Department of Dermatology, Comprehensive Cancer Center Cancer Chemoprevention Program, University of Alabama at Birmingham, Birmingham, Alabama.
VA Medical Center, Birmingham, Alabama.
Endocrinology. 2018 May 1;159(5):1992-2007. doi: 10.1210/en.2017-03230.
The skin, a self-regulating protective barrier organ, is empowered with sensory and computing capabilities to counteract the environmental stressors to maintain and restore disrupted cutaneous homeostasis. These complex functions are coordinated by a cutaneous neuro-endocrine system that also communicates in a bidirectional fashion with the central nervous, endocrine, and immune systems, all acting in concert to control body homeostasis. Although UV energy has played an important role in the origin and evolution of life, UV absorption by the skin not only triggers mechanisms that defend skin integrity and regulate global homeostasis but also induces skin pathology (e.g., cancer, aging, autoimmune responses). These effects are secondary to the transduction of UV electromagnetic energy into chemical, hormonal, and neural signals, defined by the nature of the chromophores and tissue compartments receiving specific UV wavelength. UV radiation can upregulate local neuroendocrine axes, with UVB being markedly more efficient than UVA. The locally induced cytokines, corticotropin-releasing hormone, urocortins, proopiomelanocortin-peptides, enkephalins, or others can be released into circulation to exert systemic effects, including activation of the central hypothalamic-pituitary-adrenal axis, opioidogenic effects, and immunosuppression, independent of vitamin D synthesis. Similar effects are seen after exposure of the eyes and skin to UV, through which UVB activates hypothalamic paraventricular and arcuate nuclei and exerts very rapid stimulatory effects on the brain. Thus, UV touches the brain and central neuroendocrine system to reset body homeostasis. This invites multiple therapeutic applications of UV radiation, for example, in the management of autoimmune and mood disorders, addiction, and obesity.
皮肤是一种自我调节的保护屏障器官,具有感觉和计算功能,可以对抗环境应激源,维持和恢复受损的皮肤内稳态。这些复杂的功能由皮肤神经内分泌系统协调,该系统还以双向方式与中枢神经系统、内分泌系统和免疫系统进行通信,所有这些系统都协同作用以控制身体内稳态。尽管紫外线能量在生命的起源和进化中发挥了重要作用,但皮肤对紫外线的吸收不仅会引发保护皮肤完整性和调节整体内稳态的机制,还会诱导皮肤病理学(例如癌症、衰老、自身免疫反应)。这些效应是紫外线电磁能量转化为化学、激素和神经信号的结果,由吸收特定紫外线波长的发色团和组织隔室的性质定义。紫外线辐射可以上调局部神经内分泌轴,其中 UVB 比 UVA 效率更高。局部诱导的细胞因子、促肾上腺皮质释放激素、尿皮质素、促黑激素原肽、内啡肽或其他物质可以释放到循环中,发挥全身效应,包括激活中枢下丘脑-垂体-肾上腺轴、阿片样作用和免疫抑制作用,而与维生素 D 合成无关。眼睛和皮肤暴露于紫外线时也会出现类似的效应,其中 UVB 激活下丘脑室旁核和弓状核,并对大脑产生非常迅速的刺激作用。因此,紫外线触及大脑和中枢神经内分泌系统以重置身体内稳态。这为紫外线辐射的多种治疗应用开辟了道路,例如在管理自身免疫和情绪障碍、成瘾和肥胖方面。