A review of studies on the effects of ultraviolet irradiation on the resistance to infections: evidence from rodent infection models and verification by experimental and observational human studies

Termorshuizen, Fabian; Garssen, Johan; Norval, Mary; Koulu, Leena; Laihia, Jarmo K.; Leino, Lasse; Jansén, Christer T.; Gruijl, Frank de; Gibbs, Neil K.; Simone, Clara De; Loveren, Henk Van

doi:10.1016/s1567-5769(01)00178-3

Cited by 38 publications

(24 citation statements)

References 53 publications

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“…Exposure to seasonally variable external factors during the maturation of the immune system is suspected to be an inducing factor for IBD, with the immune response varying in different seasons. For example, the immune function decreases during the winter, when there is a lower production of proinflammatory cytokines and an increased TH1/TH2 ratio [30,31], which differs from those found during the summer and spring [32,33]. The possible factors modulating the immune response in different seasons and at different temperatures has been studied by some groups.…”

Section: Discussionmentioning

confidence: 99%

Seasonality in Flares and Months of Births of Patients with Ulcerative Colitis in a Chinese Population

Bai

Guo

Shen³

et al. 2008

Dig Dis Sci

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Background and Aims Reports on seasonality in flares or months of births of inflammatory bowel disease patients have been inconsistent, but little data are available in a Chinese population. The aim of this study was to determine whether symptom flares and births of ulcerative colitis (UC) patients follow a seasonal pattern. Methods Patients with a diagnosis of UC established between January 1990 and December 2007 were investigated according to the occurrence of flares of symptoms and months of births. The expected flares or births were calculated on a monthly basis over the study period, taking into consideration the difference in the number of days in the month in each year. Results A total of 409 UC patients were included in the study, and 1030 flares of symptoms were determined. The peak number of flares occurred during the spring and summer, especially in June, while the nadir occurred in the winter, especially in January (v 2 (11 df) = 32.74304, P \ 0.005). The symptom flares also occurred more frequently in the spring-summer period than in the autumnwinter period (v 2 (3 df) = 22.1269, P \ 0.001). There was no statistical difference in birth distribution on a monthly or seasonal (spring, summer, autumn, winter) basis. However, the births of UC patients occurred more frequently in the autumn-winter period than in the spring-summer period when the data were merged into these two seasonal components (v 2 (1 df) = 5.255607, P \ 0.025). Conclusions The data indicate that the symptom flares of UC occurred more frequently in the spring and summer, while the births of UC patients occurred more often in the autumn and winter. Environmental recurring factors may be associated with the symptom flares of UC, and these factors during pregnancy or postpartum may be associated with susceptibility to UC later in life.

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Section: Discussionmentioning

confidence: 99%

Seasonality in Flares and Months of Births of Patients with Ulcerative Colitis in a Chinese Population

Bai

Guo

Shen³

et al. 2008

Dig Dis Sci

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“…Various human studies indicate that acute erythemagenic doses of UVR may adversely influence immune responses that follow the first contact with an antigen, either at the site of irradiation or at a distant non-irradiated skin site (Cooper et al, 1992;Duthie et al, 1999;Kelly et al, 2000;Termorshuizen et al, 2002). In addition, induction of antigen-specific tolerance following erythemagenic doses of UVR was demonstrated in humans (Cooper et al, 1992).…”

Section: Discussionmentioning

confidence: 99%

Sunlight Exposure and (Sero)Prevalence of Epidermodysplasia Verruciformis-Associated Human Papillomavirus

Termorshuizen

Feltkamp

Struijk

et al. 2004

Journal of Investigative Dermatology

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Ultraviolet radiation (UVR) is associated with an increased risk of squamous cell carcinoma (SCC), which is in part due to immunomodulation. In addition, human papilloma virus (HPV), especially the epidermodysplasia verruciformis (EV)-associated types, may be involved. In view of the capacity of UVR to impair host resistance to infections, we investigated the relationship between solar exposure and the prevalence of cutaneous HPV. In a case-control study on skin cancer (320 controls and 156 patients) a lifetime-retrospective questionnaire on sun exposure was administered. The presence of DNA of HPV types 5, 8, 15, 20, 24, and 38 in plucked eyebrow hair and type-specific seroreactivity were assessed and analyzed in relation to estimated exposure. Sunburn episodes in the past, especially at age 13-20 y, appeared to be associated with an enhanced risk of EV-HPV DNA positivity. In contrast, a higher lifetime sun exposure was associated with a lower risk of HPV infection. These results indicate that UVR at erythematogenic doses increases the risk of EV-HPV infection, possibly due to impaired host resistance to HPV and/or a direct effect of UVR on viral replication. The favorable association between lifetime sun exposure and HPV prevalence, however, underscores the enigmatic role of HPV in skin carcinogenesis.

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“…One exception might be herpes simplex, which is well known to exacerbate upon UVR exposure in susceptible persons (Norval, 2006). However, bacterial superinfections even after extensive natural or artificial UVR exposure are extremely rare, and impetiginization is not at all a problem for patients with sunburn (Termorshuizen et al, 2002). In contrast, impetiginized atopic skin can improve upon UVR exposure without antibiotic or antiseptic treatment (Silva et al, 2006).…”

Section: Uvr-induced Immunosuppression and Microbial Infectionsmentioning

confidence: 99%

The Dark and the Sunny Sides of UVR-Induced Immunosuppression: Photoimmunology Revisited

Schwarz

2010

Journal of Investigative Dermatology

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Immunosuppression induced by solar UVR is regarded as one of the major negative impacts of sunlight on human health. Despite this immunosuppression, bacterial superinfections are rarely observed after UVR exposure. A possible explanation for this seeming paradox may be that although it suppresses T-cell-mediated immune reactions, UVR induces the release of cutaneous antimicrobial peptides--an essential component of the innate immune system. The "sunshine vitamin," vitamin D, also appears to be involved, as UVR suppresses the adaptive but induces the innate immune response. T cells in the skin are the critical cellular mediators of the vast majority of inflammatory dermatoses, and thus probably more harmful than beneficial. Hence, it is tempting to speculate that a certain and constant level of immunosuppression by physiological UVR doses might be beneficial, taming overshooting immune reactions. At the same time, by inducing antimicrobial peptides, these low UVR doses may foster the antibacterial defense. Thus, suppression of the adaptive and induction of the innate immune system by UVR may be components of a physiological protection process. These insights might have effect on the future recommendations for daily sun protection.

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A review of studies on the effects of ultraviolet irradiation on the resistance to infections: evidence from rodent infection models and verification by experimental and observational human studies

Cited by 38 publications

References 53 publications

Seasonality in Flares and Months of Births of Patients with Ulcerative Colitis in a Chinese Population

Seasonality in Flares and Months of Births of Patients with Ulcerative Colitis in a Chinese Population

Sunlight Exposure and (Sero)Prevalence of Epidermodysplasia Verruciformis-Associated Human Papillomavirus

The Dark and the Sunny Sides of UVR-Induced Immunosuppression: Photoimmunology Revisited

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