efficacy and safety profile. NOD2 is an intracellular pattern recognition receptor involved in immune responses and inflammation, and its expression is elevated in psoriatic skin. This study investigates the impact of NB-UVB phototherapy on NOD2 expression in psoriasis patients. Sixty participants were included, comprising 30 psoriasis patients and 30 healthy controls matched for age and sex. Clinical data, including Psoriasis Area and Severity Index (PASI) scores, were collected. Immunohistochemical analysis was performed to assess NOD2 expression in the epidermis and dermis before and after NB-UVB treatment. The psoriasis group had a male-to-female ratio of 3:1, with ages ranging from 18 to 70 years (mean age 40 ± 16.56 years). Initial PASI scores ranged from 3.6 to 25.5 (mean 11.36 ± 5.84). Patients received 18 to 86 NB-UVB sessions (mean 42 ± 14.45) over 5 ± 1.5 months. UVB doses ranged from 0.89J/cm² to 5J/cm², with cumulative doses between 13.7J/cm² and 67.19J/cm² (mean 30.56 ± 13.4J/cm²). Significant improvements were observed in acanthosis, hyperkeratosis, parakeratosis, the granular cell layer, and supra papillary thinning (P < 0.001 for all). No significant difference was found in Munro-micro abscesses (p = 0.08). Dermal findings showed significant reductions in inflammatory cells and angiogenesis (P < 0.001 for both). Regarding epidermal NOD2 Expression, before treatment, all psoriasis patients showed positive NOD2 expression (100%), with strong staining in 50%. After treatment, 93.33% were positively stained, with significant reductions in intensity (P < 0.001). Concerning dermal expression, before treatment, all psoriasis patients showed positive NOD2 expression (100%), with strong staining in 26.67%. After treatment, 86.67% were positively stained, with significant reductions in intensity (P < 0.001). A significant positive correlation was found between epidermal NOD2 expression before treatment, initial PASI score, and disease duration (rs = 0.443, 0.738; p = 0.014, p < 0.001, respectively). NB-UVB phototherapy effectively modulates NOD2 expression and improves clinical and histopathological outcomes in psoriasis patients. Further large-scale studies are recommended to confirm these findings and explore the underlying mechanisms.

P25 Genome-wide association study and predictive models for the efficacy and safety of NB-UVB phototherapy in psoriasis

Abstract Background Psoriasis is a chronic inflammatory skin disease affecting ∼125 million individuals worldwide. Although the treatment of psoriasis has entered an era of biological agents and small molecule drugs, narrowband ultraviolet B (NB-UVB) phototherapy still represents an effective, cost-efficient, and safe therapeutic option for patients with plaque psoriasis. However, the clinical and genetic predictors of NB-UVB treatment response remain limited. Objective We aimed to detect single nucleotide polymorphisms (SNPs) associated with the efficacy of NB-UVB in treating psoriasis and its adverse events (AEs), in order to establish predictive models for the efficacy and safety of NB-UVB phototherapy. Methods A total of 252 patients with moderate-to-severe plaque psoriasis were enrolled in this study and underwent 12 weeks of NB-UVB phototherapy. Psoriasis area and severity index (PASI) and the AEs of NB-UVB treatment were recorded during follow-up. Whole blood samples were collected from the participants, and extracted DNA was genotyped using Infinium Global Screening Array-24 v3.0 BeadChip. Genome-wide association studies (GWASs) were performed to identify SNPs related to NB-UVB treatment response. Predictive models for the efficacy and safety of NB-UVB therapy, which involved SNPs along with clinical parameters, were developed utilizing logistic regression and further validated by receiver operating characteristic (ROC) curve and calibration curve. Results After 4 weeks of NB-UVB phototherapy, 40.8% of patients achieved PASI50. Through GWASs, we discovered that SLC7A13 rs35314286 TA allele [odds ratio (OR) = 2.631, P = 5.96 × 10−6] and DYNC1H1 rs941636 A allele (OR = 3.066, P = 3.15 × 10−6) were significantly correlated with better efficacy of 4-week NB-UVB treatment. After 12 weeks of treatment, 61.4% of patients achieved PASI75. Seven ATP2B2 SNPs and 11 PSMB7 SNPs significantly impacted 12-week PASI75 achievement. During the treatment, 29.8% of patients experienced AEs that included pruritus, sting, numbness, erythema, vesicles, desquamation, hyperpigmentation, and photosensitivity. Two KCNA2 SNPs, seven THSD7B SNPs and one TENM4 SNP were considerably associated with the occurrence of AEs. Based on the clinical parameters (body mass index, smoking history, PASI score, and the percentage of PASI improvement at Week 4) and NB-UVB relevant SNPs, predictive models for the efficacy and safety of NB-UVB phototherapy were established, demonstrating excellent predictive capacities with area under the curve (AUC) value being 0.81 for 4-week efficacy, 0.80 for 12-week efficacy, and 0.85 for AE development. Conclusion Multiple gene SNPs were identified to be correlated with the efficacy and safety of NB-UVB phototherapy. Moreover, predictive models of NB-UVB treatment response were subsequently established. Our findings might contribute to the advancement of precision phototherapy in psoriasis. Clinical trial registration (www.chictr.org.cn), identifier (ChiCTR2000036186).

A Retrospective Comparison Between Home and in-Office NB-UVB Efficacy for Patients With Mycosis Fungoides.

This study addresses the gap in research comparing the effectiveness between home and in-office narrowband ultraviolet B (NB-UVB) phototherapy for the treatment of mycosis fungoides (MF). Elderly and disabled patients with this condition disproportionally lack access to home units due to insurance denial. A retrospective review included patients diagnosed with MF or Sezary syndrome who underwent either in-office or home UVB between 2016 and 2023. Eighty-four patients used home NB-UVB, while 75 used in-office. Clinical characteristics, treatment response, and access were evaluated. Overall, there was no significant difference in response rates between home and in-office NB-UVB phototherapy. Subgroup analysis based on adjuvant treatment revealed a significant difference in clinical response rates for patients using NB-UVB with topicals (p = 0.008) and NB-UVB with multiple systemic therapies (p = 0.04). Financial and time constraints were the most common cause of treatment discontinuation for in-office patients (28%). The effectiveness of home NB-UVB treatment is comparable, if not superior, to in-office treatment, likely attributed to treatment ease in access and compliance. Medicare and other health insurance companies should expand coverage to include home-based phototherapy for patients with MF, a potentially fatal cancer with a relative paucity of effective alternate therapies.

Evaluation the efficacy of NB-UVB treatment alone in comparison with combination therapy of NB-UVB and oral prednisolone in treatment of vitiligo

Background: The treatment landscape for vitiligo has witnessed diverse approaches yielding variable outcomes. Objective: To discern the optimal approach in terms of both tolerability and efficacy by comparing Narrow Band Ultraviolet B (NB-UVB) phototherapy with adjunctive oral mini pulse (OMP) prednisolone tablets. Patients and Methods: A total of eighty-seven individuals with progressive vitiligo were enrolled in a one-year study, with participants allocated randomly across three study groups through a continuous selection method. Group 1 received a combination of NB-UVB and OMP prednisolone tablets, group 2 underwent NB-UVB treatment only, and group 3 received OMP prednisolone tablets alone. Clinical assessments were conducted at three- and six-month intervals, and statistical analyses were performed utilizing descriptive and bivariate techniques, including the chi-square test, to gauge the significance of differences between the various groups. Results: In Group 1 (NB-UVB + OMP), substantial improvement was observed in 41.4%, accompanied by moderate improvement in 44.8% of patients. Group 2 (NB-UVB) demonstrated marked improvement in 31.0% and moderate improvement in 38.0%. In Group 3 (OMP), a lower proportion experienced marked (13.8%) or moderate (3.4%) improvement. Chi-square test findings indicated that the combination of NB-UVB and OMP correlated significantly with marked and moderate improvement in contrast to OMP alone, with respective values of χ² = 6.434 (p = 0.001) and χ² = 7.831 (p = 0.015) after a six-month follow-up. Conclusion: Through a comprehensive evaluation of three treatment modalities in vitiligo patients, it was established that the sole application of oral mini pulse steroids (OMP) held an adjunctive value, lacking substantial efficacy on its own. Remarkably, the amalgamation of Narrow Band UVB and OMP presented a clear advantage over either treatment administered independently.

Evaluation the Efficacy of NB-UVB Treatment Alone in Comparison with Combination Therapy of NB-UVB and Oral Prednisolone in Treatment of Vitiligo

Background: The treatment landscape for vitiligo has witnessed diverse approaches yielding variable outcomes. Objective: To discern the optimal approach in terms of both tolerability and efficacy by comparing Narrow Band Ultraviolet B (NB-UVB) phototherapy with adjunctive oral mini pulse (OMP) prednisolone tablets. Patients and Methods: A total of eighty-seven individuals with progressive vitiligo were enrolled in a one-year study, with participants allocated randomly across three study groups through a continuous selection method. Group 1 received a combination of NB-UVB and OMP prednisolone tablets, group 2 underwent NB-UVB treatment only, and group 3 received OMP prednisolone tablets alone. Clinical assessments were conducted at three- and six-month intervals, and statistical analyses were performed utilizing descriptive and bivariate techniques, including the chi-square test, to gauge the significance of differences between the various groups. Results: In Group 1 (NB-UVB + OMP), substantial improvement was observed in 41.4%, accompanied by moderate improvement in 44.8% of patients. Group 2 (NB-UVB) demonstrated marked improvement in 31.0% and moderate improvement in 38.0%. In Group 3 (OMP), a lower proportion experienced marked (13.8%) or moderate (3.4%) improvement. Chi-square test findings indicated that the combination of NB-UVB and OMP correlated significantly with marked and moderate improvement in contrast to OMP alone, with respective values of χ² = 6.434 (p = 0.001) and χ² = 7.831 (p = 0.015) after a six-month follow-up. Conclusion: Through a comprehensive evaluation of three treatment modalities in vitiligo patients, it was established that the sole application of oral mini pulse steroids (OMP) held an adjunctive value, lacking substantial efficacy on its own. Remarkably, the amalgamation of Narrow Band UVB and OMP presented a clear advantage over either treatment administered independently. Keywords: Vitiligo, NB-UVB, OMP, Prednisolone.

P07 Mutagenicity of narrowband ultraviolet B

Abstract Introduction and aims Exposure to ultraviolet (UV) radiation causes DNA mutations in skin and development of skin cancer. Despite this, UV radiation in the form of narrowband UVB is commonly used by dermatologists to treat skin diseases such as psoriasis. However, the mutagenicity of narrowband UVB in human skin is unknown. In this study, we investigated the mutation burden resulting from a course of narrowband UVB in patients with psoriasis. Methods Skin biopsies were taken from uninvolved skin of sixteen patients with psoriasis before and after a treatment course of narrowband UVB. Following microdissection, DNA was extracted from the epidermis and sequenced using nanorate sequencing (NanoSeq), which detects mutations in single molecules of DNA with an error rate of fewer than five errors per billion base pairs. Whole-genome sequencing of blood DNA was employed as germline control. Comparison of mutations in prenarrowband UVB and postnarrowband UVB skin samples allowed quantification of mutation burden and mutational signatures owing to narrowband UVB. Results There was a significant increase in the mutation burden in skin following the narrowband UVB treatment course, with UV radiation signatures SBS7a, SBS7b and DBS1 documented in both nonsun-exposed skin and frequently sun-exposed skin samples. Comparison of the magnitude of the mutation burden resulting from narrowband UVB to that in keratinocyte cancers provided insight into the mutagenicity of narrowband UVB in relation to the potential numbers of narrowband UVB courses over a lifetime that might lead to skin cancer development. Conclusions Narrowband UVB treatment for psoriasis Results in significant numbers of UV-radiation-induced mutations in human skin.

The effect of narrowband ultraviolet B on tissue level of interleukin-15 and interleukin-15 receptor alpha subunit in active nonsegmental vitiligo cases: an interventional cohort study

Background Vitiligo is an acquired depigmenting skin disorder in which CD8 effector and memory T-cells contribute to its pathogenesis and recurrence. Interleukin (IL)-15 contributes to CD8 effector T-cell cytotoxicity and CD8 memory T-cell survival and maturation. Objective To evaluate the effect of total narrowband ultraviolet B (NB-UVB) on tissue levels of IL-15 and IL-15 receptor alpha (IL-15Ra) in active nonsegmental vitiligo. Patients and methods The patients were assessed clinically for vitiligo extent and activity before and after treatment. Perilesional skin biopsies were taken from 30 vitiligo patients before and after 48 sessions of NB-UVB and from 30 healthy controls. Tissue levels of IL-15 and IL-15 Ra were evaluated by enzyme-linked immunosorbent assay before and after treatment to evaluate the effect of NB-UVB on them. Results Before NB-UVB treatment, the tissue levels of both IL-15 and IL-15Ra were significantly higher in vitiligo patients than controls; moreover, they were significantly higher than those after NB-UVB treatment. In contrast, after NB-UVB treatment, no statistically significant difference was detected between the patients and controls. The levels of IL-15 and IL-15Ra were significantly correlated, whereas they were not correlated with either vitiligo activity or extent. Conclusion IL-15 and IL-15Ra were higher in vitiligo patients than controls before treatment. However, their tissue levels were normalized after treatment with NB-UVB, emphasizing its therapeutic potential.

Vitiligo non-responding lesions to narrow band UVB have intriguing cellular and molecular abnormalities that may prevent epidermal repigmentation.

We have discovered that human vitiligo patients treated with narrow-band UVB (NBUVB) demonstrated localized resistance to repigmentation in skin sites characterized by distinct cellular and molecular pathways. Using immunostaining studies, discovery-stage RNA-Seq analysis, and confirmatory insitu hybridization, we analyzed paired biopsies collected from vitiligo lesions that did not repigment after 6 months of NBUVB treatment (non-responding) and compared them with repigmented (responding) lesions from the same patient. Non-responding lesions exhibited acanthotic epidermis, had low number of total, proliferative, and differentiated melanocyte (MC) populations, and increased number of senescent keratinocytes (KCs) and of cytotoxic CD8+ T cells as compared with responding lesions. The abnormal response in the non-responding lesions was driven by a dysregulated cAMP pathway and of upstream activator PDE4B, and of WNT/β-catenin repigmentation pathway. Vitiligo-responding lesions expressed high levels of WNT10B ligand, a molecule that may prevent epidermal senescence induced by NBUVB, and that in cultured melanoblasts prevented the pro-melanogenic effect of α-MSH. Understanding the pathways that govern lack of NBUVB-induced vitiligo repigmentation has a great promise in guiding the development of new therapeutic strategies for vitiligo.

Screening for Biomarkers Related to Pigmentation and Formation in Vitiligo.

Vitiligo is an autoimmune skin disorder primarily characterized by the absence of melanocytes, leading to the development of white patches on the patient's skin. Narrowband Ultraviolet B (NB-UVB) therapy is among the most effective approaches for stimulating the reformation of hyperpigmentation. This treatment utilizes a narrow spectrum of NBUVB wavelengths ranging from 311 to 313 nm to irradiate the affected area, thereby preventing the destruction of migrating and proliferating melanocytes. Nevertheless, the molecular alterations occurring in both the hair follicle and the interfollicular epidermis during NB-UVB treatment remain unknown. In this study, we conducted a comprehensive analysis of the consistency of differentially expressed genes (DEGs) within the enrichment pathways both before and after NB-UVB treatment, utilizing a bioinformatics approach. Furthermore, we employed CYTOHUBBA and Random Forest algorithms to identify and sequence hub genes from the pool of DEGs. Following validation of these hub genes through ROC curve analysis, we proceeded to construct an interaction network between these hub genes, miRNA, and drugs. Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR) was used to further verify the difference in the expression of hub genes between the disease group and the control group. Gene Set Enrichment Analysis of DEGs indicated strong associations with vitiligo in most pathways. Subsequently, we conducted Gene Ontology and Metascape enrichment analyses on the overlapping genes from DEGs. We identified key genes (COL11A1, IGFBP7, LOX, NTRK2, SDC2, SEMA4D, and VEGFA) within the Protein-Protein Interaction (PPI) network. We further explored potential drugs that could be used for the clinical treatment of vitiligo through the drug-hub gene interaction network. Finally, the results of RT-qPCR experiments demonstrated that the expression levels of the identified hub genes in both groups were consistent with the bioinformatics analysis results. The hub genes obtained in this study may be a biomarker related to the development of vitiligo pigmentation. Our research not only contributes to a better understanding of the treatment mechanisms of vitiligo but also provides valuable insights for future personalized medical approaches and targeted therapies for vitiligo.

Frequency of skin cancer among psoriasis, vitiligo, and mycosis fungoides patients treated with narrowband ultraviolet B phototherapy.

Narrowband ultraviolet B (NB-UVB) phototherapy is a popular and relatively contemporary treatment option. However, only a few studies to date have explored the potential risk of skin cancer following NB-UVB treatment. This study aimed to investigate the potential long-term risk of skin cancer in patients treated with NB-UVB. This cohort study included patients with psoriasis, vitiligo, and mycosis fungoides treated with NB-UVB at two university hospitals in Israel in 2000-2005. Patients were followed up for skin cancer for at least 10 years. Data were extracted from the hospital and community medical records. A total of 767 patients were included in this study: 509 with psoriasis, 122 with vitiligo, and 136 with mycosis fungoides. The mean follow-up duration was 13 years. Among these patients, 4.43% developed skin cancer during the follow-up (3.93% had psoriasis, 2.46% had vitiligo, and 8.09% had mycosis fungoides). Old age and fair skin type were the only significant independent risk factors for skin cancer. There was no significant difference in the mean number of NB-UVB treatments among patients who developed skin cancer and those who did not (99.09 vs. 94.79, respectively). No association was observed between the number of NB-UVB treatments and carcinogenesis in any study group. Age is a significant risk factor, and older patients treated with NB-UVB should be followed up carefully.

RasGRP1 influences imiquimod-induced psoriatic inflammation via T-cell activation in mice.

The vascular endothelial growth factor (VEGF) signal transduction pathway has been shown to be a potential target for the treatment of psoriasis. Ras guanyl-releasing protein 1 (RasGRP1), a downstream target gene of VEGF, regulates the development, homeostasis, and differentiation of T cells, but the contribution of RasGRP1 to psoriasis is limited. In this manuscript, we aimed to investigate the role of RasGRP1 in psoriasis. The RNA-Seq transcriptome sequencing data from the mouse model of psoriasis treated with IMQ (imiquimod) were analyzed. The effect of RasGRP1 was investigated through in vivo injection of activators or small molecular inhibitors, as well as adeno-associated virus injections. Gene knockout and NB-UVB (narrow-band ultraviolet B) treatments were utilized to interfere with the psoriatic mouse model. By transfection of lentivirus in vitro, the effect of RasGRP1 gene function on the secretion of psoriasis-related cytokines by T cells was confirmed. We showed that cutaneous VEGF and RasGRP1 were strongly activated in human psoriatic lesions and the skin of mice with IMQ-induced psoriasis. RasGRP1 deficiency and overexpression influence IMQ-induced psoriasis-like manifestations and skin inflammation in mice. VEGF, secreted mainly by epidermal cells, mediates psoriatic inflammation through the RasGRP1-AKT-NF-κB pathway. RasGRP1 is required for psoriasis development mediated by VEGF. These results confirmed the role of RasGRP1 in the pathogenesis of psoriasis and provided potential targets for clinical psoriasis treatment.

Reliability and agreement testing of a new automated measurement method to determine facial vitiligo extent using standardized ultraviolet images and a dedicated algorithm.

Facial repigmentation is the primary outcome measure for most vitiligo trials. The Facial Vitiligo Area Scoring Index (F-VASI) score is often chosen as the primary outcome measure to assess the efficacy of treatments for facial vitiligo. Although useful, this scoring system remains subjective and has several limitations. To assess the agreement and reliability of an algorithmic method to measure the percentage depigmentation of vitiligo on the face. We developed a dedicated algorithm called Vitil-IA® to assess depigmentation on standardized facial ultraviolet (UV) pictures. We then conducted a cross-sectional study using the framework of the ERASE trial (NCT04843059) in 22 consecutive patients attending a tertiary care centre for vitiligo. Depigmentation was analysed before any treatment and, for 7 of them, after 3 and 6 months of narrowband UVB treatment combined with 16 mg methylprednisolone, both used twice weekly. Interoperator and interacquisition repeatability measures were assessed for the algorithm. The results of the algorithmic measurement were then compared with the F-VASI and the percentage of depigmented skin scores assessed by 13 raters, including 7 experts in the grading of vitiligo lesions. Thirty-one sets of pictures were analysed with the algorithmic method. Internal validation showed excellent reproducibility, with a variation of < 3%. The percentage of depigmentation assessed by the system showed high agreement with the percentage of depigmentation assessed by raters [mean error (ME) -11.94 and mean absolute error (MAE) 12.71 for the nonexpert group; ME 0.43 and MAE 5.57 for the expert group]. The intraclass correlation coefficient (ICC) for F-VASI was 0.45 [95% confidence interval (CI) 0.29-0.62] and 0.52 (95% CI 0.37-0.68) for nonexperts and experts, respectively. When the results were analysed separately for homogeneous and heterogeneous depigmentation, the ICC for homogeneous depigmentation was 0.47 (95% CI 0.31-0.77) and 0.85 (95% CI 0.72-0.94) for nonexperts and experts, respectively. When grading heterogeneous depigmentation, the ICC was 0.19 (95% CI 0.05-0.43) and 0.38 (95% CI 0.20-0.62) for nonexperts and experts, respectively. We demonstrated that the Vitil-IA algorithm provides a reliable assessment of facial involvement in vitiligo. The study underlines the limitations of the F-VASI score when performed by nonexperts for homogeneous vitiligo depigmentation, and in all raters when depigmentation is heterogeneous.

Comparative Study of Topical Latanoprost, Tacrolimus and Clobetasol Propionate in Combination with Microneedling and Narrow-Band Ultraviolet B in the Treatment of Non-Segmental Vitiligo

Abstract Background Vitiligo is a common skin disease in both sex. There are multiple options in the treatment of vitiligo but the response is unsatisfactory. In this comparative study we will study the effect of topical latanoprost, tacrolimus, clobetasol propionate in combination with microneedling and narrow-band ultraviolet B (NB-UVB) in the treatment of non-segmental vitiligo. Objective To evaluate and compare the efficacy and safety of topical latanoprost, tacrolimus, clobetasol propionate when combined with microneedling and NB-UVB in the treatment of nonsegmental vitiligo lesions. Patients and Methods This randomized self-controlled clinical trial included 30 vitiligo patients with at least 5 patches of stable vitiligo (150 patches), the patches were divided into five groups according to the treatment modality. The patients were recruited from the outpatient clinic of dermatology of Ain Shams University Hospital in the period from July 2019 to September 2020. Results Regarding safety of considered therapies, pain and erythema was reported with Microneedling + latanoprost and NB-UVB and Microneedling + topical tacrolimus and NB-UVB. Itching was associated with Microneedling + topical clobetasol propionate and NB-UVB while burning and dryness were associated with NB-UVB therapy. Conclusion Combination therapy in treatment of vitiligo showed higher efficiency compared to monotherapy. Microneedling + latanoprost and NB-UVB treatment combined therapy showed the maximal repigmentation in included patients followed by Microneedling + tacolimus and NB-UVB treatment. Monotherapy using NB-UVB showed minimal response when compared to other combination modalities.

Home Narrowband UV-B Treatment for Psoriasis

This cohort study describes and identifies patient characteristics associated with use of in-office narrowband UV-B (NBUVB) or systemic therapy following home NBUVB machine receipt.

Effect of NB-UVB therapy on IL-6 and neopterin levels in patients with psoriasis

Abstract Background Psoriasis is a chronic and non-transient disease with increased epidermal proliferation in the skin. Dysregulation of the immune system is an important factor in this pathology. Inflammation markers, pro-inflammatory cytokines, and immune cells are reported to be changed in psoriasis. Study design In the current cohort study, the possible changes in interleukin-6 (IL-6), neopterin levels, and kynurenine (Kyn) pathway in 42 psoriasis patients compared to 30 controls, and their change with narrow-band (NB) UVB treatment were investigated. Methodology IL-6 and serum neopterin levels were analyzed with ELISA kits. HPLC analyses were performed to detect urinary neopterin, serum Kyn, and tryptophan (Trp) levels. Results IL-6 levels were lower, while Kyn levels and the Kyn-to-Trp ratio were higher in psoriasis patients compared to control subjects (p &lt; 0.01, all). Conclusion Narrow-band ultraviolet B (NB-UVB) treatment decreased Psoriasis Area and Severity Index (PASI) scores and increased urinary neopterin levels of the patients (both, p &lt; 0.01). Serum neopterin was correlated with Kyn and Kyn/Trp levels before and after NB-UVB treatment (p &lt; 0.05, all). These findings point out that the measured parameters might be considered to support the PASI score in both diagnosis and prognosis of psoriasis rather than evaluating the severity of the disease.

COMPARISON OF EFFICACY OF TCI MONOTHERAPY WITH TCI AND NARROW BAND UVB IN VITILIGO: A HOSPITAL BASED STUDY.

Background:&#x0D; A skin condition known as vitiligo is an advanced depigmentation of the skin that is characterized by the development of depigmented macules that cause significant social and psychological distress. Although there are various therapy options available, vitiligo management is still a therapeutic challenge for many dermatologists. Topical calcineurin inhibitors, ultraviolet B phototherapy, and topical steroids are examples of conservative treatments.&#x0D; Objective: This study aims to compare the effectiveness of tacrolimus monotherapy and narrowband ultraviolet B phototherapy (NB-UVB) for treating vitiligo.&#x0D; Materials and Methods: :For a period of two years, 100 vitiligo patients who presented to the dermatology outpatient department of the first Dali university associated hospital underwent a prospective and comparative study (from 2018-1-1 to 2019-12-31). All of the participants in this study met the inclusion and exclusion criteria after receiving the necessary ethical approval. According to the vitiligo data Proforma, demographic information was checked during the initial appointment.&#x0D; All individuals with vitiligo underwent a complete clinical and dermatological examination of their condition. The associated laboratory tests were all finished. It was assessed how much of the body's surface area is affected by vitiligo. On the basis of their course of therapy, patients were divided into two groups at random. Tacrolimus ointment was applied topically to 50 patients in group A twice daily. 50 patients in group B received topical medication three times per week in addition to NB-UVB phototherapy.&#x0D; The VASI (Vitiligo Area Severity Index) was used to compare the effectiveness of the two groups from the beginning of the trial to its conclusion. Global ratings from both patients and physicians were calculated as part of the study's secondary efficacy measure. Software called SPSS 23.0 was used to do the statistical analysis. At p 0.05, the difference was statistically significant.&#x0D; Results: After 12 months of treatment, topical treatment alone outperformed Narrow Band UVB in terms of overall effectiveness. Patients treated with narrow band UVB plus topical treatment have earlier repigmentation response to lesions in the face, trunk, upper limbs, and lower limbs than those treated with topical treatment alone. When comparing the trunk, face, upper, and lower limbs for both types of therapies, lesions in the hands and feet require a lengthier course of treatment.&#x0D; Conclusion: &#x0D; Narrow band UVB along with TCI is of higher efficacy, better tolerated and superior to TCI monotherapy in the treatment of vitiligo. There was a statistically significant reduction in percentage of VASI p= with Narrow Band UVB along with TCI group when compared to TCI mono therapy alone.

Elucidating the NB-UVB mechanism by comparing transcriptome alteration on the edge and center of psoriatic plaques

Narrow band-ultraviolet B (NB-UVB) is an effective treatment for psoriasis. We aim to generate a potential mechanism of NB-UVB through comparing the transcriptomic profile before and after NB-UVB treatment between the peripheral edge of lesional skin (PE skin) and the center of lesional skin (CE skin) on the basis of molecular mechanisms of these two areas display different downstream functions. More than one-fourth of the NB-UVB-altered genes were found to be plaque-specific. Some of them were psoriasis signature genes that were downregulated by NB-UVB in, both, PE and CE skin (core alteration), such as IL36G, DEFB4A/B, S100A15, KRT16, and KRT6A. After NB-UVB treatment, the activity score of upstream cytokines, such as interferons, interleukin (IL)-6, IL-17, and IL-22 in pathogenesis decreased. In addition, NB-UVB could restore normal keratinization by upregulating LORICRIN and KRT2, particularly in the CE skin. Finally, we illustrated that NB-UVB is capable of suppressing molecules from the initiation to maintenance phase of plaque formation, thereby normalizing psoriatic plaques. This finding supports the usefulness of NB-UVB treatment in clinical practice and may help in the development of new treatment approaches in which NB-UVB treatment is included for patients with psoriasis or other inflammatory skin diseases.

343 Endogenous double-stranded RNA is a potential target for psoriasis therapy

The activation of endogenous double-stranded RNA (endo-dsRNA) signalling pathways is linked to a variety of autoimmune diseases. Here, we investigated the role of endogenous dsRNA in psoriasis by quantifying dsRNA binding protein (DRBP) mRNA and mitochondrial dsRNA formation in response to narrow-band UVB (NB-UVB) treatment. RNAseq data from 34 psoriatic patients treated with NB-UVB were analysed. Biopsies were obtained from four sites 24h after NB-UVB irradiation (lesional unirradiated, nonlesional unirradiated lesional irradiated with one minimal erythemal dose (MED), lesional irradiated with three MEDs. Psoriatic lesional skin had a significantly higher expression of all examined DRBP (RIG, MDA5, LGP2, PKR, OAS1-3, OASL) as compared to nonlesional skin (increase between 1.5-21.7 fold, p <0.001 for all eight genes). NB-UVB treatment had no effect on the DRBPs after 24h of one or three MEDs of NB-UVB. Additionally, a significant reduction (about 20%) of dsRNA from mitochondrial transcripts was detected in response to both NB-UVB doses(p-value 0.012 and 0.001, respectively). These results indicate that increased levels of dsRNA activate RIG, MDA5, and LGP2 in lesional compared to nonlesional psoriasis skin. RIG, MDA5, and LGP2 in turn upregulate type1 IFN via recruiting TBK1, and IRF3/7, all of which were significantly upregulated in the lesional unirradiated skin. PKR binds endo-dsRNA, and activation of PKR enhances IFN-α/β expression via IRF3. Moreover, OASs trigger an antiviral response via a RIG induced IFN pathway. Once activated, IFN strongly enhances the transcription of DRBP thus creating a vicious cycle that exacerbates the immune response. In conclusion, upregulation of all DRBP genes in psoriatic lesional skin indicates that endo-dsRNA may play a crucial role in psoriasis pathogenesis, and the early reduction of the mitochondrial dsRNA after NB-UVB treatment suggests that dsRNA is an important target for psoriasis therapy.

Effect of Narrowband UV-B Irradiation on the Growth Performance of House Crickets.

Indoor co-cultivation systems can answer to the need for sustainable and resilient food production systems. Rearing organisms under light-emitting diodes (LEDs) irradiation provides the possibility to control and shape the emitted light spectra. UV-B-irradiation (280-315 nm) can positively affect the nutritional composition of different plants and other organisms, whereas information on edible insects is scarce. To evaluate the potential effect of the photosynthetically active radiation (PAR) and LED-emitting LEDs on the rearing and nutritional quality of edible insects, house crickets (Acheta domesticus) were reared from the age of 21 days under controlled LED spectra, with an additional UV-B (0.08 W/m2) dose of 1.15 KJm2 d-1 (illuminated over a period for 4 h per day) for 34 days. UV-B exposure showed no harm to the weight of the crickets and significantly increased their survival by ca. 10% under narrowband UV-B treatment. The nutritional composition including proteins, fat and chitin contents of the insects was not affected by the UV-B light and reached values of 60.03 ± 10.41, 22.38 ± 2.12 and 9.33 ± 1.21%, respectively, under the LED irradiation. Therefore, house crickets can grow under LED irradiation with a positive effect of narrowband UV-B application on their survival.

Transcriptome profiling in psoriasis: NB-UVB treatment-associated transcriptional changes and modulation of autoinflammation in perilesional skin in early-phase disease

BackgroundPsoriasis is a chronic inflammatory skin condition. It is widely treated with phototherapy using narrowband ultraviolet B (NB-UVB). The therapeutic mechanisms of NB-UVB, however, remain unclear, particularly in the early phases of the disease. ObjectiveTo investigate the mechanisms underlying the effects of NB-UVB on psoriasis in a model of perilesional psoriasis. MethodsPsoriatic patients that received NB-UVB treatment and were evaluated with the psoriasis area and severity index were included in the study. Skin biopsies obtained before and after treatment were subjected to RNA sequencing (RNA-seq) and Ingenuity Pathway Analyses for genome-wide transcriptome profiling to gain further insights into the signaling pathways underlying the improvement of psoriasis with therapeutic intervention. ResultsOur findings revealed that NB-UVB treatment may exert its effects by suppressing nuclear factor kappa B, which leads to upregulation of the sirtuin signaling pathway, as well as by decreasing the function of major upstream regulators associated with proinflammatory and inflammatory cytokines, which blocks the expression of downstream toll-like receptors. Psoriasis improvement after NB-UVB treatment was associated with decreased expression of NFKBIZ, SERPINB4, ATG13, and CTSS and increased expression of SKP1 gene. Our results also highlighted the expression of proposed genes associated with the modulation of autoinflammation. ConclusionsTo the best of our knowledge, this is the first study to apply advanced molecular techniques to explore the effects of phototherapy on psoriasis in the early-phase, providing new insights into the disease pathogenesis and novel genetic information for the development of new therapeutic modalities and potential treatment targets.