Novel non-calcemic secosteroids that are produced by human epidermal keratinocytes protect against solar radiation.

CYP11A1 hydroxylates the side chain of vitamin D3 (D3) in a sequential fashion [D3→20S(OH)D3→20,23(OH)2D3→17,20,23(OH)3D3], in an alternative to the classical pathway of activation [D3→25(OH)D3→1,25(OH)2D3]. The products/intermediates of the pathway can be further modified by the action of CYP27B1. The CYP11A1-derived products are biologically active with functions determined by the lineage of the target cells. This pathway can operate in epidermal keratinocytes. To further define the role of these novel secosteroids we tested them for protective effects against UVB-induced damage in human epidermal keratinocytes, melanocytes and HaCaT keratinocytes, cultured in vitro. The secosteroids attenuated ROS, H2O2 and NO production by UVB-irradiated keratinocytes and melanocytes, with an efficacy similar to 1,25(OH)2D3, while 25(OH)D3 had lower efficacy. These attenuations were also seen to some extent for the 20(OH)D3 precursor, 20S-hydroxy-7-dehydrocholesterol. These effects were accompanied by upregulation of genes encoding enzymes responsible for defense against oxidative stress. Using immunofluorescent staining we observed that the secosteroids reduced the generation cyclobutane pyrimidine dimers in response to UVB and enhanced expression of p53 phosphorylated at Ser-15, but not at Ser-46. Additional evidence for protection against DNA damage in cells exposed to UVB and treated with secosteroids was provided by the Comet assay where DNA fragmentation was markedly reduced by 20(OH)D3 and 20,23(OH)2D3. In conclusion, novel secosteroids that can be produced by the action of CYP11A1 in epidermal keratinocytes have protective effects against UVB radiation. This article is part of a special issue entitled '17th Vitamin D Workshop'.

Photobiological safety evaluation of UV nail lamps.

We evaluated six UV nail lamps representative of major US manufacturers to evaluate radiant hazards as defined in ANSI/IESNA RP-27 Recommended Practice for Photobiological Safety. Lamps were evaluated at three positions, 1 cm above the inner surface approximating exposure to the hand and the 20 cm RP-27 non-general light source distance, oriented normal and 45° to the opening. Hazard to skin at intended use distance classified these devices into Risk Group 1 or 2 (Low to Moderate) with S(λ) weighted Actinic UV ranging 1.2-1.7 µW cm(-2) and 29.8-276.25 min permissible daily exposure. At 20 cm on center and 45° UV risk to skin and eyes were all within Exempt classification. Actinic UV ranged 0.001-0.078 µW cm(-2) and unweighted near UV (320-400 nm) ranged 0.001-0.483 mW cm(-2). Likewise the retinal photochemical blue light hazard and retinal thermal and cornea/lens IR were also Exempt. One device had aphakic eye hazard slightly rising into Risk Group 1 (Low). There were no other photobiological risks to normal individuals. Total exposure following programmed times and steps accumulate to only a small fraction of RP-27 permissible daily occupational exposure. These risks are further mitigated in realistic nonoccupational use scenarios as it is unlikely to be a daily occurrence.

The value of the ratio of UVA to UVB in sunlight.

The objective of this communication is to present the calculated ratio between UVA and UVB irradiance from sunrise to sunset and under a number of weather conditions. UVA plays an important role in the sun spectrum and a lot of attention has been paid lately regarding the protection of people from UVA. Solar spectra were collected in Kuwait City located at 29.3° North latitude (similar to that of Houston, TX) over a period of 8 months and under various weather conditions. Spectra were collected from 260 nm to 400 nm in 2 nm increments for solar elevation angles from 10° to 90° using a calibrated Optronics Laboratories OL-742 Spectroradiometer. The measurements reported in this study the ratio of UVA (320-400 nm) to UVB (280-320 nm) in solar terrestrial radiation remains essentially constant and equal to 20 for the part of the day when the solar elevation is greater than 60°. Consequently the value of the ratio of solar UVA/UVB should be considered as equal to 20 for studies in photobiology and photomedicine. When the wavelength limiting the range of UVA and UVB is 315 nm (i.e. UVB: 280-315 nm and UVA: 315-400 nm) the ratio of UVA to UVB becomes equal to 41.

FDA-sunlamp recommended Maximum Timer Interval And Exposure Schedule: consensus ISO/CIE dose equivalence.

The authors compared calculations of sunlamp maximum exposure times following current USFDA Guidance Policy on the Maximum Timer Interval and Exposure Schedule, with USFDA/CDRH proposals revising these to equivalent erythemal exposures of ISO/CIE Standard Erythema Dose (SED). In 2003, [USFDA/CDRH proposed replacing their unique CDRH/Lytle] erythema action spectrum with the ISO/CIE erythema action spectrum and revising the sunlamp maximum exposure timer to 600 J m(-2) ISO/CIE effective dose, presented as being biologically equivalent. Preliminary analysis failed to confirm said equivalence, indicating instead ∼38% increased exposure when applying these proposed revisions. To confirm and refine this finding, a collaboration of tanning bed and UV lamp manufacturers compiled 89 UV spectra representing a broad sampling of U.S. indoor tanning equipment. USFDA maximum recommended exposure time (Te) per current sunlamp guidance and CIE erythemal effectiveness per ISO/CIE standard were calculated. The CIE effective dose delivered per Te averaged 456 J(CIE) m(-2) (SD = 0.17) or ∼4.5 SED. The authors found that CDRH's proposed 600 J(CIE) m(-2) recommended maximum sunlamp exposure exceeds current Te erythemal dose by ∼33%. The current USFDA 0.75 MED initial exposure was ∼0.9 SED, consistent with 1.0 SED initial dose in existing international sunlamp standards. As no sunlamps analyzed exceeded 5 SED, a revised maximum exposure of 500 J(CIE) m(-2) (∼80% of CDRH's proposal) should be compatible with existing tanning equipment. A tanning acclimatization schedule is proposed beginning at 1 SED thrice-weekly, increasing uniformly stepwise over 4 wk to a 5 SED maximum exposure in conjunction with a tan maintenance schedule of twice-weekly 5 SED sessions, as biologically equivalent to current USFDA sunlamp policy.

Cutaneous hypothalamic-pituitary-adrenal axis homolog: regulation by ultraviolet radiation.

The hypothalamic-pituitary-adrenal (HPA) axis maintains basal and stress-related homeostasis in vertebrates. Skin expresses all elements of the HPA axis including corticotropin-releasing hormone (CRH), proopiomelanocortin (POMC), ACTH, ß-endorphin (ß-END) with corresponding receptors, the glucocorticoidogenic pathway, and the glucocorticoid receptor (GR). To test the hypothesis that cutaneous responses to environmental stressors follow the organizational structure of the central response to stress, the activity of the "cutaneous HPA" axis homolog was investigated after exposure to ultraviolet radiation (UVR) wavelengths of UVA (320-400 nm), UVB (280-320 nm), and UVC (100-280 nm) in human skin organ culture and in co-cultured keratinocytes/melanocytes. The level of stimulation of CRH, POMC, MC1R, MC2R, CYP11A1, and CYP11B1 genes was dependent on UV wavelengths and doses, with the highest effects observed for highly energetic UVC and UVB. ELISA and Western assays showed significant production of CRH, POMC, ACTH, and CYP11A1 proteins and of cortisol, with a decrease in GR expression only after UVB and UVC. However, ß-END expression was also stimulated by UVA. Immunocytochemistry localized the deposition of the aforesaid antigens predominantly to the epidermis with additional accumulation of CRH, ß-END, and ACTH in the dermis. UVR-stimulated CYP11A1 expression was seen in the basal layer of the epidermis and cells of adjacent dermis. Thus, the capacity to activate or change the spatial distribution of the cutaneous HPA axis elements is dependent on highly energetic wavelengths (UVC and UVB), implying a dependence of a local stress response on their noxious activity with overlapping or alternative mechanisms activated by UVA.

Comparative effectiveness of clinically used light sources for cutaneous protoporphyrin IX-based photodynamic therapy.

This report documents the optical characteristics of a number of photodynamic therapy (PDT) light sources of varied types, measured and indexed relative to estimated effectiveness for activation of the PDT chromaphore protoporphyrin IX (PpIX). PDT sources in use at several clinics, including intense pulsed light (IPL) sources, lasers, and continuous wave (CW) light sources, were spectroradiometrically measured and indexed relative to their overlap to an absorption spectrum of PpIX. The sources were highly disparate, varying in power from irradiance in the mW/cm(2) range for the CW sources up to ∼30 J/cm(2) per flash for the IPL sources. Our PpIX Index ranged by a factor of nearly 100 (0.008-0.630) in estimated PpIX PDT effectiveness following the distinct spectral characteristics of the light sources surveyed. Application of this PpIX Index, tempered with an understanding of the biology of the lesion being treated and effective spectrum of the light source reaching the lesion requiring therapy, provides a rational algorithm to approximate equivalent light doses prior to clinical protocols to establish equivalent patient outcomes employing alternative PDT light sources.

Variability of pre-vitamin D3 effectiveness of UV appliances for skin tanning.

While there is limited documentation that certain indoor tanning lamps effectively produce vitamin D, the diversity of such devices has not been extensively surveyed. This study compares the spectral effectiveness of a variety of tanning units, and solar spectra, for ultraviolet (UV) photosynthesis of pre-vitamin D3 (preD3) and UV induced erythema. Well-established techniques exist for the calculation of spectral effectiveness for photobiological responses that have defined action spectra. Using spectroradiometric data from sunlamp measurements, and standard solar reference spectra, we computed effective irradiances using the CIE action spectrum for the production of preD3 in human skin and the ISO/CIE human erythema reference action spectrum. We found, as with sunlight at different times or latitude, the preD3 and erythemal effectiveness of sunlamps varied as a function of the UV-B proportion of the spectrum. Ratios of sunlamp preD3 to erythemal effectiveness ranged from approximately 0.5 to nearly 2.0, similar to ratios for sunlight. Optimal risk to benefit conditions for preD3 from solar UV exposure occurs under high solar altitude, low zenith angle, midday midsummer sunlight. Analogous optimal preD3 exposure conditions are provided by low to intermediate pressure sunlamps with greater UV-B spectral overlap with the preD3 action spectrum. Similar to low altitude or high latitude sunlight, high pressure tanning units, filtered for negligible UV-B emissions, have insignificant vitamin D benefit. We conclude that while vitamin D can be made by both UVB exposure from indoor tanning units and by exposure UVB from sunlight, the effect is also comparably variable. Unlike sunlight, indoor tanning offers privacy and environmental conditions for practical full body exposure, lowering the requisite exposure per skin surface area, and device timers limit the potential of overexposure. Guidance for optimal use of tanning sources for vitamin D benefit is needed.

Holick's rule and vitamin D from sunlight.

Holick's rule says that sun exposure 1/4 of a minimal erythemal dose (MED) over 1/4 of a body is equivalent to 1000 International Units (IU) oral vitamin D3. Webb and Engelsen recently commented that the ultraviolet (UV) spectrum used to establish Holick's rule is unknown. They consequently used a spring midday Boston solar spectrum to estimate ample sunlight exposures for previtamin D3 (preD3) at various locations. Literature review found the source upon which this rule is based was a fluorescent sunlamp (FS lamp). The FS spectrum is known and its relative weighting against the action spectra for erythema and the preD3 is significantly different from the solar spectrum used to derive the standard vitamin D effective dose (SDD). The preD3 effectiveness of the solar spectrum per unit erythemal hazard is greater than the FS lamp by a factor of 1.32. Consequently, UV exposure estimates based on Boston reference sunlight, instead of the UV lamp employed in the originating experiments, over estimate UV exposure equivalent to approximately 1000 IU orally by approximately 1/3. This redefinition of SDD impacts risk/benefit assessments of optimal/feasible sun exposure for vitamin D maintenance and the application of Holick's rule to rational public health messages.

The FDA proposed solar simulator versus sunlight.

The US Food and Drug Administration is in the process of formulating final rules for sunscreen labeling and testing. They have adopted a version of the solar simulator standard proposed by COLIPA, a European cosmetic products trade association. From our files we have selected spectral data on several solar simulators that comply with the proposed rules and have compared these sources both one to another and to several standard solar spectra of Air Mass 1.0, 1.5, and 2.0. In doing so we have used additional spectral analysis procedures including examining the goodness of fit between each solar simulator spectrum and an Air Mass 1.0 (0 degrees zenith angle) solar spectrum. The index of goodness of fit ranges from approximately 78% to just over 90% compared to solar spectra representing other Air Masses of 1.5 and 2.0, the goodness of fit is lower. Unfortunately, one may not assume that complying with a standard assures that other solar simulators also complying will produce identical results. In fact, by our analysis, none of the solar simulators we examined would be expected to produce the same SPF as sunlight.

Examination of solar simulators used for the determination of sunscreen UVA efficacy.

The U.S. FDA recently proposed both in vivo and in vitro UVA efficacy tests for sunscreen products with the lower result used to establish the sunscreen's labeled UVA protection claim. The FDA stated their rationale for dual tests was concern that the in vivo test method overemphasizes UVA-2 (320-340 nm) photoprotection. We attribute FDA's observation to the relative lack, compared to sunlight, of UVA-1 (340-400 nm) radiation in the current JCIA UVA solar simulator specification, allowing the method to generate higher UVA protection factors than sunscreens will provide in sunlight. Our work is based upon comparisons of Air Mass 1.0 sunlight to variously filtered UVA solar simulators. Sources near the JCIA UVA-2/UVA limits (8-20%) had a goodness of fit to solar UVA of only 67-79%. We propose that instead of using ratios of UVA-2 to UVA the standard should be a goodness of fit to the UVA region of an Air Mass 1 solar reference spectrum. As the spectral distribution of solar UVA varies much less than UVB, sunlight of reasonable zenith angles of < or = 60 degrees will have similar spectral shapes and approximate risk spectrum. Goodness of fit to this spectrum will produce UVA protection values predictive to those actually achieved in sunlight of different zenith angles.

Indoor tanning injuries: an evaluation of FDA adverse event reporting data.

BACKGROUND/AIMS: In 1979 the Food and Drug Administration (FDA) designated indoor tanning units would be regulated medical devices and that each must have an exposure timer. In 1985 FDA added a scheduled series of doses designed to allow tanning with little risk of concomitant sunburn. Subsequently FDA/CDRH maintained databases in which medical device associated injuries were reported. The databases, MAUDE and its predecessor MDR, are available online. While these records, in part, are not intended for evaluation of adverse event rates, analysis provides insight into the etiology of UV-related tanning injuries. METHODS/RESULTS: We compiled 142 records reported for 1985-2006 including 22% noninjury malfunctions. Of the reported injuries approximately 50% resulted from UV exposure, an average of <1/year resulted in hospitalization. At least 36% of the UV-related injuries were attributable to various (user/operator) noncompliance with FDA sunlamp guidance policies. During 1985-1995 there were six times more UV injuries than 1996-2006, presumably reflecting cessation of much mandatory reporting in 1996. Injury reports declined steady from 1997 to 2006. CONCLUSIONS: FDA guidance appears most efficacious in injury prevention and we encourage its incorporation into the enforceable performance standard. We also advise that tanning industry professional training programs seek standardization/accreditation of their personnel certifications through recognized accreditation bodies such as ANSI or ISO/IEC.

In vitro sunscreen transmittance measurement with concomitant evaluation of photostability: evolution of a method.

The recent paper by Miura et al. (Photochem. Photobiol. 84[6], 1569-1575) offers a re-examination of extant in vitro methods for dynamically measuring sunscreen photodegradation under continuous irradiation in situ. We commend the authors' efforts toward developing an improved system for accurate in vitro sunscreen assessment. This work describes an alternate derivative apparatus incorporating an improved detector which may prove an exceptionally valuable contribution toward that goal. Unfortunately their report suffers from insufficient detail in instrumentation description and lacks requisite calibration procedures. Their utilization of a solar simulator filtered for conventional in vivo sun protection factor (SPF) testing poses transmittance measurement limitations at short wavelengths that are not adequately addressed and is also deficient, relative to sunlight, in longer UVA wavelengths shown to contribute to sunscreen photoinstability. We concur that the in vitro sunscreen testing should utilize continuous or multiple irradiation doses and should ideally use the same 2 mg cm(-2) product application amount as does the human SPF test. We encourage their proposal that methodology, which simultaneously measures sunscreen spectral transmittance and photodegradation under continuous irradiation to an accumulated erythemic endpoint, as we previously described, be developed into a consensus test standard.

Do melanoidins induced by topical 9% dihydroxyacetone sunless tanning spray inhibit vitamin d production? A pilot study.

We report here preliminary pilot study data of the effect of sunless tanning spray with 9% [Correction added after online publication (August 24th, 2009): The concentration of Dihydroxyacetone used in the study was 9% and not 3% as previously stated] dihydroxyacetone (DHA) on 25-hydroxyvitamin D [25(OH)D] serum levels in subjects exposed to controlled amounts of UV-B radiation during April/May in Omaha, NE, 41 degrees N latitude. We found that DHA-induced melanoidins in skin act as a topical sunscreen attenuating the formation of 25(OH)D.

Analysis of compact fluorescent lights for use by patients with photosensitive conditions.

Ultraviolet radiation (UVR) is hazardous to patients with photosensitive skin disorders, such as lupus erythematosus, xeroderma pigmentosum and skin cancer. As such, these patients are advised to minimize their exposure to UVR. Classically, this is accomplished through careful avoidance of sun exposure and artificial tanning booths. Indoor light bulbs, however, are generally not considered to pose significant UVR hazard. We sought to test this notion by measuring the UV emissions of 19 different compact fluorescent light bulbs. The ability to induce skin damage was assessed with the CIE erythema action spectrum, ANSI S(lambda) generalized UV hazard spectrum and the CIE photocarcinogenesis action spectrum. The results indicate that there is a great deal of variation amongst different bulbs, even within the same class. Although the irradiance of any given bulb is low, the possible daily exposure time is rather lengthy. This results in potential daily UVR doses ranging from 0.1 to 625 mJ cm(-2), including a daily UVB (290-320 nm) dose of 0.01 to 15 mJ cm(-2). Because patients are exposed continually over long time frames, this could lead to significant cumulative damage. It would therefore be prudent for patients to use bulbs with the lowest UV irradiance.

The risk of ultraviolet radiation exposure from indoor lamps in lupus erythematosus.

It is well known that ultraviolet radiation can exacerbate skin disease in patients with lupus erythematosus. While many patients are advised to avoid sunlight and artificial tanning, it is not clear how best to counsel patients regarding the use of indoor lamps. Indeed, many of the light bulbs commonly used in the home and workplace emit low-dose ultraviolet radiation. The irradiance is considerably lower than that of the sun, however the exposure time can last for hours and is typically repeated on a daily basis. Therefore, it is possible that this chronic exposure could ultimately result in a significant accumulation of damage.

Commentary on 'UVB-SPF': the SPF labels of sunscreen products convey more than just UVB protection.

The FDA recently published a proposed amendment of the Final Monograph for OTC Sunscreen Products. Among the proposals, FDA revised solar simulator performance specifications and additional labeling for sunscreen products. The maximum allowable labeled sun protection factor (SPF) was increased to SPF 50 while simultaneously requiring it to be called 'UVB-SPF'. UVB accounts for 80-91% of the erythemic effectiveness of the UV solar simulator specified in the amendment. Analysis of the specified solar simulator spectrum used to determine SPF indicates that if 100% of the UVB is blocked, it is mathematically impossible to achieve an SPF in excess of approximately 11 without also blocking at least some UVA. Consequently significant UVA protection must be provided for sunscreen products to achieve SPFs of 15 and higher. At the maximum allowed SPF 50, where only 2% or less of the effective UV risk remains, the minimum reduction of UVA erythemal effectiveness must by definition be 78-90%. While mandating UVA protection criteria is doubtless important, especially as it relates to sunscreen photostability, there is no utility in, or basis for, the proposed 'UVB-SPF' descriptor as existing high SPF labeling indicates both UVB and UVA protection.

25-Hydroxyvitamin D, cholesterol, and ultraviolet irradiation.

Vitamin D deficiency may have implications for cardiovascular health. The purpose of this study was to determine the relationship of 25-hydroxyvitamin D (25[OH]D) to cholesterol and lipoprotein particles and to determine whether increasing 25(OH)D through ultraviolet (UV) irradiation impacted on these parameters in healthy young men and women. This was a randomized trial of 51 adults exposed to suberythemal doses of whole-body irradiation using UV lamps that emitted UV-A and UV-B radiation, compared with a control group, twice weekly for 12 weeks. 25-Hydroxyvitamin D, cholesterol, and lipoprotein subfractions were measured at baseline and after 12 weeks. There was a significant (P < .03) positive association between 25(OH)D and apolipoprotein A-I (Apo A-I) and lipoprotein A-I (Lp A-I). The ratio of low-density lipoprotein to high-density lipoprotein was significantly (P < or = .044) negatively correlated with 25(OH)D levels. The levels of 25(OH)D increased significantly in the treated compared with control group (P < .05). Overall, there were no significant differences between the treated and control groups in any lipoproteins or apolipoproteins after administration of UV irradiation. Subgroup analysis for Apo A-II confined to those with 25(OH)D insufficiency (25[OH]D <75 nmol/L [30 ng/mL]) revealed decreases in Apo A-II in the treated group and increases in the control group that were statistically significantly different between the groups (P = .026). We found a significant positive correlation between 25(OH)D and Apo A-I and Lp A-I and a significant negative correlation between 25(OH)D and the ratio of low-density lipoprotein to high-density lipoprotein. In those with vitamin D insufficiency, we found small decreases in Apo A-II in the treated relative to the control group. Overall, though, twice weekly exposure to UV radiation resulting in an increase in serum 25(OH)D had no significant impact on lipoprotein composition.