Photoadaptation to ultraviolet (UV) radiation in vivo: photoproducts in epidermal cells following UVB therapy for psoriasis

Abstract

Background Ultraviolet (UV) radiation is mutagenic and induces specific DNA lesions in human skin that are often found at dipyrimidine sites. These photoproducts are likely to be biologically relevant regarding skin carcinogenesis, as p53 mutations in skin tumours are most often found at these UV radiation-specific sites within DNA. Psoriasis patients receiving long-term phototherapy are at an increased risk of non-melanoma skin cancers.Objectives The aim of this study was to quantify DNA photoproducts in human epidermis in vivo following consecutive doses of UVB and to investigate variations in DNA damage according to skin type, UVB dose and age. Methods Eleven psoriasis patients receiving UVB phototherapy three times a week were recruited and underwent skin biopsies on a non-sun-exposed site before starting phototherapy and after three, nine and 18 UVB exposures. A biopsy was also taken at least 4 weeks after stopping phototherapy. DNA was extracted from separated epidermis and three types of photoproducts were quantified using a novel 32 P high-performance liquid chromatographic technique. Results The mean level of cyclobutane dipyrimidine dimers (CPDs) after three doses of UVB (dose range 0´03±0´15 J cm 22 ) was 3´2 (range 0´8±8´9) photoproducts per 10 6 normal nucleotides for TTT dimers and 4´5 (range 0±14) per 10 6 normal nucleotides for TTC dimers. The mean levels of TT±C 6±4 photoproducts after three doses of UVB were very low (0´2, range 0±1´8). Overall, the levels of TTT and TTC reached a plateau at three exposures and were found to decrease for subsequent exposures despite increasing UVB doses. Skin type was negatively associated with mean levels of CPDs. However, significant differences in levels of photoproducts were seen between individuals, even after adjusting for skin type. No association was found between challenge dose of UVB and photoproduct yield in this study. Conclusions This study showed a great individual variation in the accumulation of DNA photoproducts following exposure to repetitive doses of UVB. Photoadaptive responses of human skin involving DNA repair, tanning and epidermal thickening are likely to explain the overall lack of increase in DNA lesions throughout phototherapy. This in vivo study confirms that psoriasis patients produce a significant amount of DNA photolesions at suberythemal doses of UVB. Further work is needed to investigate which host factors are most likely to predict susceptibility to UV radiationinduced DNA damage.

Phototherapy and Photochemotherapy for Psoriasis

“…65 The amount of CPD increased in the psoriatic skin during the first three treatment sessions, but not hereafter, whereas clinical improvement is usually only noted after several weeks of treatment. 66 …”

The Effect of Chronic Ultraviolet Radiation on the Human Immune System†

“…Bataille et al. (14) assessed the level of photoproducts in the skin of patients with psoriasis following UVB phototherapy, administered three times weekly for at least 6 weeks. The photoproducts reached a maximum after three exposures and decreased thereafter, despite the dose increasing by between 20% and 30% on each occasion.…”

The Influence of UV Exposure on 5-Aminolevulinic Acid-induced Protoporphyrin IX Production in Skin¶

“…Tanning and thickening of skin epidermis are supposed to be photoadaptive responses to UV radiation (7-9). On the contrary, patients with psoriatic skin that has no epidermal layer get a significant amount of DNA photolesions even at suberythemal doses of UV (8). Surprisingly, ALA-PDT was found to delay the development of UV-induced skin tumors in mice (10).…”