Influence of Serum Vitamin D Level in the Response of Actinic Keratosis to Photodynamic Therapy with Methylaminolevulinate

Abstract

In mouse models of squamous cell carcinoma, pre-treatment with calcitriol prior to photodynamic therapy with aminolevulinic acid (ALA) enhances tumor cell death. We have evaluated the association between vitamin D status and the response of actinic keratoses to photodynamic therapy with methylaminolevulinate. Twenty-five patients with actinic keratoses on the head received one session of photodynamic therapy with methylaminolevulinate. Biopsies were taken at baseline and six weeks after treatment. Immuno-histochemical staining was performed for VDR, P53, Ki67 and β-catenin. Basal serum 25(OH)D levels were determined. Cases with a positive histological response to treatment had significantly higher serum 25(OH)D levels (26.96 (SD 7.49) ngr/mL) than those without response (18.60 (SE 7.49) ngr/mL) (p = 0.05). Patients with a complete clinical response displayed lower basal VDR expression (35.71% (SD 19.88)) than partial responders (62.78% (SD 16.735)), (p = 0.002). Our results support a relationship between vitamin D status and the response of actinic keratoses to photodynamic therapy with methylaminolevulinate.

Influence of serum vitamin D level in the response of actinic keratosis to ingenol mebutate

“…In our study, serum 25(OH) D levels and subsequently PTH were the only variables significantly associated with the response of AK to IM. Our group showed similar association with the response of AK to PDT 19 . The mechanisms through which VD may influence the response of AK to IM are unknown; however, VD has proved antiproliferative and differentiation‐promoting effects on keratinocytes through up‐regulation of p53 20 or through the intervention of the immune system 21 .…”

“…Our group showed similar association with the response of AK to PDT. 19 The mechanisms through which VD may influence the response of AK to IM are unknown; however, VD has proved antiproliferative and differentiation-promoting effects on keratinocytes through up-regulation of p53 20 or through the intervention of the immune system. 21 We suggest 25(OH)D serum level be considered a biochemical biomarker of response of AK to IM that should be checked before treating to enhance this response.…”

“…22 In line with this study, our research group verified that MAL-PDT might be able to increase keratinocytic VDR expression in AK. 19 In consequence, either IM or PDT may improve dysplastic keratinocyte sensitivity to serum VD, thus supplying other way through which PDT and IM interact with VD triggering its antioncogenic effects on keratinocytic neoplasms such as AK.…”

Vitamin D and Vitamin D Analogs as Adjuncts to Field Therapy Treatments for Actinic Keratoses: Current Research and Future Approaches

“…These important preclinical studies have not as yet been fully translated into human studies. However, the addition of topical calcipotriol has been shown to significantly improve AK clearance [ 117 ] compared to MAL or 5-ALA alone [ 118 ]. Patients also tolerated PDT with vitamin D analogs well [ 119 ].…”

Anti-aging and anti-carcinogenic effects of 1α, 25-dihyroxyvitamin D3 on skin

“…Vitamin D (VD) is a prohormone involved in a broad range of functions in the organism that has been shown to exert protective effects against several types of cancer [1] and skin aging [2] , among others. In the human epidermis, exposure to sunlight -ultraviolet B radiation (UVB, 280-315 nm) -promotes the transformation of 7-dehydrocholesterol to previtamin D 3 , which undergoes thermal isomerization into cholecalciferol, also known as vitamin D 3 [Figure 1].…”