Ala-Houhala Meri J, Karppinen Toni, Vähävihu Katja, Kautiainen Hannu, Dombrowski Yvonne, Snellman Erna, Schauber Jürgen, Reunala Timo
Department of Dermatology, Tampere University Hospital, FIN-33521 Tampere, Finland.
Acta Derm Venereol. 2014 Mar;94(2):146-51. doi: 10.2340/00015555-1685.
A course of treatment with narrow-band ultraviolet B (NB-UVB) improves psoriasis and increases serum 25-hydroxyvitamin D (25(OH)D). In this study 12 patients with psoriasis who were supplemented with oral cholecalciferol, 20 µg daily, were given a course of NB-UVB and their response measured. At baseline, serum 25(OH)D was 74.14 ± 22.9 nmol/l. At the 9th exposure to NB-UVB 25(OH)D had increased by 13.2 nmol/l (95% confidence interval (95% CI) 7.2-18.4) and at the 18th exposure by 49.4 nmol/l (95% CI 35.9-64.6) above baseline. Psoriasis Area Severity Index score improved from 8.7 ± 3.5 to 4.5 ± 2.0 (p < 0.001). At baseline, psoriasis lesions showed low vitamin D metabolizing enzyme (CYP27A1, CYP27B1) and high human β-defensin-2 mRNA expression levels compared with those of the healthy subjects. In conclusion, NB-UVB treatment significantly increases serum 25(OH)D in patients with psoriasis who are taking oral vitamin D supplementation, and the concentrations remain far from the toxicity level. Healing psoriasis lesions show similar mRNA expression of vitamin D metabolizing enzymes, but higher antimicrobial peptide levels than NB-UVB-treated skin in healthy subjects.
窄谱中波紫外线（NB - UVB）治疗疗程可改善银屑病并提高血清25 - 羟维生素D（25(OH)D）水平。在本研究中，对12例每日口服20μg胆钙化醇补充剂的银屑病患者进行了NB - UVB治疗疗程，并测量了他们的反应。基线时，血清25(OH)D为74.14±22.9nmol/L。在第9次接受NB - UVB照射时，25(OH)D较基线水平升高了13.2nmol/L（95%置信区间（95%CI）7.2 - 18.4），在第18次照射时升高了49.4nmol/L（95%CI 35.9 - 64.6）。银屑病面积和严重程度指数评分从8.7±3.5改善至4.5±2.0（p＜0.001）。与健康受试者相比，基线时银屑病皮损显示维生素D代谢酶（CYP27A1、CYP27B1）的mRNA表达水平较低，而人β - 防御素2的mRNA表达水平较高。总之，NB - UVB治疗显著提高了口服维生素D补充剂的银屑病患者的血清25(OH)D水平，且浓度仍远低于毒性水平。愈合的银屑病皮损显示维生素D代谢酶的mRNA表达类似，但抗菌肽水平高于健康受试者中接受NB - UVB治疗的皮肤。
