Photodermatology, photoimmunology & photomedicine最新文献

Background/purpose: Platelet-rich plasma (PRP) and plasma rich in growth factors (PRGF) are autologous preparations widely applied in regenerative medicine because of their potential to enhance tissue repair and cellular activity. Low-level laser therapy (LLLT) has also been reported to promote fibroblast proliferation and mitochondrial activity. This study aimed to investigate the combined effects of PRP, PRGF, and LLLT on human dermal fibroblasts (HDFCs).

Methods: HDFCs were cultured and treated with varying concentrations of PRP and PRGF. Cells were subsequently exposed to a gallium-aluminum-arsenide (GaAlAs) laser at 830 nm, 10 mW, continuous mode, for 90 s, 3 min, or 6 min. Proliferation, metabolic activity, and oxidative stress were evaluated using MTT, ATP, and ROS assays at 24 h and 48 h.

Results: A significant increase (p < 0.001) in proliferation and ATP production was observed in the PRP 30% and PRGF 60% groups after 90 s of LLLT. MTT values were 1.17 ± 0.00 and 1.39 ± 0.05 at 24 h, and 1.40 ± 0.04 and 1.62 ± 0.01 at 48 h, respectively. ATP levels reached 6710.33 ± 59.72 and 18,709 ± 535.29 RLU at 24 h, and 8202 ± 333.39 and 22,272 ± 839.64 RLU at 48 h, compared with control (1005 ± 52.92 RLU). No significant differences in ROS activity were detected among most groups, although PRGF 70% showed elevated ROS with and without laser irradiation.

Conclusion: PRP and PRGF synergistically enhanced fibroblast proliferation and metabolism when combined with LLLT. PRGF consistently demonstrated greater effects compared with PRP. Optimal stimulation was achieved with 90 s of LLLT at 10 mW (3.78 J/cm²) combined with 30% PRP or 60% PRGF.

Background: Actinic keratoses (AKs) are precancerous lesions that may progress to squamous cell carcinoma (SCC). Photodynamic therapy (PDT) with methyl aminolevulinate (MAL) is an established treatment, often preceded by mechanical curettage to enhance photosensitizer penetration. However, curettage is associated with pain and discomfort, necessitating alternative pretreatment strategies, also applicable in daylight PDT.

Methods: Thirty-six patients with symmetrical facial AKs were randomized to receive MAL-PDT on two contralateral areas: one pretreated with a 10% urea-based keratolytic compound (UBC) for 14 days and the other untreated (control). Protoporphyrin IX (PpIX) fluorescence, clinical outcomes, cosmetic results, and patient satisfaction were assessed. Statistical analyses included the Wilcoxon, Mann-Whitney, and chi-squared tests (p ≤ 0.05).

Results: The urea-pretreated group showed significantly higher fluorescence intensity (median: 7 [5-9]) vs. controls (median: 5 [3-6]; **p < 0.0001**), indicating improved MAL penetration. Both groups had significant AK reductions (**p = 0.02**). The reduction in Olsen grade I AKs was greater with UBC (**p < 0.0001**), while no significant differences were observed for grade II lesions. Tolerability and patient satisfaction were high, with no significant differences in pain scores, local skin reactions, or cosmetic outcomes.

Conclusions: Pretreatment with a 10% UBC enhances PpIX fluorescence and improves efficacy in grade I AKs when compared to no pretreatment. Thus, it provides a non-invasive pretreatment option with good efficacy in thin AKs, along with good patient satisfaction and safety.

Background: Phototherapy reduces serum free bilirubin levels but can also cause various short- and long-term side effects. This meta-analysis examined the potential relationship between phototherapy duration and type, as well as oxidative and inflammatory reactions in newborns with hyperbilirubinemia.

Methods: We searched PubMed, the Cochrane Library, Web of Science, and Embase for observational studies published before December 31, 2023. The Quality in Prognostic Studies (QUIPS) tool was used to evaluate the risk of bias. The intervention included the durations (1.5, 12, 24, 36, 48, 72, and > 90 h) and types (light-emitting diode (LED), conventional, and intensive) of phototherapy.

Results: A total of 24 observational studies with 1230 newborns were included in the study. Phototherapy increased the increased oxidative stability index. The oxidative indexes decreased after 1.5 or 90 h of phototherapy but increased after 24 or 48 h. Phototherapy increased nitric oxide levels but was associated with reduced total antioxidant capacity and glutathione. Conventional phototherapy reduced antioxidant indices, whereas LED was associated with increased oxidative indices. After 36 h, phototherapy reduced hematocrit levels. Phototherapy increased the secretion of inflammatory mediators by peripheral blood mononuclear cells after 24 h. In addition, conventional phototherapy increased levels of inflammatory mediators in the serum of infants after 72 h.

Conclusion: Side effects of phototherapy, such as altered oxidant/antioxidant status and inflammatory reactions, may vary depending on the type of phototherapy used. However, no clear pattern was observed in the alterations in these oxidative/inflammatory markers as a function of the duration of phototherapy.

Background: Photoprotective INGredients (PINGs) are non-filtering agents that enhance the skin's intrinsic defenses against solar radiation. Acting through antioxidant, DNA repair, immunomodulatory, anti-inflammatory, and pigmentation-regulating mechanisms, PINGs may prevent or repair photodamage. When incorporated into sunscreens, they offer protection beyond ultraviolet (UV) filters. This strategy of biological photoprotection could address key limitations of traditional sunscreens and reduce dependence on high UV filter concentrations.

Methods: We conducted a focused literature review based on our prior evidence-based classification of over 1700 topical PINGs. We selected ingredients with the strongest clinical and mechanistic support and assessed their biological activity, formulation compatibility, and relevance to key endpoints such as erythema, pigmentation, photoaging, and immunosuppression.

Results: Top-ranked PINGs, including L-ascorbic acid, tocopherol, photolyase, and nicotinamide, demonstrated efficacy across multiple photodamage endpoints. Antioxidants like L-ascorbic acid and tocopherol enhanced protection against UVR and IR-A-induced oxidative stress. DNA repair enzymes, such as photolyase, reduced cyclobutane pyrimidine dimer formation and supported immune function. Nicotinamide improved DNA repair and prevented UV-induced immunosuppression. Pigmentation modulators such as p-coumaric acid and isobutylamido thiazolyl resorcinol showed benefits in darker phototypes.

Conclusions: Fewer than 2% of candidate PINGs are clinically validated, and only 18 are approved for use in sunscreens. Protection against visible and infrared radiation remains largely underexplored. Standardized testing and additional clinical trials are needed to advance PINGs as effective components of next-generation sunscreens.

Sunscreens have evolved significantly from their ancient origins to become essential tools in photoprotection. This special edition on sunscreens traces the development of sunscreen agents, assesses their safety profile based on clinical and toxicological studies, and explores current trends in public perception and usage behavior. Differences in sunscreen indications based on skin tone and the regulatory disparities affecting sunscreen filter availability across geographic regions are also included in this special edition.

Background/purpose: Ultraviolet (UV) radiation is a key environmental carcinogen implicated in the development of various skin malignancies. Recent studies highlight the pivotal roles of macrophage migration inhibitory factor (MIF) and its homolog D-dopachrome tautomerase (DDT) in UV-induced skin carcinogenesis. This review aims to consolidate current knowledge of how MIF and DDT contribute to tumor initiation and progression under UV stress, with a focus on their biological functions, signaling pathways, and therapeutic potential.

Methods: This narrative review synthesizes findings from basic, translational, and clinical studies examining MIF and DDT in the context of UV-mediated skin carcinogenesis. The literature was selectively reviewed to highlight mechanistic insights, pathological significance, and emerging therapeutic strategies.

Results: Both MIF and DDT are upregulated upon UVB exposure and promote tumorigenesis by suppressing p53-mediated apoptosis, enhancing inflammatory signaling, and modulating the tumor immune microenvironment. Transgenic mouse models demonstrate that overexpression of either cytokine accelerates UVB-induced tumor formation, while inhibition reduces tumor burden. Although MIF and DDT share CD74-mediated pathways, they exhibit mechanistically distinct yet functionally complementary roles. In addition to melanoma, emerging evidence suggests involvement in non-melanoma skin cancers, particularly cutaneous squamous cell carcinoma (cSCC). Selective small-molecule inhibitors are under development, and expression profiles of MIF and DDT are being evaluated as biomarkers for prognosis and response to immunotherapy.

Conclusion: MIF and DDT are critical mediators of UV-induced skin carcinogenesis. Their overlapping yet non-redundant signaling properties and emerging clinical relevance suggest that targeting these cytokines may offer new opportunities for prevention, diagnosis, and treatment of UV-induced skin cancers.

Background/purpose: While biologics and small-molecule inhibitors are first-line systemic treatments for psoriasis, phototherapy remains an alternative for patients unable to access these treatments because of medical or financial constraints. Narrow-band ultraviolet B (NB-UVB) is effective for localized psoriasis but less so for extensive disease. To address this limitation, bathwater delivery of psoralen plus ultraviolet A (bath-PUVA) was introduced in 2004. This study evaluates the efficacy, safety, and patient characteristics associated with bath-PUVA therapy in a large cohort.

Methods: This retrospective analysis included 229 patients (180 males, 49 females) treated with bath-PUVA from 2004 to September 2021. Baseline characteristics and treatment outcomes were assessed using the psoriasis area and severity index (PASI). Statistical analyses examined relationships between treatment outcomes and factors, including baseline PASI, body mass index (BMI), and smoking status.

Results: The mean baseline PASI score was 24.9. Bath-PUVA achieved PASI 75 in 80.4% of patients, PASI 90 in 44.1%, and PASI 100 in 2.6%, with efficacy comparable to biologics. Patients achieving PASI 90 had significantly higher baseline PASI scores (p = 0.005), while the number of irradiations required did not differ (p = 0.692). Higher baseline PASI scores correlated with elevated BMI (p = 0.002), but BMI did not influence improvement rates (p = 0.094). Smokers had significantly higher baseline PASI scores (p = 0.004) compared with non-smokers, yet smoking status did not affect improvement rates (p = 0.862).

Conclusion: Bath-PUVA demonstrates efficacy comparable with biologics for psoriasis, regardless of BMI or smoking status. This analysis supports its use as an effective and accessible treatment option for patients with extensive disease.