Janssens A S, Pavel S, Out-Luiting J J, Willemze R, de Gruijl F R
Department of Dermatology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, the Netherlands.
Br J Dermatol. 2005 Jun;152(6):1268-74. doi: 10.1111/j.1365-2133.2005.06690.x.
Ultraviolet (UV) B hardening has been widely used as a prophylactic treatment in patients with polymorphic light eruption (PLE). Recent investigations have shown that in patients with PLE Langerhans cells (LCs) and neutrophils display less migration from and to the epidermis after an intense UVB irradiation compared with controls.
To investigate the effect of UVB hardening of patients with PLE on their cell migratory responses after intense UVB exposure.
Thirteen patients with PLE were recruited and UVB provocation testing was performed before entering the study. Among these patients, seven developed PLE rash upon UVB provocation ('UVB-P') and the other six did not respond ('UVB-NP'). Eleven age/sex-matched controls were included. Buttock skin of all included individuals was exposed to 6 minimal erythema doses (MED) of UVB (TL-12 lamps). Biopsies were taken after 24 h and 48 h, together with one control biopsy of unirradiated skin. Patients received total-body UVB hardening therapy consisting of 12 irradiations, on average rising from 10% to 140% of the initial MED in 6 weeks. Subsequently, MEDs were reassessed and biopsies were taken from newly irradiated (6 MED UVB) and unirradiated buttock skin. Skin sections were stained for the presence of LCs, macrophages and neutrophils. The cross-sectional area (in percentage) of positively stained cells within the epidermis was assessed from patients before and after hardening and compared with controls.
Before therapy, epidermal LC depletion and neutrophil influx at 48 h after 6 MED were most significantly reduced in 'UVB-P' patients (P = 0.025 and P =0.006, respectively) when compared with controls. 'UVB-NP' patients did not differ significantly from controls. After therapy, there were no longer any significant differences in the cell numbers among these three groups.
UVB hardening significantly improves UV-induced cell migratory responses in patients with PLE. UVB provokability of PLE appears to be most strongly linked to reduced UVB-induced trafficking of LCs and neutrophils, and 'UVB-P' patients show normalization of these responses after UVB hardening.
紫外线（UV）B 光硬化已被广泛用作多形性日光疹（PLE）患者的预防性治疗方法。最近的研究表明，与对照组相比，PLE 患者的朗格汉斯细胞（LCs）和中性粒细胞在高强度 UVB 照射后从表皮迁移至表皮外以及从表皮外迁移至表皮内的情况较少。
研究 PLE 患者的 UVB 光硬化对其在高强度 UVB 照射后的细胞迁移反应的影响。
招募了 13 例 PLE 患者，在进入研究前进行了 UVB 激发试验。在这些患者中，7 例在 UVB 激发后出现了 PLE 皮疹（“UVB-P”），另外 6 例无反应（“UVB-NP”）。纳入了 11 名年龄/性别匹配的对照组。所有纳入个体的臀部皮肤接受 6 个最小红斑量（MED）的 UVB（TL-12 灯）照射。在 24 小时和 48 小时后进行活检，并取一份未照射皮肤的对照活检样本。患者接受全身 UVB 光硬化治疗，共照射 12 次，平均在 6 周内从初始 MED 的 10%升至 140%。随后，重新评估 MED，并从新照射的（6 个 MED 的 UVB）和未照射的臀部皮肤取活检样本。对皮肤切片进行染色以检测 LCs、巨噬细胞和中性粒细胞的存在。评估硬化前后患者表皮内阳性染色细胞的横截面积（百分比），并与对照组进行比较。
治疗前，与对照组相比，“UVB-P”患者在 6 个 MED 照射后 48 小时的表皮 LC 耗竭和中性粒细胞流入减少最为显著（分别为 P = 0.025 和 P = 0.006）。“UVB-NP”患者与对照组无显著差异。治疗后，这三组之间的细胞数量不再有任何显著差异。
UVB 光硬化可显著改善 PLE 患者紫外线诱导的细胞迁移反应。PLE 的 UVB 激发性似乎与 UVB 诱导的 LCs 和中性粒细胞运输减少最密切相关，并且“UVB-P”患者在 UVB 光硬化后这些反应恢复正常。
