Medium dose ultraviolet A1 phototherapy and mRNA expression of interleukin 8, interferon γ, and chemokine receptor 4 in acute skin lesions in atopic dermatitis

Abstract

IntroductionMechanisms responsible for UVA1 efficacy in atopic dermatitis (AD) are not fully elucidated.AimTo investigate IL-8, CCR-4, and IFN-γ mRNA expression in AD before and after UVA1, to identify correlations among them, and to determine whether and to what degree mRNA expression is influenced by UVA1.Material and methodsTwenty-five patients with AD underwent medium dose UVA1-phototherapy at daily dosages of 10, 20, 30, 45, and then continuing 45 J/cm2 up to 20 days, from Monday to Friday for 4 weeks. Before and after UVA1, biopsies from acute skin lesions were studied using reverse-transcription and RT-PCR.ResultsThe levels of CCR-4 mRNA correlated with those of IFN-γ, both before and after UVA1 phototherapy (p < 0.05). A significant correlation was found after UVA1 between mRNA levels of IL-8 and IFN-γ (p < 0.05). After UVA1 an increase in IL-8 mRNA expression in comparison to the baseline assessment (p = 0.02) was found, while no significant difference was revealed in the expression of CCR-4 and IFN-γ mRNA. UVA1 improved both SCORAD and severity of AD (p < 0.001). SCORAD and the severity of AD did not correlate with the degree of expression of measured cytokine mRNA, neither before nor after UVA1.ConclusionsCCR-4 is expressed in parallel with IFN-γ in acute skin lesions of patients with AD both before and after UVA1 phototherapy. UVA1 significantly improves SCORAD index, lessens the severity of AD and increases the expression of IL-8, with no direct effects on other studied molecules.

Phototherapy in systemic sclerosis: Review

“…The activated monocytes also produce IL‐8 . One study showed that UVA1 irradiation reduced TNF‐α from suction blister fluid at the irradiated site compared with nonirradiated skin; however, another study demonstrated that TNF‐α increased after UVA1 irradiation in human epidermoid carcinoma cell line . TNF‐α is able to reduce type I and III collagen production by inhibiting the mRNA levels of collagens and of fibronectin, and increasing collagenase production and collagenase mRNA levels in scleroderma fibroblasts .…”

“…TNF‐α is able to reduce type I and III collagen production by inhibiting the mRNA levels of collagens and of fibronectin, and increasing collagenase production and collagenase mRNA levels in scleroderma fibroblasts . UVA1 exposure induces keratinocytes secreting IL‐8; however, another study showed that UVA1 irradiation decreases IL‐8, IL‐6, and human beta‐defensins in the lesion of localized scleroderma . UVA1 can also induce trans‐urocanic acid (UCA) isomerization to cis‐UCA, which has immunosuppressive effects …”

The Damaging Effects of Long UVA (UVA1) Rays: A Major Challenge to Preserve Skin Health and Integrity

“…UVA1 phototherapy is commonly used in the treatment of immune-mediated skin diseases [ 210 ] such as atopic dermatitis, lupus erythematosus and urticaria pigmentosa. In patients with atopic dermatitis, in which the immune response is exacerbated [ 211 ], UVA1 therapy used to manage flares was found to be accompanied by a reduction in IL-5, IL-13 and IL-31 mRNA expression, an increase in the expression of IL-8 and a decrease in the serum level of eosinophil cationic protein [ 212 ]. At the cellular level, it was linked to reductions in the number of dermal LCs, activated eosinophils and mast cells and, in a relative number of intraepidermal IgE+ LCs, was linked to an increase in the percentage of dermal CD8+ T lymphocytes [ 213 ].…”

Atopic dermatitis yardstick: Practical recommendations for an evolving therapeutic landscape

“…Short courses of UVA1 can be recommended for exacerbations; and for patients with severe, widespread AD, UVA with psoralen can be tried. 9,57,83,85 The choice of dosing protocols and frequency of treatment depends on the minimal erythema dose and/or the Fitzpatrick skin type and should be individualized according to the patient's characteristics, history, and symptoms. 57,83 The authors' experience suggests that phototherapy is not optimal for treating severe disease.…”