Characteristics of corneal stromal demarcation line after different cross-linking methods in keratoconus and its influence on the cross-linking effect / 中华实验眼科杂志

Objective:To compare the characteristics of corneal stromal demarcation line after different surgical methods of riboflavin/ultraviolet A corneal collagen cross-linking (CXL) in early keratoconus, and analyze the influence of the demarcation line on the cross-linking effect.Methods:A non-randomized controlled clinical study was conducted.Sixty-nine eyes of 69 patients treated with riboflavin/ultraviolet A CXL in the Eye Hospital of Shandong First Medical University from May 2019 to February 2021 were included.According to the cross-linking methods, the patients were divided into epithelium-on treatment group (21 eyes) and epithelium-off treatment group (48 eyes). There were 25 eyes in 5.4 J energy group and 44 eyes in 7.2 J energy group.The morphology and changes of corneal stromal cross-linking reaction (corneal stromal demarcation line) were observed at 2 weeks, 1, 3 and 4 months after operation.Changes in the thinnest corneal thickness (TCT), uncorrected visual acuity (UCVA, LogMAR), best corrected visual acuity (BCVA, LogMAR) and corneal maximum curvature (Kmax) were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Eye Hospital of Shandong First Medical University (No.2019.05). Written informed consent was obtained from each subject.Results:Of the 69 eyes after operation, 44 eyes (63.77%) had demarcation lines, and 25 eyes (36.23%) had no demarcation lines.The occurrence rate of demarcation lines in the epithelium-on treatment group was 79.17%(38/48), which was significantly higher than 28.57%(6/21) in the epithelium-off treatment group ( χ2=16.186, P<0.01). The occurrence rate of demarcation line in 5.4 J energy group was 72.00%(18/25), and the 7.2 J energy group was 56.80%(25/44), with no significant difference ( χ2=1.565, P=0.302). Slit lamp microscopy and anterior segment-optical coherence tomography showed that the demarcation line appeared at 1-2 weeks after operation, gradually converged and strengthened after 1 month, turned diffuse, blurred and faded by degrees after 2-3 months, and basically disappeared after 4 months.The depth of the demarcation line reached 141-423 μm, with an average depth of (263.44±84.22)μm.Scanning laser confocal microscopy showed that corneal stromal cells were activated and light reflection was enhanced after CXL.Collagen fibers extended vertically and horizontally, crisscrossed, and were in a reticular arrangement.The TCT decreased from preoperative (458.69±38.28)μm to (443.86±36.54)μm at 4 months after operation, showing a statistically significant difference ( t=6.705, P<0.001). There was no significant difference in the TCT reduction between groups with and without demarcation lines ( t=1.684, P=0.100). At 4 months postoperatively, the UCVA of all eyes increased from preoperative 0.74±0.37 to 0.69±0.38, and the difference was statistically significant ( t=2.109, P=0.039). There was no significant difference in BCVA between before and after operation ( t=1.006, P=0.319). There was no significant difference in change of UCVA and BCVA between groups with and without demarcation lines ( t=0.065, P=0.949; t=0.346, P=0.730). There was no significant difference in Kmax in all patients between before and after operation ( t=0.050, P=0.950). There was no significant difference in the Kmax change between groups with and without demarcation lines ( t=-0.739, P=0.464). The change in TCT in the epithelium-off treatment group was significantly greater than that in the epithelium-on treatment group ( t=2.815, P=0.008). There was no significant difference in UCVA, BCVA and Kmax changes between epithelium-on and epithelium-off treatment groups (all at P>0.05). There was no obvious corneal scarring, infectious keratitis, corneal endothelial decompensation or other complications. Conclusions:The demarcation line after CXL may be a sign of the depth of cross-linking reaction, which is more prone to occur after the epithelium-off operation method.Both the epithelium-on and epithelium-off operation methods have similar therapeutic effects.Demarcation line after different cross-linking methods has no significant influence on the cross-linking effect in keratoconus.

A 5-years Retrospective Study on Narrowband Ultraviolet B (NBUVB) Phototherapy Utilisation Experience in A Tertiary Hospital in East Malaysia

Background@#Phototherapy had been a less favourable treatment in recent years. Our study aims to audit the usage of NB-UVB phototherapy service in a tertiary hospital in East Malaysia.@*Methods@#This is a retrospective study. Phototherapy file of patients who underwent NB-UVB phototherapy between year 2016 and 8 March 2021 were reviewed. Demographic data, treatment history, and acute side effects were analysed.@*Results@#Forty eight subjects were recruited in this study. The majority (33.3%) of the subjects were in 20-29 age group. There was an equal number of male and female subjects. About 66.7% of the subjects had psoriasis and 18.8% of them had vitiligo. Nearly 36.6% of the subjects had 26-50% body surface area involved at initial phototherapy. Almost 54.2% of the subjects had <50 sessions of NB-UVB phototherapy. About 52.1% of the subjects had a cumulative dose of NB-UVB <25 J/cm2 while 26.7% of subjects had a cumulative dose >200 J/cm2. Acute side effects including burning (17.8%), pruritus (4.4%) and flare of psoriasis (2.2%).@*Discussion@#Low utilization rate of NB-UVB phototherapy was likely due to logistical and transportation factors. Psoriasis was the commonest indication for NB-UVB in our study followed by vitiligo. Annual skin malignancy surveillance should be done especially on patients received NB-UVB >350 sessions even after the discontinuation of treatment. Most patients tolerate NB-UVB phototherapy well with no major side effects.@*Conclusion@#In conclusion, NB-UVB phototherapy is a relatively safe yet underutilised treatment in our centre.

The effect of parasitic ions on riboflavin permeability and cross-linking effectiveness in iontophoresis-assisted scleral cross-linking / 生物医学工程学杂志

The effect of parasitic ions on the results of ultraviolet A (UVA) cross-linking in iontophoresis was still not clear. In this work, the porcine sclera was cross-linked by riboflavin lactate Ringer's solution (group A) and riboflavin normal saline (group B)

Comparative Study of Safety and Efficacy of Narrow Band Ultraviolet B (NBUVB) and Psoralen Ultraviolet A (PUVA) Therapy in Psoriasis Vulgaris

Introduction: Psoriasis is a group of chronic, inflammatoryand proliferative condition of skin, associated withsystemic manifestations in many organ systems. The mostcharacteristic lesions consist of erythematous, scaly, sharplydemarcated indurated plaques, present particularly over theextensor surfaces and scalp). Phototherapy is one of the mostefficacious treatment options for psoriasis. New, emergingstudies are beginning to define the biological mechanismsby which phototherapy improves psoriasis- with NBUVBand psoralen ultraviolet A (PUVA) as the most widely usedapplications.Material and methods: This prospective study was carriedout on 76 patients attending OPD of Rohilkhand medicalcollege and hospital in one year from November 2017 toOctober 2018. The patients were randomly divided intotwo groups;Systemic PUVA (Trimethylpsoralen+UVA) andNBUVB groups and therapy will be administered thrice perweek on non-consecutive days.Results: The initial mean PASI score was 17.43 and 17.01in group A and group B patients respectively, while posttreatment PASI score was 3.08 and 2.01 in respective groups.The average cumulative dose for 80% clearance with PUVAwas found to be 60.51 J/cm2 while with NBUVB it wasfound to be 6.76 J/cm2. Side effects were observed in 28.94%patients in group A while 5.2% patientsin group B. Amongstgroup A 18.42%, 7.8% and 2.6% patients presented witherythema, burning and vesiculations respectively while undergroup B 2.6% patients in each group presented with erythemaand burning.Conclusion: Both PUVA and NBUVB are effective for thetreatment of psoriasis vulgaris. However, NBUVB has adistinct edge over PUVA in terms of efficacy and lesser sideeffects. The advantages of NBUVB therapy over PUVAtherapy includes lack of psoralen-related side effects and lessmean cumulative dose for clearance and so, good adherence.

Severe focal stromal degeneration up to Descemet membrane after corneal collagen cross-linking

Corneal collagen cross-linking (CXL) is an effective treatment for arresting progression in keratoconus cases. It is considered safe despite a few complications that have been recorded earlier. In this case series, we report a rare and late complication caused due to severe stromal thinning up to Descemet's membrane in three patients who underwent CXL 3 to 6 years back for keratoconus. Deep anterior lamellar keratoplasty (DALK) was then done for the affected eye with good outcomes. This case series highlights the possible late effects of UVA irradiation post CXL.

To determine irradiance of ultraviolet A in ambient sunlight and optimum exposure time for PUVAsol in a North Indian location

Background: Psoralen with ultraviolet A is an effective photochemotherapeutic modality. A subtype of this, PUVAsol, uses sunlight as the natural source of ultraviolet A. The amount of sunlight received and the consequent ultraviolet A exposure vary according to the month in the year, time of the day and geographical location of a place. Aim: The aim of this study is to determine irradiance of ultraviolet A in ambient sunlight and optimum exposure time for PUVAsol. Materials and Methods: This was an observational study carried out at Postgraduate Institute of Medical Education and Research, Chandigarh (30.7333°N, 76.7794°E), India using a photometer. Ultraviolet A irradiance was recorded at a fixed place at 10 AM, once weekly for a period of 12 months. Results: The irradiance of peak ultraviolet A was found to be 3.1 mW/cm2 in June 2016 while irradiance of 0.64 mW/cm2 was recorded in January 2017. The exposure time needed for therapeutic dose of 2 J/cm2 was 11 min 6 s in June 2016 while exposure time for achieving therapeutic dose of 2 J/cm2 was 52 min 5 s in January 2017. The duration of exposure was found to be significantly longer in the winter months. Limitation: The limitation of the study is not determining ultraviolet B radiation and infrared exposure. Other limitation of this study is that the irradiance was measured only at 10 am. This data cannot be used to determine irradiance at different time points in the day as the patient may expose himself/herself to sunlight anytime depending on his/her convenience. Conclusions: The study demonstrates the mean exposure time required for a given therapeutic dose of ultraviolet A in different months. The wide variation in ultraviolet A irradiance in natural sunlight over the year in different months also suggests that exposure times for PUVAsol should be based on the season and geographical location at the site of therapy and not based on uniform guidelines.

A non-inferiority randomized controlled clinical trial comparing Unani formulation & psoralen plus ultraviolet A sol in chronic plaque psoriasis

Background & objectives: Though Unani medications have been used for centuries to treat psoriasis, there is paucity of published studies which have systematically evaluated their efficacy and safety. This study was conducted to establish non-inferiority of Unani medications (oral UNIM-401 and topical UNIM-403) vs psoralen plus ultraviolet A (PUVA) sol in treatment of moderate-severe chronic plaque psoriasis (CPP) in achieving psoriasis area severity index (PASI) 75 at 12 wk and to estimate proportion of patients who relapsed in follow up period of 12 weeks, after having achieved PASI 50. Methods: In this randomized, controlled trial patients with CPP were block randomized to receive either Unani treatment (147 patients) or PUVA sol (140 patients) for 12 weeks. Percentage reduction in PASI was determined in each patient at 12 wk to calculate number of patients who achieved PASI 75 as also to estimate median of percentage reduction in PASI in each group. All patients who achieved PASI 50 at 12 weeks were followed up for another 12 wk to determine proportion of patients who relapsed. Results: Of the 287 patients randomized, 84 of 147 in Unani group and 67 of 140 in PUVA sol group completed 12 weeks of treatment. On intention-to-treat (ITT) analysis, the response in patients on Unani medication was not inferior to those receiving PUVA sol, in attaining PASI 75 (16.3% in Unani group vs 15.7% in the PUVA sol group). Median of percentage reduction of PASI at 12 wk from baseline in Unani group (68.2%; ?60, 100) and PUVA sol group (63%; ?15.7, 100) was comparable. Proportion of patients who relapsed at 24 wk was comparable in both groups. However, frequency of clinical side effects was significantly higher (P =0.001) in PUVA sol group (16.4%) compared to Unani group (2%). Interpretation & conclusions: The findings of the present study indicated that oral UNIM-401 and topical UNIM-403 were effective and well tolerated therapeutic options in patients with moderate-severe CPP.

Folliculotropic Mycosis Fungoides in 20 Korean Cases: Clinical and Histopathologic Features and Response to Ultraviolet A-1 and/or Photodynamic Therapy

BACKGROUND: Folliculotropic mycosis fungoides (FMF) is a variant of mycosis fungoides (MF) that is characterized clinically by variable types of skin eruptions, including plaques, acneiform lesions, and alopecic patches. Histopathologically, FMF is characterized by folliculotropic infiltrates. OBJECTIVE: This study was conducted to scrutinize the clinical and histopathologic features of FMF in Koreans and the responses to phototherapy. METHODS: Twenty Koreans diagnosed with MF who had histopathologic evidence of folliculotropism were enrolled. RESULTS: Eighteen patients had head-and-neck-region infiltration, while five had solitary lesion. In all patients, the atypical lymphocytic infiltrate had a perifollicular distribution. Twelve patients were treated with ultraviolet A (UVA)-1. Eleven of these 12 patients with early-stage FMF experienced >80% improvement (8: complete remission; 3: partial remission). Four patients, including 2 who relapsed after UVA-1, were treated with photodynamic therapy (PDT), reaching complete remission after PDT. CONCLUSION: As FMF has variable clinical presentations, skin biopsy is required to confirm the diagnosis. And both UVA-1 and methyl aminolevulinate-PDT are clinically effective in treatment of early-stage FMF.

Curcumin influence the expression of matrix metalloproteinases in pterygium epithelial via inhibiting NF-κB signaling pathway / 医学研究生学报

Objective Ultraviolet radiation can induce the expression of matrix metalloproteinases (MMPs) in pterygium epithelial cells. To investigate the effects of curcumin on the expression of MMP 2 and MMP 9 in human pterygium fibroblasts (HPFs) on UVA-irradiation and its possible mechanism.Methods After optimizing the dose of UVA irradiation and the concentration of curcumin, HPFs in the second generation were divided into control group (no exposure to UVA, no medication), UVA group (exposure to UVA), and UVA + curcumin group (exposure to UVA + curcumin). MMP-2 and MMP-9 levels were tested by zymography. The mRNA expression of MMP-2 and MMP-9 was detected by RT-PCR. The NF-κB-DNA binding activity was detected by electrophoretic mobility shift assay (EMSA).Results Compared with the control group, the secretion of MMP-2 and MMP-9 in the UVA group was increased significantly (P<0.05), which could be suppressed by curcumin (P<0.05). The MMP-9 mRNA levels were also significantly increased in UVA group \[(100±0)% vs (247.0±10.8)%, P<0.05\], and could be inhibited by curcumin \[(88.7±5.1)% vs (247.0±10.8)%, P<0.05\]. The NF-κB-DNA binding was remarkably increased in UVA group (P<0.05), and significantly decreased after treatment with curcumin (P<0.05).Conclusion Curcumin can inhibit the expression of MMP-2 and MMP-9 in UVA-irradiated HPFs, and the mechanism involved in this protective effect might be its inhibitory effect on NF-κB activation.

Pulsed and continuous accelerated scleral cross-linking using riboflavin and ultraviolet A irradiation for the prevention of myopia progression in a guinea pig model / 中华实验眼科杂志

Objective To evaluated the effect of oral administration of riboflavin combined with pulsed and continuous light accelerated scleral cross-linking on the histological and biomechanical properties of sclera in a guinea pig model to control the progression of myopia.Methods Thirty 4-week-old guinea pigs were divided into 5 groups,or the control group,non cross-linking group,conventional cross-linking group,pulse light cross-linking group and continuous light cross-linking group with 6 guinea pigs in each group.Three cross-linking groups were administered 0.1％ riboflavin solution with vitamin C by gavage from 3 days before modeling to modeling process.The conventional cross-linking group underwent cross-linking with 1 hour of (ultraviolet A (UVA) exposure at 0.67 mW/cm2,the pulse light cross-linking group received a pulsed-light accelerated crosslinking for 8 minuctes (1 second on/1 second off) of UVA exposure at 10 mW/cm2,and the continuous light accelerated cross-linking group was crosslinked with continuous-light accelerated crosslinking at 10 mW/cm2 for 4 minuctes.The same procedure was conducted on the non cross-linking group without UVA irradiation and 0.1％ riboflavin solution before modeling and modeling process.No any intervene was carried out in the control group.Retinoscopy and the axial length measurement were performed before and after experiment.The animals were euthanized 2 weeks after experiment and then biomechanical and histopathological examinations of scleras were conducted.The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results Myopia models were established with an increased axial length and myopic diopter 2 weeks after myopic modeling process.Axial length in the non cross-linking group was longer than that of the control group at 2 weeks,with a siginificant difference between them (P＜0.01).The myopic Diopter in the non cross-linking groupwas significantly increased in comprasion with the control group at 2 weeks (P＜0.01).Compared with myopic eyes in the non cross-linking groups,axial length,diopter and strain assessment values were decreased significantly in three scleral cross-linking groups (all at P＜0.01).The sclera ultimate load and stress assessment in the conventinal cross-lingking group,pulse light cross-linking group,continuous light cross-linking group were significantly higher than those in the non-cross-linking group Max stress:[2.20±0.03],[2.67±0.05],[2.41±0.04] Mpa vs.[1.30±0.02] Mpa;Max load:[1.92±0.03],[2.33 ±0.28],[1.91 ±0.03] P vs.[1.54±0.06] P) (all at P＜0.01).Collagenous tissue of the scleras in the pulse light cross-linking group and continious ligh cross-linking group was similar in appearance to the control group.In addition,MMP2 expression of pulse light cross-linking group and continuous light cross-linking group was significantly increased,and TIMP-2 expression showed a reduce.Conclusions Pulsed and continuous light accelerated scleral cross-linking using oral administration of riboflavin and riboflavin UVA irradiation can effectively prevent the myopia development by increasing scleral biomechanical strength in guinea pig.

Enhancement of scleral biomechanics and safety following minimally invasive riboflavin-ultraviolet A collagen crosslinking in rabbits / 中华实验眼科杂志

Objective To evaluate the enhancing effects of scleral biomechanics and safety of collagen crosslinking by using minimally invasive riboflavin and ultraviolet A.Methods Fifty-six healthy New Zealand white rabbits were randomized into non-cosslinking group,post-crosslinking 1-day group,post-crosslinking 7-day group,postcrosslinking 15-day group,post-crosslinking 1-month group,post-crosslinking 2-month group and post-crosslinking 3-month group,eight for each group.Riboflavin solution at the concentration of 0.1％ was dropped once per 2 minutes for 20 minutes,and then minimally invasive riboflavin and ultraviolet A was carried out in the right eyes by putting the lighting emitting diode (LED) probe end of microinvasive ultraviolet scleral crosslinking device to irradiate the posterior sclera for 30 minutes with the wavelength of 370 nm and radiation energy of 3 mW/cm2,and the left eyes served as the normal controls.The scleral temperature was measured using clinical thermometer during the crosslinking period.The rabbits were sacrificed according to the grouping and the eyeballs were obtained.The scleral thickness was measured by callipers,the pretension and tensile failure tests of sclera strips were tested by micromaterial mechanics performance test system to measure the extreme stress,extreme strain and 8％ elastic modulus.Hematoxylin-eosin staining was employed to examine the morphology of eye tissues.Retinal cell apoptosis was detected by TUNEL assay.Results The scleral thickness was insignificantly different among the non-crosslinking group,post-crosslinking 1-day group,post-crosslinking 7-day group,post-crosslinking 15-day group,post-crosslinking 1-month group,post-crosslinking 2-month group and post-crosslinking 3-month group and between right eyes and left controls (F,es =0.02,P＞0.05;Fgroup =1.71,P＞0.05).Compared with the non-crossliking group,the extreme stress and 8％ elastic modulus of the scleras were significantly increased,and the extreme strain of the scleras was significantly decreased in post-crosslinking 1-day group,post-crosslinking 7-day group,post-crosslinking 15-day group,post-crosslinking 1-month group,postcrosslinking 2-month group and post-crosslinking 3-month group (all at P＜0.05).Not any morphological abnormalities were found in corneas,scleras,irises,ciliary bodies and choroids in various groups.The apoptosis rates of retinal cells were (11.00±0.33)％,(12.33±1.58)％,(12.02±0.45)％,(11.81±0.85)％,(12.15± 0.61)％,(12.14±0.25)％and (11.74±0.63) ％ in the non-crosslinking group,post-crosslinking 1-day group,post-crosslinking 7-day group,postcrosslinking 15-day group,post-crosslinking 1-month group,post-crosslinking 2-month group and post-crosslinking 3-month group,respectively,with no significant difference among the three groups (F =1.78,P =0.14).Conclusions Rabbit sclera collagen crosslinking by using the minimally invasive riboflavin and ultraviolet A can effectively enhance the biomechanical strength of the sclera,and this procedure is safe.

Research on sunscreen lipstick to protect UVA and UVB / 药学实践杂志

Objective To prepare the sunscreen lipstick in order to prevent UVA and UVB.Methods The ratio of bees-wax,castor oil and liquid paraffin were optimized with the orthogonal test based on viscosity and heat resistance.The spread-able ability,stability and the anti-ultraviolet effect of the optimized lipstick were investigated.Results The best ratio of bees-wax,castor oil and liquid paraffin was 8:5:4(w/w/w).The viscosity of the sunscreen lipstick was appropriate,easy to spread and stable,which was demonstrated the good prevention effect from UVA and UVB.Conclusion The advantages of the prepared sunscreen lipstick included simple preparation,low cost and stable quality.It could be a new type of sunscreen lipstick protecting from UVA and UVB.

Ultraviolet A1 phototherapy: One center’s experience.

Background: Ultraviolet A1(UVA1) phototherapy is increasingly being used in the treatment of morphea, atopic dermatitis, lupus and some other recalcitrant dermatoses. We present a retrospective review of our experience with this modality. Aim: To evaluate the treatment response rates for various dermatoses and adverse effects of UVA1 phototherapy. Methods: We reviewed phototherapy notes along with electronic and/or paper case records for all patients treated with UVA1 phototherapy from October 1996 to December 2008. Results: A total of 269 patients (outcomes available for 247) had 361 treatment courses (treatment data available for 317 courses) over this period. We found phototherapy to be benefi cial in 28 (53%) of 53 patients with atopic dermatitis and 19 (51%) of 37 patients with morphea. A benefi cial outcome was recorded in all six (100%) cases of urticaria and six (85.7%) of seven patients treated for a polymorphic light eruption. Benefi t was also recorded in systemic lupus erythematosus (8 (44.4%) of 18), lichen sclerosus (6 (42.9%) of 14), mastocytosis (2 (33.3%) of 6), necrobiosis lipoidica (4 (30.8%) of 13), granuloma annulare (2 (25%) of 8), scleroderma (2 (22.2%) of 9) and keloids (1 (7.7%) of 13). Overall, treatment was well tolerated with no patients having to stop treatment due to adverse effects. Limitations: This is a retrospective study with no control group. Subjective/recall bias is quite possible as a number of patients were followed up over the phone. Conclusions: Our data suggest that ultraviolet A1 can be considered for the treatment of selected dermatoses. However, long-term malignancy risk is as yet unknown.

Current advance in treatment of fungal keratitis by corneal collagen cross-linking / 国际眼科杂志(Guoji Yanke Zazhi)

Corneal collagen cross-linking (CXL) is a photochemotherapy for keratoconus, keratectasias and infectious keratitis.Corneal collagen fiber infiltrated with riboflavin, a photosensitizer which generates reactive oxygen species when activated by UVA at 370nm, was induced to form the crosslinks in corneal stroma.Corneal collagen cross-linking alone or combined with medicine therapy could be used to treat fungal keratitis, improve the cure rates, and reduce the complications and the demands of corneal transplantation surgery.The purpose of this paper is to review the basic principle, procedure, laboratory researches, clinical applications and the safety about this treatment.

Effects of curcumin on NF-κB expression and UVA-induced corneal injury in mice / 眼科新进展

Objective To investigate the protective effect of curcumin (Cur) on mice cornea against ultraviolet A (UVA)-induced damage.Methods Together 30 C57BL/6 mice were randomly divided into 3 groups (10 mice in each group):UVA irradiation group (UVA group),UVA irradiation with curcumin treatment group (UVA + Cur group) and control group.Mice in the UVA group was exposed to UVA for 24 h,with the wavelength of 320-400 nm and the irradiation intensity of 0.05 W · cm-2.In UVA + Cur group,mice were given 30 mg · kg-1 curcumin intraperitoneally 3 days before irradiation and lasted until 48 h after irradiation.And the control group was left untreated.Then corneal opacity was evaluated and scored through slit-lamp biomicroscopy.After irradiation for 48 h,corneal tissue was collected for the detection of the expression of NF-κB by electrophoretic mobility shift assay.Results After irradiation for 48 h,the score of corneal opacity in the UVA group (3.10 ± 0.74) was higher than that of the control group (0) and UVA + Cur group (0.35 ± 0.24) (P ＜ 0.05).The expression of NF-κB in cornea was detectable at a low level in the control group (1.25 ± 0.13),but was remarkably increased in UVA group (3.98 ± 0.58) and suppressed by curcumin in UVA +Cur group (1.58 ± 0.34) (P ＜ 0.05).There was no significant difference in corneal opacity score and NF-κB expression between control and UVA + Cur group (P ＞ 0.05),but there was significant difference between control and UVA group and UVA + Cur and UVA group (all P ＜ 0.05).Conclusion Curcumin can protect cornea against UVA-induced damage via inhibiting NF-κB activation.

Phototherapeutic modalities pose no significantly increased risk of oxidative damage to DNA in dark skinned individuals.

Background: 8‑oxoguanine, a major product of DNA oxidation, is considered a key parameter in measuring the carcinogenic effects of ultraviolet radiation. Objective: To assess and compare the carcinogenic potential of different photo (chemo) therapeutic modalities in photoresponsive skin diseases by measuring the levels of 8‑oxoguanine in dark‑skinned individuals before and after photo (chemo) therapy. Methods: A prospective, randomized controlled pilot study was conducted in 63 patients of skin types III–V with photo‑responsive dermatoses including vitiligo, psoriasis and mycosis fungoides. Patients were divided into three groups; Group 1 (received narrowband ultraviolet‑B), Group 2 (received psoralen plus ultraviolet‑A) and Group 3 (received broadband ultraviolet‑A). Biopsies were taken before and after phototherapy to measure 8‑oxoguanine levels using enzyme‑linked immunosorbent assay. Biopsies were also taken from the sun‑protected skin in 21 controls subjects who had no dermatological disease. Results: Regardless of the disease, a significantly higher level of 8‑oxoguanine was found after treatment when compared to the pre‑treatment baseline levels; however, these levels were comparable to those in control subjects. A weakly significant positive correlation was found between cumulative dose and 8‑oxoguanine levels following psoralen plus ultraviolet‑A therapy. In controls, comparing the 8‑oxoguanine levels between skin types III and IV showed significantly lower 8‑oxoguanine in skin type IV. Conclusion: Therapeutic doses of ultraviolet radiation are relatively safe in dark skinned patients; however, minimizing the cumulative dose of phototherapeutic modalities (particularly psoralen plus ultraviolet‑A) is recommended.

Progress of research on corneal collagen cross-linking for corneal melting / 国际眼科杂志(Guoji Yanke Zazhi)

?Corneal collagen cross-linking ( CXL ) could increase the mechanical strength, biological stability and halt ectasia progression due to covalent bond formed by photochemical reaction between ultraviolet - A and emulsion of riboflavin between collagen fibers in corneal stroma. Corneal melting is an autoimmune related noninfectious corneal ulcer. The mechanism of corneal melting, major treatment, the basic fundamental of ultraviolet- A riboflavin induced CXL and the clinical researches status and experiment in CXL were summarized in the study.

Platelet-Rich Fibrin Lysate Can Ameliorate Dysfunction of Chronically UVA-Irradiated Human Dermal Fibroblasts

To determine whether platelet-rich fibrin lysate (PRF-L) could restore the function of chronically ultraviolet-A (UVA)-irradiated human dermal fibroblasts (HDFs), we isolated and sub-cultured HDFs from six different human foreskins. HDFs were divided into two groups: those that received chronic UVA irradiation (total dosages of 10 J cm-2) and those that were not irradiated. We compared the proliferation rates, collagen deposition, and migration rates between the groups and between chronically UVA-irradiated HDFs in control and PRF-L-treated media. Our experiment showed that chronic UVA irradiation significantly decreased (p<0.05) the proliferation rates, migration rates, and collagen deposition of HDFs, compared to controls. Compared to control media, chronically UVA-irradiated HDFs in 50% PRF-L had significantly increased proliferation rates, migration rates, and collagen deposition (p<0.05), and the migration rates and collagen deposition of chronically UVA-irradiated HDFs in 50% PRF-L were equal to those of normal fibroblasts. Based on this experiment, we concluded that PRF-L is a good candidate material for treating UVA-induced photoaging of skin, although the best method for its clinical application remains to be determined.

Guidelines for bath PUVA, bathing suit PUVA and soak PUVA.

Background: The aim of these guidelines is to encourage dermatologists to use bath psoralen plus ultraviolet A (PUVA), bathing suit PUVA and soak PUVA in the treatment of psoriasis vulgaris and other conditions. Methods: Evidence was collected using searches of the PubMed, MEDLINE and COCHRANE databases using the keywords “bath PUVA,” “soak PUVA,” “bathing suit PUVA” and “turban PUVA.” Only publications in English were reviewed. Results: One hundred and thirty-eight studies were evaluated, 57 of which fulfi lled the criteria for inclusion. Conclusions: Both bath PUVA and bathing suit PUVA are very effective and safe treatments for generalized stable plaque psoriasis (strength of recommendation, A). Soak PUVA is very effective in the treatment of both palmoplantar psoriasis and chronic palmoplantar eczema (strength of recommendation, A).

Inflammatory Cytokine Expression and Sebum Production after Exposure of Cultured Human Sebocytes to Ultraviolet A Radiation and Light at Wavelengths of 650 nm and 830 nm

BACKGROUND: The effectiveness of ultraviolet (UV) radiation, visible light, or infrared light therapy for the treatment of acne is the subject of ongoing scientific debate. OBJECTIVE: This study was conducted to investigate changes in sebum production and the expression of inflammatory cytokines, matrix metalloproteinases (MMPs), and antimicrobial peptides (AMPs), following exposure of cultured human sebocytes to UVA radiation and light at wavelengths of 650 nm and 830 nm. METHODS: Reverse transcription polymerase chain reaction assays were performed to measure the gene expression levels of inflammatory cytokines (interleukin [IL]-1beta, IL-6, IL-8, and tumor necrosis factor-alpha), MMPs (MMP-1, MMP-3, and MMP-9), and AMPs (psoriasin, hBD-2, hBD-3, and LL-37) in cultured sebocytes after exposure to UVA radiation (2 J/cm2, 3 J/cm2, and 5 J/cm2) and light at wavelengths of 650 nm (14 J/cm2, 29 J/cm2, and 87 J/cm2) and 830 nm (5 J/cm2, 10 J/cm2, and 30 J/cm2). Expression of inflammatory cytokine proteins and sebum production were measured using enzyme-linked immunoassays and a lipid analysis kit, respectively. RESULTS: Exposure of cultured sebocytes to UVA radiation and light at wavelengths of 650 nm and 830 nm did not show a significant increase in the expression of inflammatory cytokines, MMPs, or AMPs. Sebum production was not significantly decreased after exposure to UVA radiation and light at both wavelengths. CONCLUSION: We propose that UVA radiation, visible light, and infrared light can be used to target Propionibacterium acnes for the treatment of acne, without an increase in the expression of inflammatory biomarkers and sebum production.