Can dietary furanocoumarin ingestion enhance the erythemal response during high-dose UVA1 therapy?

Beattie, P.E.; Wilkie, Murray J.V.; Smith, Gillian; Ferguson, J.; Ibbotson, S.H.

doi:10.1016/j.jaad.2006.07.003

Cited by 11 publications

(6 citation statements)

References 20 publications

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“…We found an increased erythemal response to NB-UVB in subjects with high consumptions of furocumarins-rich foods; this is in contrast with Beattie et al, who found no effect when analyzing UVA-related photosensitivity [42].…”

Section: Discussioncontrasting

confidence: 99%

Diet-Related Phototoxic Reactions in Psoriatic Patients Undergoing Phototherapy: Results from a Multicenter Prospective Study

et al. 2021

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Vegans and vegetarians often consume foods containing photosensitizers capable of triggering phytophotodermatitis. The potential effect of vegan and vegetarian diets on the response of psoriatic patients undergoing phototherapy is not well characterized. We assessed clinical outcomes of vegan, vegetarian and omnivore adult psoriatic patients undergoing band ultraviolet B phototherapy (NB-UVB). In this multicenter prospective observational study, we enrolled 119 adult, psoriatic patients, of whom 40 were omnivores, 41 were vegetarians and 38 were vegans, with phototherapy indication. After determining the minimum erythemal dose (MED), we performed NB-UVB sessions for 8 weeks. The first irradiation dosage was 70.00% of the MED, then increased by 20.00% (no erythema) or by 10.00% (presence of erythema) until a maximum single dose of 3 J/cm2 was reached and constantly maintained. All the enrolled patients completed the 8 weeks of therapy. Severe erythema was present in 16 (42.11%) vegans, 7 (17.07%) vegetarians and 4 (10.00%) omnivores (p < 0.01). MED was lowest among vegans (21.18 ± 4.85 J/m2), followed by vegetarians (28.90 ± 6.66 J/m2) and omnivores (33.63 ± 4.53 J/m2, p < 0.01). Patients with severe erythema were more likely to have a high furocumarin intake (OR 5.67, 95% CI 3.74–8.61, p < 0.01). Vegans consumed the highest amount of furocumarin-rich foods. A model examining erythema, adjusted for gender, age, skin type, MED, phototherapy type, number of phototherapies and furocumarin intake, confirmed that vegans had a lower number of treatments. Vegans had more frequent severe erythema from NB-UVB, even after adjustment of the phototherapy protocol for their lower MED. Assessing diet information and adapting the protocol for vegan patients may be prudent.

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Section: Discussioncontrasting

confidence: 99%

Diet-Related Phototoxic Reactions in Psoriatic Patients Undergoing Phototherapy: Results from a Multicenter Prospective Study

et al. 2021

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“…Two studies reported undetectable levels of furanocoumarins following furanocoumarin-containing vegetable intake in humans [1, 40], although the furanocoumarins 5-MOP and 8-MOP (1.2 and 0.6 mg/kg, respectively) administered in purified form as a treatment for certain skin disorders such as psoriasis resulted in detectable levels of the compounds in blood samples [51, 52]. In comparison to the pharmacological dose of furanocoumarins above, the consumption of a single serving of 100 g of parsnips could deliver 0.4–14.5 mg of total furanocoumarins Our observations here suggest that even if present at low levels in apiaceous vegetables, imperatorin, isopimpinellin, and trioxsalen may contribute significantly to CYP1A2 inhibition in vivo, although further investigation in humans is warranted.…”

Section: Discussionmentioning

confidence: 99%

Effects of Furanocoumarins from Apiaceous Vegetables on the Catalytic Activity of Recombinant Human Cytochrome P-450 1A2

et al. 2011

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Inhibition of cytochrome P-450 1A2 (CYP1A2)-mediated activation of procarcinogens may be an important chemopreventive mechanism. Consumption of apiaceous vegetables (rich in furanocoumarins) inhibits CYP1A2 in humans. Because many furanocoumarins are potent inhibitors of several CYP, we characterized the effects of three furanocoumarins from apiaceous vegetables on human CYP1A2 (hCYP1A2). We assessed hCYP1A2 methoxyresorufin O-demethylase (MROD) activity using microsomes from Saccharomyces cerevisiae expressing hCYP1A2. Isopimpinellin exhibited mechanism-based inactivation (MBI) of hCYP1A2 (Ki = 1.2 μM, kinact = 0.34 min−1, and partition ratio = 8). Imperatorin and trioxsalen were characterized as mixed inhibitors with Ki values of 0.007 and 0.10 μM, respectively. These results indicate that even if present at low levels in apiaceous vegetables, imperatorin, trioxsalen and isopimpinellin may contribute significantly to CYP1A2 inhibition and potentially decreased procarcinogen activation. Moreover, the in vivo effect of isopimpinellin on CYP1A2 may be longer lasting compared to reversible inhibitors.

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“…Potential photosensitizers include fluoroquinolone antibiotics and St John’s wort (hypericin) 24 . Dietary psoralens have no significant effect 25 . If a patient starts a photoactive drug during UVA1 treatment, the UVA1 MED should be rechecked.…”

Section: Acute Adverse Effects Of Uva1mentioning

confidence: 99%

“…24 Dietary psoralens have no significant effect. 25 If a patient starts a photoactive drug during UVA1 treatment, the UVA1 MED should be rechecked. The suggested MED assessment dose ranges are 7-56 J ⁄ cm 2 for skin phototype I, 7-80 J ⁄ cm 2 for phototype II, and 10-112 J ⁄ cm 2 for phototypes III and IV.…”

Section: Fibrosing Skin Diseasementioning

confidence: 99%

Ultraviolet A1 phototherapy: a British Photodermatology Group workshop report

Kerr

Ferguson

Attili

et al. 2012

Clinical and Experimental Dermatology

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SummaryWhole-body ultraviolet (UV)A1 (340-400 nm) phototherapy was first introduced 30 years ago, but is currently available in the UK in only three dermatology departments. A workshop to discuss UVA1 was held by the British Photodermatology Group in May 2009, the aim of which was to provide an overview of UVA1 phototherapy and its role in practice, and to identify areas in which further studies are required. The conclusions were that UVA1 phototherapy is an effective treatment in several inflammatory skin diseases, including localized scleroderma and atopic eczema (AE); however, deficiencies and limitations exist in the published evidence base. For most diseases, such as AE, other treatments also exist, which are generally more effective than UVA1. However, for some diseases, particularly morphoea, the evidence of efficacy is stronger for UVA1 than for other treatments. Acute adverse effects of UVA1 are minimal. The risk of long-term adverse effects, particularly skin cancer, is unknown. Medium to high doses of UVA1 are needed for efficacy in most situations, but the equipment to deliver such doses is large, expensive and difficult to install. UVA1 is currently underprovided, and the recommendation of the workshop is that more tertiary centres should have access to UVA1 phototherapy in the UK.

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Can dietary furanocoumarin ingestion enhance the erythemal response during high-dose UVA1 therapy?

Cited by 11 publications

References 20 publications

Diet-Related Phototoxic Reactions in Psoriatic Patients Undergoing Phototherapy: Results from a Multicenter Prospective Study

Diet-Related Phototoxic Reactions in Psoriatic Patients Undergoing Phototherapy: Results from a Multicenter Prospective Study

Effects of Furanocoumarins from Apiaceous Vegetables on the Catalytic Activity of Recombinant Human Cytochrome P-450 1A2

Ultraviolet A1 phototherapy: a British Photodermatology Group workshop report

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