Narrowband ultraviolet B treatment improves vitamin D balance and alters antimicrobial peptide expression in skin lesions of psoriasis and atopic dermatitis |
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| Authors: | K. Vähävihu M. Ala‐Houhala M. Peric P. Karisola H. Kautiainen T. Hasan E. Snellman H. Alenius J. Schauber T. Reunala |
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| Affiliation: | 1. Department of Dermatology, Tampere University Hospital, PO Box 2000, FIN‐33531 Tampere, Finland;2. Medical School, University of Tampere, PO Box 2000, FIN‐33531 Tampere, Finland;3. Department of Dermatology and Allergology, Ludwig‐Maximilians‐University, Munich, Germany;4. Finnish Institute of Occupational Health, Helsinki, Finland;5. Orton Rehabilitation Unit, Helsinki and Central Finland Central Hospital, Jyv?skyl?, Finland |
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| Abstract: | 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 < 0·001) serum calcidiol. The increase was 59·9 nmol L?1 (95% confidence interval, CI 53·5–66·9) in psoriasis, 68·2 nmol L?1 (95% CI 55·4–80·1) in AD and 90·7 nmol L?1 (95% CI 63·8–123·4) in healthy subjects. Psoriasis Area and Severity Index and SCORAD improved significantly (P < 0·001) but no correlation to the increase of serum calcidiol was found. Cathelicidin and human β‐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)‐1β 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. |
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| Keywords: | antimicrobial peptides atopic dermatitis calcidiol psoriasis ultraviolet B radiation vitamin D |
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