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1.
Cutaneous Photoprotection: A Review of the Current Status and Evolving Strategies.
Suozzi, K, Turban, J, Girardi, M
The Yale journal of biology and medicine. 2020;(1):55-67
Abstract
Ultraviolet radiation (UVR) exposure is well established as the major environmental risk factor for the development of melanoma, cutaneous squamous cell carcinoma (cSCC), and basal cell carcinoma (BCC). Additional risk factors including genetic mutations, other environmental agents, and immune status are important in modulating the effects of UVR. Dermatologists advocate a multi-pronged approach to minimizing UVR exposure including lifestyle modifications, UVR protective clothing, and topically applied sun-protective products, i.e. sunscreen. New Federal Drug Administration (FDA) regulations on sunscreen have brought certain long-standing ingredients in sunscreen products under scrutiny. The FDA's proposed rule for over the counter (OTC) monograph states that the inorganic sunscreens, zinc oxide and titanium dioxide, were found to be "generally recognized as safe and effective," but cite insufficient evidence to grant organic sunscreens the same designation. This proposed rule by the FDA and our increasing understanding of multifactorial mechanisms of UVR damage are an impetus for innovation and advances in sun protective technology. A complete set of strategies designed to limit the risk of UV-induced skin cell malignant transformation and tumor development must address the fuller consideration of genetic, environmental, and immune factors that cooperatively drive cutaneous carcinogenesis. Recent advances in our understanding of the biochemical processes underpinning UVR associated cutaneous cellular damage, genotoxicity, and clonal expansion provide investigators with a spectrum of opportunities for technologic innovation in the prevention of skin cancer. Strategies to improve upon current topical sunscreen formulations have strived for broader UVR spectral coverage, more favorable aesthetics, increased adherence, and minimal penetration into the living epidermis. In addition to improved sunscreens, future topical therapies may target processes within the epidermis that contribute to carcinogenesis. These include reactive species quenching, delivery of DNA repair enzymes, and targeting of cytokines essential to the proliferation of mutant keratinocytes.
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2.
Ultraviolet A protective potential of plant extracts and phytochemicals.
Skarupova, D, Vostalova, J, Rajnochova Svobodova, A
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia. 2020;(1):1-22
Abstract
Chronic exposure to solar radiation is related to an increased incidence of various skin disorders, including premature skin aging and melanoma and non-melanoma skin cancers. Ultraviolet (UV) photons in particular are responsible for skin damage. Solar UV photons mainly belong to UVA wavebands, however UVA radiation has been mostly ignored for a long time. At the cellular level, UVA photons mainly provoke indirect oxidative damage to biomolecules via the massive generation of unstable and highly reactive compounds. Human skin has several effective mechanisms that forestall, repair and eliminate damage caused by solar radiation. Regardless, some damage persists and can accumulate with chronic exposure. Therefore, conscious protection against solar radiation (UVB+UVA) is necessary. Besides traditional types of photoprotection such as sunscreen use, new strategies are being searched for and developed. One very popular protective strategy is the application of phytochemicals as active ingredients of photoprotection preparations instead of synthetic chemicals. Phytochemicals usually possess additional biological activities besides absorbing the energy of photons, and those properties (e.g. antioxidant, anti-inflammatory) magnify the protective potential of phytochemicals and extracts. Therefore, compounds of natural origin are in the interest of researchers as well as developers. In this review, only studies on UVA protection with well-documented experimental conditions are summarized. This article includes 17 well standardized plant extracts (Camellia sinensis (L.) Kuntze, Silybum marianum L. Gaertn., Punica granatum L., Polypodium aureum L., Vaccinium myrtillus L., Lonicera caerulea L., Thymus vulgaris L., Opuntia ficus-indica (L.) Mill., Morinda citrifolia L., Aloe vera (L.) Burm.f., Oenothera paradoxa Hudziok, Galinsoga parviflora Cav., Galinsoga quadriradiata Ruiz et Pavón, Hippophae rhamnoides L., Cola acuminata Schott & Endl., Theobroma cacao L. and Amaranthus cruentus L.) and 26 phytochemicals.
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3.
[Power station sun and hormone factory skin : A current assessment of the importance of vitamin D metabolism during human evolution and strategies for UV prevention].
Saternus, R, Reichrath, J
Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete. 2020;(10):772-785
Abstract
The sun is of great importance for human health. One important reason for this is the production of vitamin D, endorphins and many other hormones by the skin due to stimulation by sunlight. Insufficient access to sunlight increases the risk for vitamin D deficiency, a pandemic which would affect more than one billion people worldwide and under which ca. 60% of the population in Germany would suffer. The skin has a unique position in vitamin D metabolism as elementary steps for vitamin D production take place here and it is furthermore a target organ for actions of vitamin D. Due to the many positive effects of the sun, a healthy balance must be found between UV protection to shield against skin cancer but also ensuring sufficient vitamin D production. For regulation of this fragile balance between photoprotection and vitamin D production, which has accompanied mankind throughout evolution, sunscreens are an integral part of the modern lifestyle, although critical reports on possible risks for their use have recently become more frequent. This article discusses the current state of knowledge on the importance of vitamin D metabolism in human skin and the use of sun creams.
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4.
Ultraviolet Exposure Scenarios: Balancing Risks of Erythema and Benefits of Cutaneous Vitamin D Synthesis.
Webb, AR, Engelsen, O
Advances in experimental medicine and biology. 2020;:387-405
Abstract
Exposure to sunlight is a major source of vitamin D for most people. Yet public health advice has focused overwhelmingly on avoiding exposure of unprotected skin because of the risks of erythema and skin cancer. Given that there are also health risks associated with low vitamin D status, we explore the possibilities of achieving a range of targets associated with vitamin D and the accompanying erythema risk. We have calculated the exposure required to gain a number of proposed oral-equivalent doses of vitamin D, as functions of latitude, season, skin type and skin area exposed, together with the associated risk of erythema, expressed in minimum erythema doses. The model results show that a recommended daily intake of 400 IU is readily achievable through casual sun exposure in the midday lunch hour, with no risk of erythema, for all latitudes some of the year, and for all the year at some (low) latitudes. We also show that such daily, sub-erythemal doses at lunchtime during the summer months is sufficient to avoid winter-time vitamin D deficiency for the UK all-weather climate, provided that lower arms and legs are exposed in the warmer months. At the higher proposed vitamin D dose of 1000 IU, lunchtime sun exposure is still a viable route to the vitamin but requires the commitment to expose greater areas of skin and is effective for a shorter period of the year. The highest vitamin D requirement considered was 4000 IU per day. For much of the globe and much of the year, this is not achievable in a lunchtime hour and where it is possible large areas of skin must be exposed to prevent erythema. When the only variable considered was skin type, latitudinal and seasonal limits on adequate vitamin D production were more restrictive for skin type 5 than skin type 2.
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5.
Potential of Skin Microbiome, Pro- and/or Pre-Biotics to Affect Local Cutaneous Responses to UV Exposure.
Patra, V, Gallais Sérézal, I, Wolf, P
Nutrients. 2020;(6)
Abstract
The human skin hosts innumerable microorganisms and maintains homeostasis with the local immune system despite the challenges offered by environmental factors such as ultraviolet radiation (UVR). UVR causes cutaneous alterations such as acute (i.e., sunburn) and chronic inflammation, tanning, photoaging, skin cancer, and immune modulation. Phototherapy on the other hand is widely used to treat inflammatory skin diseases such as psoriasis, atopic dermatitis, polymorphic light eruption and graft-versus-host disease (GvHD), as well as neoplastic skin diseases such as cutaneous T cell lymphoma, among others. Previous work has addressed the use of pro- and pre-biotics to protect against UVR through anti-oxidative, anti-inflammatory, anti-aging, anti-carcinogenic and/or pro-and contra-melanogenic properties. Herein, we discuss and share perspectives of the potential benefits of novel treatment strategies using microbes and pro- and pre-biotics as modulators of the skin response to UVR, and how they could act both for protection against UVR-induced skin damage and as enhancers of the UVR-driven therapeutic effects on the skin.
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6.
Protective effects of 1,25 dihydroxyvitamin D3 and its analogs on ultraviolet radiation-induced oxidative stress: a review.
Jagoda, SV, Dixon, KM
Redox report : communications in free radical research. 2020;(1):11-16
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Abstract
The active vitamin D compound, 1,25-dihydroxyvitamin D3 (1,25D) is produced in skin cells following exposure to ultraviolet radiation (UV) from the sun. However, there are many harmful effects of UV which include DNA damage caused by direct absorption of UV, as well as that caused indirectly via UV-induced reactive oxygen species (ROS). Interestingly, 1,25D and analogs have been shown to reduce both direct and indirect UV-induced DNA damage in skin cells. This was accompanied by reductions in ROS and in nitric oxide products with 1,25D following UV. Moreover, following acute UV exposure, 1,25D has been demonstrated to increase p53 levels in skin, which would presumably allow for repair of cells with damaged DNA, or apoptosis of cells with irreparably damaged DNA. Previous studies have also shown that p53 reduces intracellular ROS. Furthermore, 1,25D has been shown to induce metallothioneins, which are potent free radical scavengers. In addition to these protective effects, 1,25D has been demonstrated to inhibit stress-activated c-Jun N-terminal kinases following UV exposure, and to increase levels of the stress-induced protein heme oxygenase-1 in a model of oxidative stress. Herein, we discuss the protective effects of 1,25D and analogs in the context of UV, oxidative stress and skin cancer.
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7.
The potential role of antioxidants in mitigating skin hyperpigmentation resulting from ultraviolet and visible light-induced oxidative stress.
Nahhas, AF, Abdel-Malek, ZA, Kohli, I, Braunberger, TL, Lim, HW, Hamzavi, IH
Photodermatology, photoimmunology & photomedicine. 2019;(6):420-428
Abstract
Oxidative stress is an integral element that influences a variety of biochemical reactions throughout the body and is known to play a notable role in melanogenesis. Exogenous triggers of oxidative stress, such as ultraviolet radiation (UVR) and visible light (VL), lead to pigment formation through somewhat different pathways, but both share a common endpoint-the potential to generate cosmetically undesirable hyperpigmentation. Though organic and inorganic sunscreens are available to protect against the UVR portion of the electromagnetic spectrum, coverage is lacking to protect against the VL spectrum. In this manuscript, we review the phases of tanning, pathways of melanogenesis triggered by UVR and VL, and the associated impact of oxidative stress. We also discuss the known intrinsic mechanisms and paracrine regulation of melanocytes that influence their response to UVR. Understanding these mechanisms and their role in UVR-induced hyperpigmentation should potentially lead to identification of useful targets that can be coupled with antioxidant therapy to alleviate this effect.
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8.
Overview on vitamin D and sunbed use.
Pierret, L, Suppa, M, Gandini, S, Del Marmol, V, Gutermuth, J
Journal of the European Academy of Dermatology and Venereology : JEADV. 2019;:28-33
Abstract
Vitamin D seems to be associated with a protective effect in a vast range of diseases, including cardiovascular, autoimmune and oncologic conditions. Since ultraviolet (UV) B light is the most important prerequisite for the cutaneous synthesis of vitamin D, sunbeds are able to increase serum vitamin D levels, although only transiently in most cases. In this scenario, the artificial tanning industry relentlessly tries to promote the use of sunbeds as a 'safe' therapeutic measure to achieve an adequate serum vitamin D status. The World Health Organization classified UV-emitting tanning devices, as well as the whole UV spectrum, as group-1 carcinogens, as they significantly increase the risk of melanoma and non-melanoma skin cancer. In case of vitamin D deficiency or insufficiency, the current risk-benefit ratio is therefore in favour of vitamin D supplementation instead of sunbed use. Artificial tanning devices should never be considered as an option to achieve an appropriate vitamin D status. Their supposedly beneficial effects, vastly publicised by the artificial tanning industry, are not worth the carcinogenic risk associated with sunbed use.
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9.
A Review of the Evidence Supporting the Vitamin D-Cancer Prevention Hypothesis in 2017.
Grant, WB
Anticancer research. 2018;(2):1121-1136
Abstract
The vitamin D-cancer prevention hypothesis has been evaluated through several types of studies, including geographical ecological studies related to indices of solar ultraviolet-B (UVB) dose (the primary source of vitamin D for most people), observational studies related to UVB exposure or serum 25-hydroxyvitamin D [25(OH)D] concentrations, laboratory studies of mechanisms, and clinical trials. Each approach has strengths and limitations. Ecological studies indirectly measure vitamin D production and incorporate the assumption that vitamin D mediates the effect of UVB exposure. Findings from observational studies with long follow-up times are affected by changing 25(OH)D concentrations over time. Most clinical trials have been poorly designed and conducted, based largely on guidelines for pharmaceutical drugs rather than on nutrients. However, three clinical trials do support the hypothesis. In general, the totality of the evidence, as evaluated using Hill's criteria for causality in a biological system, supports the vitamin D-cancer prevention hypothesis.
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10.
A Critical Appraisal of the Recent Reports on Sunbeds from the European Commission's Scientific Committee on Health, Environmental and Emerging Risks and from the World Health Organization.
Reichrath, J, Lindqvist, PG, DE Gruijl, FR, Pilz, S, Kimball, SM, Grant, WB, Holick, MF
Anticancer research. 2018;(2):1111-1120
Abstract
The European Commission's Scientific Committee on Health, Environmental and Emerging Risks and the World Health Organization recently published reports which concluded that a large proportion of melanoma and non-melanoma skin cancer is attributable to sunbed use, and that there is no need to use sunbeds as there are no health benefits and they are not needed to achieve an optimal vitamin D level. The overall conclusion from both bodies was that there is no safe limit for UV irradiance from sunbeds. We are, however, deeply concerned that these assessments appear to be based on an incomplete, unbalanced and non-critical evaluation of the literature. Therefore, we rebut these conclusions by addressing the incomplete analysis of the adverse health effects of UV and sunbed exposure (what is 'safe'?) and the censored representation of beneficial effects, not only but especially from vitamin D production. The stance taken by both agencies is not sufficiently supported by the data and in particular, current scientific knowledge does not support the conclusion sunbed use increases melanoma risk.