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UVB effects on genes of those with and without Psoriasis – April 2014

Narrow-band Ultraviolet B Treatment Boosts Serum 25-hydroxyvitamin D in Patients with Psoriasis on Oral Vitamin D Supplementation

ACTA Dermato-Venereologica doi: 10.2340/00015555-1685
Meri J. Ala-Houhala, Toni Karppinen, Katja Vähävihu, Hannu Kautiainen, Yvonne Dombrowski, Erna Snellman, Jürgen Schauber, Timo Reunala
Department of Dermatology, Tampere University Hospital, FIN-33521 Tampere, Finland

A course of treatment with narrow-band ultraviolet B (NB-UVB) improves psoriasis and increases serum 25-hydroxyvitamin D (25(OH)D). In this study 12 patients with psoriasis who were supplemented with oral cholecalciferol, 20 µg daily, were given a course of NB-UVB and their response measured. At baseline, serum 25(OH)D was 74.14 ± 22.9 nmol/l. At the 9th exposure to NB-UVB 25(OH)D had increased by 13.2 nmol/l (95% confidence interval (95% CI) 7.2–18.4) and at the 18th exposure by 49.4 nmol/l (95% CI 35.9–64.6) above baseline. Psoriasis Area Severity Index score improved from 8.7 ± 3.5 to 4.5 ± 2.0 (p < 0.001). At baseline, psoriasis lesions showed low vitamin D metabolizing enzyme (CYP27A1, CYP27B1) and high human β-defensin-2 mRNA expression levels compared with those of the healthy subjects. In conclusion, NB-UVB treatment significantly increases serum 25(OH)D in patients with psoriasis who are taking oral vitamin D supplementation, and the concentrations remain far from the toxicity level. Healing psoriasis lesions show similar mRNA expression of vitamin D metabolizing enzymes, but higher antimicrobial peptide levels than NB-UVB-treated skin in healthy subjects.

Fig. 2.

  • (A) CYP27A1 mRNA,
  • (B) CYP27B1 mRNA and
  • (C) cathelicidin mRNA

expression levels in skin lesions of patients with psoriasis (n = 12) and normal skin of healthy subjects (n = 13) before and at 9th (after) narrow-band ultraviolet B (NB-UVB) exposure.
Before NB-UVB course the CYP27A1 and CYP27B1 levels are significantly lower (p < 0.001), but the cathelidicin levels do not differ (p = 0.34) in the patients with psoriasis compared with the healthy subjects.
NB-UVB exposure did not change CYP27A1 mRNA, CYP27B1 mRNA or cathelidicin mRNA levels in the patients with psoriasis (A: p = 0.17; B: p = 0.070; C: p = 0.88) but the decrease is significant (A: p< 0.001; B: p = 0.002; C: p< 0.001) in the healthy subjects.

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3815 Psorasis fig 2.jpg admin 17 Apr, 2014 12:55 69.10 Kb 1276
3814 UVB psorasis.pdf PDF 2014 admin 17 Apr, 2014 12:54 455.25 Kb 833