Narrow-band Ultraviolet B Light Research Articles

Effectiveness of Narrowband Ultraviolet Light in Chronic Kidney Disease-Associated Pruritus.

Chronic kidney disease-associated pruritus (CKDaP) is a prevalent and challenging symptom in individuals suffering from advanced chronic kidney disease (CKD). Its underlying mechanism remains inadequately understood, leading to a limited array of unsatisfactory therapeutic interventions. Despite various attempts, identifying the most effective treatment remains inconclusive. Nevertheless, there is a growing interest in employing ultraviolet phototherapy, particularly for non-responsive patients, although its efficacy is not definitively established. To investigate the potential benefits of narrowband ultraviolet B (NB-UVB) phototherapy on individuals experiencing CKDaP, we report our experience with NB-UVB light in management of CKDaP in dialysis patients. The study group consisted of patients with end-stage chronic kidney disease who underwent hemodialysis. These patients received dermatological consultations and follow-ups for itching. They were all unresponsive to the conventional treatment (emollients and antihistamines). Screening laboratory examinations, including complete blood count, liver function test, thyroid function, electrolytes, and others, were also arranged to exclude systemic etiologies. The main potential pruritogens were dosed: calcium, phosphate, and parathyroid hormone. Itch intensity was evaluated with a numericalrating scale(0-10), based on the worst level ofitchingin the past two weeks.They had sessions of NB-UVB light (311 nm, TL01) twice per week. After UVB exposure, patients were advised to use topical emollients. A questionnaire was employed to document the extent, intensity, frequency, and sleep disruption experienced to evaluate the efficiency of the treatment, using a scale from 0 to 10. Results: In a group of 38 patients, the average age of the patients was 56 years (16-80); 63.2% were female and 36.8% were male. Median duration of pruritus was 4.7 years, and that of dialysis was 8.4 years. Pruritus was intermittent and diffuse in most cases, localized to the arteriovenous fistula site in two cases, and exacerbated by heat in all cases. Itch intensity was evaluated with a numerical rating scale (0-10) based on the worst level of itching in the past two weeks and showed a moderate average score (5/10). Xerosis was found in 63%, and scratch lesions such as excoriation in 34%. NB-UVB phototherapy was used twice per week on nonconsecutive days, with protection of the genital area and also the eyes using UVB-blocking goggles. The initial dose was 0.4 J/cm2and further doses were introduced according to the erythema response until a maximum of 2 J/cm2. No sunburn, hyperpigmentation, or blistering was noted. Emollients were maintained in patients with xerosis. Average number of sessions was 13 (6-24)and reduction of itch intensity was observed starting from the sixth session. Total improvement was obtained at the end of treatment duration except for three patients who required additional sessions. One patient had recurrence one year later. Conclusion: In conclusion, phototherapy represents a significant advancement in the treatment options for CKD-associated pruritus. Its positive impact on reducing itching and improving the quality of life for many patients is undeniable. However, to fully unlock its potential, ongoing research is needed to optimize dosing, understand relapse mechanisms, and identify the patients who will benefit most from this therapy.

X-ray-Excited Long-Lasting Narrowband Ultraviolet-B Persistent Luminescence from Gd3+-Doped Sr2P2O7 Phosphor

Persistent phosphors emitting in the narrowband ultraviolet-B (NB-UVB) spectral region have aroused significant interest, owing to their special self-illuminating feature in realizing many advanced technological applications under excitation-free conditions, such as dermatological therapy and invisible optical tagging. Here, we focus our discussion on a new Gd3+-doped persistent phosphor, Sr2P2O7:Gd3+, which exhibits long-lasting NB-UVB persistent luminescence peaking at 312 nm for more than 24 h after charging by an X-ray beam. The NB-UVB light emission from the charged Sr2P2O7:Gd3+ phosphor can be clearly detected by a UVB camera in bright indoor environment. More importantly, the enhancement of NB-UVB afterglow intensity and decay time can be observed under continuous photostimulation of polychromic indoor ambient light. Furthermore, applying charged Sr2P2O7:Gd3+ phosphors as invisible optical taggants, clear and interference-free recognition of the encrypted message and location of different objects have been realized due to the lack of UVB light in bright indoor environment. The as-prepared Sr2P2O7:Gd3+ persistent phosphor is expected to offer new directional solutions for the development and application of ultraviolet luminescence technology.

Do treatments for vitiligo offer value for money?

British Journal of DermatologyVolume 184, Issue 5 p. e174-e174 Plain Language Summary Do treatments for vitiligo offer value for money? First published: 04 May 2021 https://doi.org/10.1111/bjd.19909AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Abstract Vitiligo is a relatively common skin condition that causes white patches on the skin. Very little is known about the value for money of vitiligo treatments for the National Health Service (NHS) and patients. The HI-Light Vitiligo Trial was conducted in the UK and included 398 adults and 119 children with vitiligo. These volunteers were randomly allocated to one of three treatment groups: (i) corticosteroid ointment used every other week – normal care; (ii) handheld narrowband ultraviolet B (NB-UVB) light device used on alternate days; or (iii) both treatments used together. After 9 months of treatment, the success of the treatment and costs were compared with normal care. The treatments were generally safe and well-tolerated but took a considerable amount of time over the 9-month treatment period. Some participants (12%) reported minor burns (like sunburn) around the treated patches and 2·5% of participants reported skin thinning. For people receiving normal care (corticosteroid ointment alone) 17% achieved treatment success, at a cost of £600 per participant, for those receiving NB-UVB light, 22% achieved treatment success, at a cost of £774, and for both treatments together, 27% achieved success at a cost of £813. Overall, combination treatment was more expensive but also more effective than corticosteroid ointment alone. Combination treatment could be considered cost-effective if the NHS were willing to pay £1,932 per successful treatment. Linked Article: Sach et al. Br J Dermatol 2021; 184:840–848. Volume184, Issue5May 2021Pages e174-e174 RelatedInformation

A12 SKIN EXPOSURE TO NARROW BAND UVB LIGHT MODULATES THE HUMAN INTESTINAL MICROBIOME

Abstract Background The recent worldwide rise in idiopathic immune and inflammatory diseases such as multiple sclerosis and inflammatory bowel diseases has been linked to Western society-based changes in lifestyle and environment. These include decreased exposure to sunlight/UVB light and subsequent impairment in the production of vitamin D, as well as dysbiotic changes in the makeup of the gut microbiome. Despite their association, it is unclear if there are any direct links between UVB light and the gut microbiome. Aims In this study we investigated whether exposing the skin to Narrow Band Ultraviolet B (NB-UVB) light to increase serum vitamin D levels would also modulate the makeup of the human intestinal microbiota. Methods The effects of NB-UVB light were studied in a clinical pilot study using a healthy human female cohort (n=21). Participants were divided into those that took vitamin D supplements throughout the winter prior to the start of the study (VDS+) and those who did not (VDS-). Results After three full-body NB-UVB light exposures within the same week, the serum 25(OH)D levels of participants increased on average 7.3 nmol/L. The serum response was negatively correlated to the starting 25-hydroxy vitamin D (25(OH)D) serum concentration. Fecal microbiota composition analysis using 16S rRNA sequencing showed that exposure to NB-UVB significantly increased alpha and beta diversity in the VDS- group whereas there were no changes in the VDS+ group. Bacteria from several families were enriched in the VDS- group after the UVB exposures according to a Linear Discriminant Analysis (LDA) prediction, including Lachnospiracheae, Rikenellaceae, Desulfobacteraceae, Clostridiales vadinBB60 group, Clostridia Family XIII, Coriobacteriaceae, Marinifilaceae, and Ruminococcus. The serum 25(OH)D concentrations showed a positive correlation with the relative abundance of the Lachnospiraceae, specifically members of the Lachnopsira and Fusicatenibacter genera. Conclusions This is the first study to show that humans with low 25(OH)D serum levels display overt changes in their intestinal microbiome in response to NB-UVB skin exposure and increases in 25(OH)D levels, suggesting the existence of a novel skin-gut axis that could be used to promote intestinal homeostasis and health. Funding Agencies NRCBC Childrens Hospital Research Institute

Skin Exposure to Narrow Band Ultraviolet (UVB) Light Modulates the Human Intestinal Microbiome.

The recent worldwide rise in idiopathic immune and inflammatory diseases such as multiple sclerosis (MS) and inflammatory bowel diseases (IBD) has been linked to Western society-based changes in lifestyle and environment. These include decreased exposure to sunlight/UVB light and subsequent impairment in the production of vitamin D, as well as dysbiotic changes in the makeup of the gut microbiome. Despite their association, it is unclear if there are any direct links between UVB light and the gut microbiome. In this study we investigated whether exposing the skin to Narrow Band Ultraviolet B (NB-UVB) light to increase serum vitamin D levels would also modulate the makeup of the human intestinal microbiota. The effects of NB-UVB light were studied in a clinical pilot study using a healthy human female cohort (n = 21). Participants were divided into those that took vitamin D supplements throughout the winter prior to the start of the study (VDS+) and those who did not (VDS−). After three NB-UVB light exposures within the same week, the serum 25(OH)D levels of participants increased on average 7.3 nmol/L. The serum response was negatively correlated to the starting 25-hydroxy vitamin D [25(OH)D] serum concentration. Fecal microbiota composition analysis using 16S rRNA sequencing showed that exposure to NB-UVB significantly increased alpha and beta diversity in the VDS− group whereas there were no changes in the VDS+ group. Bacteria from several families were enriched in the VDS− group after the UVB exposures according to a Linear Discriminant Analysis (LDA) prediction, including Lachnospiracheae, Rikenellaceae, Desulfobacteraceae, Clostridiales vadinBB60 group, Clostridia Family XIII, Coriobacteriaceae, Marinifilaceae, and Ruminococcus. The serum 25(OH)D concentrations showed a correlation with the relative abundance of the Lachnospiraceae, specifically members of the Lachnopsira and Fusicatenibacter genera. This is the first study to show that humans with low 25(OH)D serum levels display overt changes in their intestinal microbiome in response to NB-UVB skin exposure and increases in 25(OH)D levels, suggesting the existence of a novel skin-gut axis that could be used to promote intestinal homeostasis and health.Clinical Trial Registration: clinicaltrials.gov, NCT03962673. Registered 23 May 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03962673?term=NCT03962673&rank=1.

Home interventions and light therapy for the treatment of vitiligo (HI-Light Vitiligo Trial): study protocol for a randomised controlled trial

IntroductionVitiligo is a condition resulting in white patches on the skin. People with vitiligo can suffer from low self-esteem, psychological disturbance and diminished quality of life. Vitiligo is often poorly...

Dipeptidyl peptidase-4 inhibition and narrow-band ultraviolet-B light in psoriasis (DINUP): study protocol for a randomised controlled trial.

BackgroundModerate to severe psoriasis is a systemic inflammatory disease associated with insulin resistance, obesity and type 2 diabetes (T2DM). Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that improves glycaemia and has a marketing authorisation for the treatment of T2DM. Non-immunosuppressive therapies that are effective for psoriasis and its associated comorbidities would be a significant advance in the treatment of this chronic disease.Methods/DesignThis is a single centre, 39-week, prospective, randomised, open label, clinical trial of oral sitagliptin (Januvia®) in psoriasis patients who are due to undergo a course of narrow-band ultraviolet-B (NB-UVB) phototherapy. We plan to enrol 120 participants and allocate participants on a random and 1:1 basis to receive sitagliptin 100 mg daily for 24 weeks combined with NB-UVB or NB-UVB monotherapy. Participants will be followed up for 12 weeks after sitagliptin therapy is discontinued. The primary endpoint is the change in Psoriasis Area and Severity Index (PASI) 24 weeks after treatment initiation. Secondary endpoints include cumulative NB-UVB dose, number of NB-UVB treatments required to clear psoriasis, proportions of participants who achieve PASI-50 (50 % reduction in PASI from baseline), PASI-75, PASI-90 and the proportion of participants who relapse in each group. We will also analyse changes in cardiovascular disease risk factors, serum cytokine and hormone levels and peripheral blood mononuclear expression of immune proteins at 24 and 36 weeks. A subgroup of participants will have skin biopsies taken and analysed for skin levels and expression of immune cells, receptors, hormones and immune proteins. The genetic or epigenetic profile that predicts best response to DPP-4 inhibitor therapy will be analysed. The safety endpoints include the rate and severity of adverse events.DiscussionThis is the first randomised clinical trial assessing dipeptidyl peptidase-4 inhibition therapy in psoriasis. We hypothesise that sitagliptin therapy in combination with NB-UVB improves psoriasis severity compared to NB-UVB monotherapy.Trial registrationClinicalTrials.gov Identifier NCT02347501 (Date of registration: 27 January 2015).

Duration of remission period of narrowband ultraviolet B therapy on psoriasis vulgaris

The remission period of psoriasis vulgaris following narrowband ultraviolet B (NB-UVB) light therapy with topical vitamin D(3) application was evaluated retrospectively to investigate the therapeutic efficacy. Fifty-two patients (60 cases) were treated with a 5-day/week protocol of NB-UVB light irradiation plus topical vitamin D ointment application for 1 month and followed up for at least 12 months. We considered re-exacerbation as the time when the patients needed treatment other than topical therapy. The remission period was defined as the duration from the end of treatment until re-exacerbation. Twenty-seven cases (56%) of psoriasis showed a remission period longer than 12 months. The patients with a past history of systemic therapy or phototherapy had a significantly shorter remission period than those without such a history. No statistically significant differences were observed in sex, age, period before treatment, Psoriasis Area and Severity Index score and total irradiation dose. A previous history of systemic therapy or phototherapy may mean that the disease is severe and sufficiently active to form multiple new lesions requiring these treatments. Our results suggest that the 5-day/week NB-UVB light protocol for 4 weeks is an effective and safe treatment for psoriasis vulgaris and can induce long-term remission.

Lipidome of narrow‐band ultraviolet B irradiated keratinocytes shows apoptotic hallmarks

UV light triggers a variety of biological responses in irradiated keratinocytes that might be associated with global perturbation of their lipidome. However, lipids that are specifically affected and the exact molecular mechanisms involved remain poorly understood. To characterize time-dependent changes of the lipidome of cultured keratinocytes induced by narrow-band ultraviolet B (NB-UVB) irradiation. Immortalized human keratinocytes (HaCaT) were cultured under standard conditions, irradiated with NB-UVB light (311 nm) at 400 and 800 mJ/cm(2) and collected 1, 2, 3, 6, 12 and 24 h later for lipid extraction. Lipid extracts were separated on silica plates in chloroform/ethanol/water/triethylamine (35:40:9:35) and in n-hexane/ethylacetate (5:1) followed by quantitative shotgun lipidomics analysis. Irradiation with 800 mJ/cm(2) of NB-UVB altered morphology and lipidome composition of HaCaT cells. Ceramide content increased two-fold 6- and 12-h postirradiation with 800 mJ/cm(2), followed by threefold increase in triacylglycerols (TAGs) that peaked at 24 h. In addition, we observed marked increase of various phosphatidylcholine and phosphatidylethanolamine ethers, whereas phosphatidylcholine-species with short-chain fatty acid moieties decreased. The abundance of other lipid species was altered to lesser extent or remained unchanged. NB-UVB affected the cellular lipidome of keratinocytes in strictly apoptosis-specific manner.

Narrow‐band UVB‐induced Externalization of Selected Nuclear Antigens in Keratinocytes: Implications for Lupus Erythematosus Pathogenesis†

The aim of this study was to analyze whether sera obtained from patients with lupus erythematosus (LE) react with membrane structures found on keratinocytes irradiated with narrow-band ultraviolet B (NB-UVB). We applied atomic force microscopy (AFM) to visualize cell surface structures expressing nuclear antigens upon apoptosis following NB-UVB irradiation. Immortalized human keratinocytes (HaCaT) were cultured under standard conditions, irradiated with 800 mJ cm(-2) NB-UVB light and imaged by AFM mounted on an inverted optical microscope. It was observed that NB-UVB irradiation provoked significant alterations of the keratinocyte morphology and led to the membrane expression of antigens recognized by anti-La and anti-Ro 60 kDa sera but not by antidouble-strand DNA sera. The presence of La and Ro 60 kDa antigens on keratinocyte surfaces after NB-UVB irradiation was limited mainly to the small bleb-like protrusions found on the keratinocytes by AFM. A closer investigation by AFM also revealed that some structures positively stained with anti-Ro 60 kDa serum were also located submembranously. We hypothesize that the externalization of some nuclear antigens because of NB-UVB exposure might be responsible for exacerbation of skin symptoms in patients suffering from LE.

Structural alterations provoked by narrow‐band ultraviolet B in immortalized keratinocytes: assessment by atomic force microscopy

We applied atomic force microscopy (AFM) to visualize ultrastructural changes of the keratinocyte morphology after narrow-band ultraviolet B (NB-UVB) irradiation. Immortalized human keratinocytes were cultured under standard conditions, irradiated with NB-UVB light at doses ranging from 50 to 800 mJ/cm2 and imaged by AFM mounted on an inverted optical microscope. It was observed, that NB-UVB irradiation provoked dose-dependent alterations of the keratinocyte morphology. While the surface of non-irradiated cells exhibited homogenously distributed crest-like shaped protrusions (height 0.16 +/- 0.05 microm), cells irradiated with a dose of 800 mJ/cm2 in addition showed round shaped protrusions (height 0.14 +/- 0.06 microm) distributed predominantly around the nucleus and bleb-like protrusions irregularly distributed on the cell surface (height 0.95 +/- 0.29 microm). These irradiated cells easily detached from the supporting glass surface, showed impaired contact with adjacent keratinocytes and significantly rearranged their cytoskeleton network. We hypothesize that these structural and functional alterations reflect ongoing apoptosis in UVB treated cells.

Effectiveness of narrow‐band ultraviolet‐B phototherapy for prevention of intimal hyperplasia in a rat carotid balloon injury model

Narrow-band ultraviolet-B light (NBUVB) (313 nm) is known to have anti-proliferative effects, implying a potential treatment for intimal hyperplasia, but it remains to be ascertained. We assessed the effects of NBUVB irradiation for prevention of intimal hyperplasia. The rat carotid arteries were irradiated with NBUVB after balloon injury (BI), and the degree of intimal hyperplasia was histopathologically assessed. The anti-proliferative effects using cultured human smooth muscle cells were evaluated by flow cytometry and immunoblot analysis. NBUVB (0.3-4.5 J/cm(2)) irradiation immediately after BI reduced the degree of intimal hyperplasia at 14 and 28 days after BI (P<0.001) without any obvious complications. Neither an increase in the number of medial cells nor upregulation of proliferating cell nuclear antigen was observed in the irradiated arteries. NBUVB irradiation at 2 or 14 days after BI significantly suppressed further intimal hyperplasia (P<0.01). NBUVB-irradiated cultured cells showed inhibited proliferation involved with G(1) and G(2)/M arrests. Increased expression of p53 and inhibition of retinoblastoma protein (pRB) phosphorylation were also seen in the NBUVB-irradiated cells. These data suggest that NBUVB irradiation is an effective method for preventing intimal hyperplasia. The anti-proliferative effect is partly due to the cell cycle arrest caused by p53 expression and inhibited pRB phosphorylation.