Ultraviolet B activated 1,25(OH)(2)D affects the level of fibroblast growth factor-23 in human.

Fibroblast growth factor 23 (FGF-23) is known as a phosphaturic factor regulating phosphate homeostasis. Several studies suggest that dietary phosphate, serum phosphate and 1,25-dihydroxyvitamin D [1,25(OH)(2)D] are candidate regulators of FGF-23. While the human studies, which modulated the dietary or serum phosphate showed in rather controversial results, manipulation of the active vitamin D definitely affected FGF-23 in animals. This study was conducted to elucidate the relationship between active vitamin D directly stimulated by ultraviolet B (UVB) exposure and FGF-23 level in human. Ten healthy young adults were recruited to get the UVB exposure thrice a week at sub-minimal erythemal dose with gradual increment by 10% only for 4 weeks. Serum calcium, phosphate, mineral-related hormones and bone turnover markers were analyzed before and after the UVB exposure every 4 week for 12 whole weeks. Twenty five-hydroxyvitamin D [25(OH)D] increased by 115% (19.8 ng/mL to 40.5 ng/mL, p < 0.001) after 4 weeks of UVB exposure. While 1,25(OH)(2)D increased by 75% (49.9 pg/mL to 64.4 pg/mL, p < 0.001) then both level decreased after 4 weeks of withdrawal. C-telopeptide peaked at 2nd week then decreased, while osteocalcin increased gradually. FGF-23 started to increase from the 4th week of UVB exposure then significantly at the 4th week after withdrawal of UVB (27.8 pg/mL to 41.4 pg/mL, p < 0.05). UVB exposure effectively increased 1,25(OH)(2)D with delayed stimulatory effect on FGF-23. This result could support the regulatory loop of 1,25(OH)(2)D and FGF-23 in human, FGF-23 regulation by 1,25(OH)(2)D.

The 308-nm excimer laser: a promising device for the treatment of childhood vitiligo.

BACKGROUND: Numerous modalities have been used to treat vitiligo in children. Up to now, phototherapy and topical corticosteroids are the most commonly used treatments for adult vitiligo but studies evaluating the efficacy of these treatments in the pediatric population remain insufficient. OBJECTIVE: This study was a retrospective review to evaluate the efficacy and safety of 308-nm excimer laser treatment in 30 childhood vitiligo patients. METHODS: Thirty vitiligo patients with 40 vitiligo patches were evaluated after the cessation of 308-nm excimer laser treatment. RESULTS: Seventeen patients (56.7%) with 20 patches (50%) achieved an acceptable degree (>50%) of repigmentation at the end of the treatment, with five patches (12.5%) showing >75% of repigmentation. The treatment response showed anatomical preferences, favoring the face, neck and trunk. However, the treatment response did not correlate to the cumulative dose or duration of treatment. Side effects occurred in nine patients, but were transient and minimal. CONCLUSION: The results of this study shows that the 308-nm excimer laser can be an effective and promising device for the treatment of various vitiligo types, other than generalized, in childhood.

Quality of life for Korean patients with vitiligo: Skindex-29 and its correlation with clinical profiles.

Vitiligo considerably influences the psychological well-being of patients. Disease-induced disfigurement can cause patients to experience a high level of stigmatization, which can lead to psychosocial stresses and negative impacts on quality of life (QOL). This study aims to ascertain the QOL of vitiligo patients compared to patients with other mild skin disorders. We also attempt to study which clinical features of vitiligo are closely related to the patient's QOL. One hundred and thirty-three vitiligo patients and 112 patients with mild skin disorders were analyzed. All participants were asked to fill out questionnaires covering comprehensive clinical profiles and the Korean version of Skindex-29. Statistical correlation between Skindex-29 and each clinical profile were analyzed. The symptom scale of Skindex-29 was significantly lower in vitiligo patients than in controls, but the function scale and the emotion scale were significantly higher in the vitiligo group than in controls. However, the difference in function scales between groups was significant in female patients, but not in male patients. Several clinical profiles, such as duration of disease, severity scores and previous history of treatments, showed close correlations with the function scale. Family history of vitiligo, Köebner phenomenon, patients' perspectives on disease prognosis, and discordance of the severity scores between physicians and patients also influenced the Skindex-29 subscales differently. In conclusion, the present study suggests that patients with vitiligo were highly affected in the functional and emotional aspects of QOL, with some sex differences. Various clinical features may play an important role in the QOL of vitiligo patients.

A case of concurrent vitiligo and psoriasis.

Vitiligo and psoriasis are common dermatoses that occur in 1~3% and 0.5% of the general population, respectively. There have been several reports of the concurrence of these diseases in the English medical literature. Yet the pathogenesis of the association between these two dermatoses is still unknown. Psoriasis may occur coincidentally with vitiligo and it may be strictly confined to the vitiliginous patches or it may occur elsewhere. Despite the reports in the English literature, there has been only one case of vitiligo and psoriasis coexisting in the same patient and these diseases occurred in separate sites in the Korean dermatologic literature. A 30-year-old man recently presented with spreading vitiligo on the right forearm and a 3-month history of guttate psoriasis on the left forearm. He had a family history of psoriasis without any history of associated autoimmune disease. Herein, we report on a case of coexisting vitiligo and psoriasis in the same individual at different sites and we review the relevant literature.

Proteomic analysis of the proteins expressed by hydrogen peroxide treated cultured human dermal microvascular endothelial cells.

Reactive oxygen species (ROS) have been traditionally regarded as toxic by-products of aerobic metabolism. However, ROS also act as intracellular signaling molecules and can mediate phenotypes in vascular endothelial cells, which may be physiological or pathological in nature. To clarify the molecular mechanisms of ROS signaling, we examined hydrogen peroxide (H(2)O(2))-responsive proteins in cultured human dermal microvascular endothelial cells (HMVEC) using proteomic tools. Protein expression in HMVEC was studied after they had been exposed to low- and high-levels of H(2)O(2) for various times, and intracellular ROS production was examined by flow cytometer and UV spectrophotometer. Proteins obtained from dose- and time-dependent series were separated by two-dimensional gel electrophoresis and tentatively identified by matrix-assisted laser desorption-time of flight mass spectrometry, by matching the tryptic mass maps obtained with entries in the NCBI and Swiss-Prot protein sequence database. At least 163 proteins were changed by H(2)O(2), and 60 proteins were identified. Oxidative stress triggered dramatic change in the expression of proteins in primary microvessel endothelial cells, and their mapping to cellular process provided a view of the ubiquitous cellular changes elicited by H(2)O(2). These results could provide a framework for the understanding of the mechanisms of cellular redox homeostasis and H(2)O(2) metabolism in microendothelium environment in various biological processes as well as pathological conditions.

Expression of psoriasis-associated fatty acid-binding protein in senescent human dermal microvascular endothelial cells.

Aging is associated with the progressive pathophysiologic modification of endothelial cells. In vitro endothelial cell senescence is accompanied by proliferative activity failure and by perturbations in gene and protein expressions. Moreover, this cellular senescence in culture has been proposed to reflect processes that occur in aging organisms. In order to observe the changing patterns of protein expression in senescent human dermal microvascular endothelial cells (HDMECs), proteins obtained from both early- and late-passaged HDMECs were separated by two-dimensional electrophoresis, visualized by silver staining, and quantified by image processing. Proteins of interest were extracted by in-gel digestion with trypsin and quantified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS), by searching the National Center for Biotechnology Information protein-sequence database. More than 2000 spots were detected by 2D electrophoresis within a linear pH range of 3-10. Twenty-two major differentially expressed spots were observed in serially passaged HDMECs and identified with high confidence by MALDI-TOF-MS. One of these spots was found to be a 14-15 kDa psoriasis-associated fatty acid-binding protein (PA-FABP) with high affinity for long-chain fatty acids. The expression of PA-FABP was confirmed to be elevated in senescent HDMECs (passage 20) by fluorescence-activated cell sorting (FACS), confocal laser microscopy, and by immunohistochemistry in aged human skin tissue. Our results suggest that the overexpression of FABP in cultured senescent HDMECs is closely related to skin aging.

Effect of ultraviolet light on the expression of adhesion molecules and T lymphocyte adhesion to human dermal microvascular endothelial cells.

In order to determine the effect of ultraviolet radiation (UVR) on the cell adhesion molecules expressed in human dermal microvascular endothelial cells (HDMEC), the cells were exposed to varying UVR doses and the cell surface was examined for expression of intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM- 1), and E-selectin. The effect of UVB irradiation on the binding of T lymphocytes to HDMEC was also examined. UVA irradiation did not affect the surface expression of ICAM-1, VCAM-1, or E-selectin on the HDMEC. However, following UVB exposure, ELISA demonstrated a significant increase in the baseline ICAM-1 cell surface expression on the HDMEC. However, no induction of either E-selectin or VCAM-1 was noted. UVB also significantly augmented ICAM-1 induction by IL-1alpha and TNF-alpha. VCAM-1 was induced by stimulating HDMEC with IL-1alpha following a UVB irradiation dose of 100 mJ/cm2. Flow cytometric analysis of the HDMEC stimulated with IL-1alpha for 24h demonstrated that 12% of the cells expressed VCAM-1 but either IL-1alpha or UVB irradiation alone failed to induce VCAM-1 expression. Enhancement of T cell-HDMEC binding by IL-1alpha or TNF-alpha treatment was not significantly affected after UVB irradiation. This study demonstrated that UVB irradiation can alter ICAM-1 and VCAM-1 expression on the HDMEC surface and that augmentation of ICAM-1 expression and the IL-1alpha-dependent induction of VCAM-1 following UVB exposure might be important steps in the pathogenesis of sunburn.

Vasculitis livedoide que responde altratamiento con PUVA / Livedoid vasculitis responding to PUVA therapy

Antecedentes: La vasculitis livedoide es un trastorno crónico que se manifiesta en forma de lesiones recurrentes, dolorosas, reticuladas y ulcerativas de las piernas, que origina cicatrices atróficas de color marfil con telangiectasia e hiperpigmentación periférica. Su etiología sigue siendo oscura y el tratamiento es difícil. En este estudio evaluamos la eficacia clínica del tratamiento de psoraleno más UVA (PUVA) y sus efectos secundarios en el tratamiento de la vasculitis livedoide. Métodos: Ocho pacientes surcoreanos con vasculitis livedoide fueran tratados con 8-metoxipsoraleno (8MOP) y UVA. Se comenzó a administrar PUVA sistémico con cuatro julios/cm2 de UVA dos o tres veces en semana y después la dosis se aumentó 0,5 ó 1 julios/cm2 en cada tratamiento posterior según su tolerancia. Los efectos del tratamiento se valoraron usando fotografías de antes del estudio, durante el estudio y después del estudio. Resultados: Todos los pacientes experimentaron un cese rápido de la formación de nuevas lesiones, alivio significativo de los síntomas y cicatrización completa de las lesiones primarias. Los períodos medios de cada uno de estos parámetros fueron 3,6, 5,9 y 10 semanas y las dosis medias acumuladas de UVA fueron 55,9, 96,8 y 197,9 julios/cm2, respectivamente. Los pacientes toleraron bien el tratamiento con PUVA, usando 8-MOP, sin observarse efectos secundarios inaceptables. Conclusiones: Proponemos que el tratamiento sistémico con PUVA, usando 8-MOP, debe investigarse con más profundidad como tratamiento alternativo de los pacientes con vasculitis livedoide (AU)