Skip to main content

Abstract

Ultraviolet (UV) radiation has been used for decades with great success and at a constantly increasing rate in the management of skin diseases and has thereby become an essential part of modern dermatological therapy [28]. Its success as a therapeutic agent has stimulated studies about the mechanisms by which UVB and UVA phototherapy work. The knowledge obtained from this work is an indispensable prerequisite for making treatment decisions on a rational rather than empirical basis. Modern dermatological phototherapy has just begun to profit from this knowledge, and it is very likely that this development will continue and provide dermatologists with improved phototherapeutic modalities and regimens for established and new indications. This chapter aims to provide an overview about current concepts of the mode of action of dermatological phototherapy. Special emphasis will be given to studies that have identified previously unrecognized immunosuppressive/anti-inflammatory principles of photo(chemo)therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bevilaqua PM, Edelson RL, Gasparro FP (1991) High performance liquid chromatography analysis of 8-methoxypsoralen monoadducts and crosslinks in lymphocytes and keratinocytes. J Invest Dermatol 97: 151 - 155

    Article  Google Scholar 

  2. Epstein JH (1968) UVL-induced stimulation of DNA synthesis in hairless mouse epidermis. J Invest Dermatol 52445 - 448

    Google Scholar 

  3. Everett M, Yeargers E, Sayre R, Olson R (1966) Penetration of epidermis by ultraviolet rays. Photochem Photobiol 5533 - 542

    Google Scholar 

  4. Fadok VA, Bratton DL, Konowal A, Freed PW, Wstcott JY, Henson PM (1998) Macrophages that have ingested apoptotic cells in vitro inhibit proinflammatory cytokine production through autocrine/paracrine mechanisms involving TGF-ß, PGE2, and PAF. J Clin Invest 101: 890 - 896

    Article  PubMed  CAS  Google Scholar 

  5. Godar DE (1996) Preprogrammed and programmed cell death mechanisms of apoptosis: UV-induced immediate and delayed apoptosis. Photochem Photobiol 63: 825 - 830

    Article  PubMed  CAS  Google Scholar 

  6. Godar DE (1999) UVA 1 radiation mediates singlet-oxygen and superoxide-anion production which trigger two different final apoptotic pathways: the S and P site of mitochondria. J Invest Dermatol 112: 3 - 12

    Article  PubMed  CAS  Google Scholar 

  7. Grether-Beck S, Olaizola-Horn S, Schmitt H, Grewe M, Jahnke A, Johnson JP, Briviba K, Sies H, Krutmann J (1996) Activation of transcription factor AP-2 mediates UVA radiation- and singlet oxygen-induced expression of the human intercellular adhesion molecule-1 gene. Proc Natl Acad Sci USA 9314586-14591

    Google Scholar 

  8. Grewe M, Trefzer U, Ballhorn A, Gyufko K, Henninger HP, Krutmann J (1993) Analysis of the mechanism of ultraviolet B radiation induced prostaglandin E2 synthesis by human epidermoid carcinoma cells. J Invest Dermatol 101: 528 - 531

    Article  PubMed  CAS  Google Scholar 

  9. Grewe M, Gyufko K, Schöpf E, Krutmann J (1994) Lesional expression of interferon-y in atopic eczema. Lancet 343: 25 - 26

    Article  PubMed  CAS  Google Scholar 

  10. Grewe M, Gyufko K, Krutmann J (1995) Interleukin-10 production by cultured human keratinocytes: regulation by ultraviolet B and ultraviolet Al radiation. J Invest Dermatol 104: 3 - 6

    Article  PubMed  CAS  Google Scholar 

  11. Grewe M, Duvic M, Aragane Y, Schwarz T, Ullrich SE, Krutmann J (1996) Lack of induction of IL-10 expression in human keratinocytes. Reply. J Invest Dermatol 106: 1330-1331

    Google Scholar 

  12. Grewe M, Klammer M, Stege H, Krutmann J (1996) Involvement of direct and indirect mechanisms in ultraviolet B radiation (UVBR)-induced inhibition of ICAM-1 expression in human antigen presenting cells. Abstract. J Invest Dermatol 106: 933

    Google Scholar 

  13. Grewe M, Gyufko K, Budnik A, Berneburg M, Ruzicka T, Krutmann J (1996) Interleukin-i receptors type I and type II are differentially regulated in human keratinocytes by ultraviolet B radiation. J Invest Dermatol 107: 865 - 871

    PubMed  CAS  Google Scholar 

  14. Grewe M, Bruijnzeel-Koomen CAFM, Schöpf E, Thepen T, Langeveld-Wildschuh AG, Ruzicka T, Krutmann J (1998) A role for Thi and The cells in the immunopathogenesis of atopic dermatitis. Immunol Today 19359 - 361

    Google Scholar 

  15. Khan IU, Boehm KD, Elmets CA (1993) Modulation of IFNy-induced HLA-DR expression on the human keratinocyte cell line SCC-13 by ultraviolet radiation. Photochem Photobiol 57: 103 - 106

    Article  Google Scholar 

  16. Kripke ML (1981) Immunologic mechanisms in UV radiation carcinogenesis. Adv Cancer Res 34: 69 - 106

    Article  PubMed  CAS  Google Scholar 

  17. Krueger JG, Wolfe JT, Nabeja RT, Vallat VP, Gilleaudeau P, Heftier NS, Austin LM, Gottlieb AB (1995) Successful ultraviolet B treatment of psoriasis is accompanied by a reversal of keratinocyte pathology and by selective depletion of intraepidermal T cells. J Exp Med 182: 2057 - 2068

    Article  PubMed  CAS  Google Scholar 

  18. Krutmann J, Koeck A, Schauer E, Parlow F, Moeller A, Kapp A, Foerster E, Schoepf E, Luger TA (1990) Tumor necrosis factor 13 and ultraviolet radiation are potent regulators of human keratinocyte ICAM-i expression. J Invest Dermatol 95: 127 - 131

    Article  PubMed  CAS  Google Scholar 

  19. Krutmann J, Khan IU, Wallis RS, Zhang F, Koehler KA, Rich EA, Ellner JJ, Elmets CA (1990) The cell membrane is a major locus for ultraviolet-B-induced alterations in accessory cells. J Clin Invest 85: 1529 - 1536

    Article  PubMed  CAS  Google Scholar 

  20. Krutmann J, Czech W, Parlow F, Trefzer U, Kapp A, Schoepf E, Luger TA (1992) Ultraviolet radiation effects on human keratinocyte ICAM-i expression: UV-induced inhibition of cytokine induced ICAM-i mRNA expression is transient, differentially restored for IFN-y versus TNFa, and followed by ICAM-i induction via a TNFa-like pathway. J Invest Dermatol 98: 923-928

    Google Scholar 

  21. Krutmann J, Czech W, Diepgen T, Niedner R, Kapp A, Schöpf E (1992) High-dose UVA1 therapy in the treatment of patients with atopic dermatitis. J Am Acad Dermatol 26: 225 - 23o

    Article  PubMed  CAS  Google Scholar 

  22. Krutmann J (1994) Regulatory interactions between epidermal cell adhesion molecules and cytokines. In: Luger TA, Schwarz T (eds) Epidermal growth factors and cytokines. Dekker, New York, pp 415 - 432

    Google Scholar 

  23. Krutmann J, Elmets CA (eds)(1995) Photoimmunology. Blackwell Science, Oxford

    Google Scholar 

  24. Krutmann J, Grewe M (1995) Involvement of cytokines, DNA damage, and reactive oxygen species in ultraviolet radiation-induced modulation of intercellular adhesion molecule-i expression. J Invest Dermatol 1o5:67S-7oS

    Google Scholar 

  25. Krutmann J (1996) Phototherapy for atopic dermatitis. Dermatol Therapy 1: 24 - 31

    Google Scholar 

  26. Krutmann J (1997) High-dose UVA-i therapy for inflammatory skin diseases. Dermatol Ther 4: 123 - 128

    Google Scholar 

  27. Krutmann J, Diepgen TL, Luger TA, Grabbe S, Meffert H, Sönnichsen N, Czech W, Kapp A, Stege H, Grewe M, Schöpf E (1998) High-dose UVA1 therapy for atopic dermatitis: results of a multicenter trial. J Am Acad Dermatol 38589 - 593

    Google Scholar 

  28. Krutmann J (1999) Therapeutic photomedicine: phototherapy. In: Freedberg IM, Eisen AB, Wolff K, Austen KF, Goldsmith LA, Katz SI, Fitzpatrick TB (eds) Fitzpatrick’s dermatology in general medicine, 5th edn. McGraw-Hill, New York, pp 2870 – 2879

    Google Scholar 

  29. Kulms D, Pöppelmann B, Yarosh D, Luger TA, Krutmann J, Schwarz T (1999) Nuclear and cell membrane effects contribute independently to the induction of apoptosis in human cells exposed to UVB radiation. Proc Natl Acad Sci USA 96: 7974 - 7979

    Article  PubMed  CAS  Google Scholar 

  30. Laskin JD, Lee E, Yurkow EJ, Laskin DL, Gallo MA (1985) A possible mechanism of psoralen phototoxicity not involving direct interaction with DNA. Proc Natl Acad Sci USA 82: 6158 - 6162

    Article  PubMed  CAS  Google Scholar 

  31. Lisby S, Ralfkier E, Rothlein R, Veijsgard GL (1989) Intercellular adhesion molecule-1 ( ICAM-i) expression correlated to inflammation. Br J Dermatol 120: 479-484

    Google Scholar 

  32. Luger TA, Schwarz T (1995) Effects of UV light on cytokines and neuroendocrine hormones. In: Krutmann J, Elmets CA (eds) Photoimmunology. Blackwell Science, Oxford, pp 55 - 76

    Google Scholar 

  33. Marks DI, Fox RM (1991) Mechanism of photochemotherapy induced apoptotic cell death in lymphoid cells. Biochem Cell Biol 69754 - 76o

    Google Scholar 

  34. McDonald PP, Fadok VA, Bratton D, Henson PM (1999) Transcriptional and translational regulation of inflammatory mediator production by endogenous TGF-(3 in macrophages that have ingested apoptotic cells. J Immunol 163: 6164 - 6172

    PubMed  CAS  Google Scholar 

  35. Morison WL (1993) Photochemotherapy. In: Lim HW, Soter NA (eds) Clinical photo-medicine. Dekker, New York, pp 327 - 346

    Google Scholar 

  36. Morita A, Grewe M, Ahrens C, Grether-Beck S, Ruzicka T, Krutmann J (1997a) Ultraviolet Al radiation effects on cytokine expression in human epidermoid carcinoma cells. Photochem Photobiol 65:63o - 635

    Google Scholar 

  37. Morita A, Werfel T, Stege H, Ahrens C, Karmann K, Grewe M, Grether-Beck S, Ruzicka T, Kapp A, Klotz O, Sies H, Krutmann J (1997b) Evidence that singlet oxygen-induced human T-helper cell apoptosis is the basic mechanism of ultraviolet-A radiation phototherapy. J Exp Med 186: 1763 - 1768

    Article  PubMed  CAS  Google Scholar 

  38. Morita A, Yamauchi Y, Yasuda Y, Tsuji T, Krutmann J (2000) Malignant T-cells are exquisitely sensitive to ultraviolet A-1 (UVA-1) radiation-induced apoptosis. J Invest Dermatol (in press)

    Google Scholar 

  39. Nishigori C, Yarosh DB, Ullrich SE, Vink AA, Bucana CD, Roza L, Kripke ML (1996) Evidence that DNA damage triggers interleukin to cytokine production in UV-irradiated murine keratinocytes. Proc Natl Acad Sci USA 93: 10354 - 10359

    Article  PubMed  CAS  Google Scholar 

  40. Norris DA, Lyons B, Middleton MH, Yohn JY, Kashihara-Sawami M (1990) Ultraviolet radiation can either suppress or induce expression of intercellular adhesion molecule-1 (ICAM-1) on the surface of cultured human keratinocytes. J Invest Dermatol 95: 132 - 138

    Article  PubMed  CAS  Google Scholar 

  41. Ozawa M, Ferenci K, Kikuchi T, Cardinale I, Austin LM, Coven TR, Burack LH, Krueger JG (1999) 312-nanometer ultraviolet B light (narrow band UVB) induces apoptosis of T cells within psoriatic lesions. J Exp Med 189: 711 - 718

    Google Scholar 

  42. Picot E, Meunier L, Picot-Deheze ML, Peyron JL, Meynadier J (1992) Treatment of psoriasis with a 311 nm UVB lamp. Br J Dermatol 127: 509 - 512

    Article  PubMed  CAS  Google Scholar 

  43. Plettenberg H, Stege H, Megahed M, Ruzicka T, Hosokawa Y, Tsuji T, Morita A, Krutmann J (1999) Ultraviolet Al (340-400 nm) phototherapy for cutaneous T-cell lymphoma. J Am Acad Dermatol 41: 47 - 50

    Article  PubMed  CAS  Google Scholar 

  44. Roza L, Stege H, Krutmann J (1996) Role of UV-induced DNA damage in phototherapy. In: Hönigsmann H, Joni G, Young AR (eds) The fundamental bases of phototherapy. OEMF spa, Milano, pp 145 - 152

    Google Scholar 

  45. Simon JC, Krutmann J, Elmets CA, Bergstresser PR, Cruz D (1992) Ultraviolet B irradiated antigen presenting cells display altered accessory signaling for T cell activation: relevance to immune responses initiated in the skin. J Invest Dermatol 98: 66S - 69S

    Article  PubMed  CAS  Google Scholar 

  46. Stege H, Schöpf E, Ruzicka T, Krutmann J (1996) High-dose-UVAi for urticaria pigmentosa. Lancet 347: 64

    Article  PubMed  CAS  Google Scholar 

  47. Stege H, Berneburg M, Humke S, Klammer M, Grewe M, Grether-Beck S, Dierks K, Goerz G, Ruzicka T, Krutmann J (1997) High-dose ultraviolet Al (UVA1) radiation therapy for localized scleroderma. J Am Acad Dermatol 36938 - 943

    Google Scholar 

  48. Stege H, Budde M, Kürten V, Ruzicka T, Krutmann J (1999) Induction of apoptosis in skin-infiltrating mast cells by high-dose ultraviolet A-1 radiation phototherapy in patients with urticaria pigmentosa. J Invest Dermatol 114: 791

    Google Scholar 

  49. Stege H, Roza L, Vink AA, Grewe M, Ruzicka T, Grether-Beck S, Krutmann J (2000) Enzyme plus light therapy to repair DNA damage in ultraviolet-B-irradiated human skin. Proc Natl Acad Sci USA 97x790-1795

    Google Scholar 

  50. Trefzer U, Brockhaus M, Lötscher H, Parlow F, Budnik A, Grewe M, Christoph H, Kapp A, Schöpf E, Luger TA, Krutmann J (1993) The human 55-kd tumor necrosis factor receptor is regulated in human keratinocytes by TNFa and by ultraviolet B radiation. J Clin Invest 92: 462 - 47o

    Article  PubMed  CAS  Google Scholar 

  51. Volc-Platzer B, Hönigsmann H (1995) Photoimmunology of PUVA and UVB therapy. In: Krutmann J, Elmets CA (eds) Photoimmunology. Blackwell Science, Oxford, pp 265 - 273

    Google Scholar 

  52. Wlascheck M, Heinen G, Poswig A, Schwarz A, Krieg T, Scharfetter-Kochanek K (1994) UVA-induced autocrine stimulation of fibroblasts derived collagenase/MMP-i by interrelated loops of interkeukin-i and interleukin-6. Photochem Photobiol 59:55o -556

    Google Scholar 

  53. Wlaschek M, Briviba K, Stricklin GP, Sies H, Scharfetter-Kochanek K (1995) Singlet oxygen may mediate the ultraviolet A-induced synthesis of interstitial collagenase. J Invest Dermatol 104: 194 - 198

    Article  PubMed  CAS  Google Scholar 

  54. Voll RE, Herrmann M, Roth EA, Stach C, Kalden JR, Girkontaite I (1997) Immunosuppressive effects of apoptotic cells. Nature 390: 33o

    Google Scholar 

  55. Yoo EK, Rook AH, Elenitas R, Gasparro FP, Vowels BR (1996) Apoptosis induction by ultraviolet light A and photochemotherapy in cutaneous T-cell lymphoma: Relevance to mechanism of therapeutic action. J Invest Dermatol 107: 235-242

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Krutmann, J., Morita, A., Elmets, C.A. (2001). Mechanisms of Photo(chemo)therapy. In: Krutmann, J., Hönigsmann, H., Elmets, C.A., Bergstresser, P.R. (eds) Dermatological Phototherapy and Photodiagnostic Methods. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-04511-4_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-04511-4_2

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-04513-8

  • Online ISBN: 978-3-662-04511-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics