Photoimmunology of Lupus Erythematosus and Dermatomyositis: A Speculative Review

Sontheimer, Richard D.

doi:10.1111/j.1751-1097.1996.tb05660.x

Cited by 75 publications

(45 citation statements)

References 141 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In summary, although we cannot exclude the role of these limitations and alternative possibilities in our results, the very strong correlations noted in this study of many centers in areas with a wide range of UV exposure, and the biologic relevance of UV radiation in the possible induction and exacerbation of DM and autoantibody formation (12,34), suggest it is unlikely that such limitations or alternative explanations alone could account for the present findings.…”

Section: Discussioncontrasting

confidence: 55%

“…UV radiation may also alter the expression of, cellular location of, or immune responses to autoantigens (9,10). Although little is known about the role of UV radiation in the development of autoimmune diseases, it has been anecdotally associated with the development of some disorders (3,11) and is known to increase the clinical expression of conditions characterized by photosensitive rashes, such as lupus and dermatomyositis (DM) (12). The mechanisms by which it has these effects, however, remain poorly understood.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Global surface ultraviolet radiation intensity may modulate the clinical and immunologic expression of autoimmune muscle disease

Okada

Targoff

Wesley

et al. 2003

Arthritis & Rheumatism

166

View full text Add to dashboard Cite

Objective. To determine if geoclimatic factors may influence the nature and frequency of dermatomyositis (DM), polymyositis, and associated autoantibodies around the world.Methods. We assessed, in the first global evaluation of these conditions, the relationship between 13 geoclimatic variables that may modulate disease and the relative proportion of DM and its associated autoantibody anti-Mi-2, directed against an SNF2-superfamily helicase associated with the nucleosome remodeling and histone acetylation and deacetylation complex, in a global myositis population. Altogether, 919 consecutive patients from populations at 15 locations were studied.Results. Univariate and multivariate analyses demonstrated that of the variables evaluated, surface ultraviolet (UV) radiation intensity (irradiance) most strongly contributed to the relative proportion of DM and was strongly related to the proportion of anti-Mi-2 autoantibodies (weighted r ‫؍‬ 0.939, P < 4 ؋ 10 -7 and weighted r ‫؍‬ 0.69, P ‫؍‬ 0.02, respectively). Published ethnogeographic immunogenetic allele frequencies imply that the striking differences in the proportion of DM-and DM-specific autoantibodies observed around the world are not the result of inherent global variations in known genetic risk factors.Conclusion. These data suggest that UV radiation exposure may modulate the clinical and immunologic expression of an autoimmune disease in different populations around the world.

show abstract

Section: Discussioncontrasting

confidence: 55%

mentioning

confidence: 99%

Global surface ultraviolet radiation intensity may modulate the clinical and immunologic expression of autoimmune muscle disease

Okada

Targoff

Wesley

et al. 2003

Arthritis & Rheumatism

166

View full text Add to dashboard Cite

show abstract

“…This might be due to the higher sensitivity of patients with CLE to exogenous factors, such as UV light. The mechanisms of photosensitivity and the induction of skin lesions after solar or UV irradiation as an important element in the pathogenesis of CLE have been extensively studied (12,23,27,50,51). It has been proposed that UV light exposure might cause exacerbation of local and systemic autoimmunity by inducing changes in the expression and binding of keratinocyte autoantigens (17,52,53).…”

Section: Discussionmentioning

confidence: 99%

Accumulation of apoptotic cells in the epidermis of patients with cutaneous lupus erythematosus after ultraviolet irradiation

Kuhn

Herrmann

Kleber

et al. 2006

Arthritis & Rheumatism

191

124

View full text Add to dashboard Cite

Objective. To examine whether apoptosis contributes to the pathogenesis of skin lesions in patients with cutaneous lupus erythematosus (CLE) after ultraviolet (UV) irradiation.Methods. In situ nick translation and TUNEL were performed to detect apoptosis in 85 skin biopsy specimens from patients with various subtypes of CLE. Specimens from normal healthy donors and patients with polymorphous light eruption were used as controls. In addition to assessment of primary lesions, provocative phototesting was carried out to investigate events occurring secondary to UV irradiation during a very early stage of lesion formation.Results. A significant increase in apoptotic nuclei was found in the upper epidermal layer of primary and UV light-induced skin lesions of CLE patients compared with controls. In tissue sections obtained from control subjects at 24 hours after a single exposure to UV light, a slight increase in the count of epidermal apoptotic nuclei was present as compared with skin tissue from CLE patients obtained under the same conditions before lesion formation. In sections obtained from controls at 72 hours after irradiation, a significant decrease in the apoptotic nuclei count was observed, consistent with a proper clearance of apoptotic cells in the period between 24 and 72 hours after irradiation. In striking contrast, the number of apoptotic nuclei increased significantly within this period in tissue sections from patients with CLE.Conclusion. These data support the hypothesis that apoptotic cells accumulate in the skin of patients with CLE after UV irradiation, as a result of impaired or delayed clearance. The nonengulfed cells may undergo secondary necrosis and release proinflammatory compounds and potential autoantigens, which may contribute to the inflammatory micromilieu that leads to formation of skin lesions in this disease.

show abstract

“…Reapplication of sunscreen should occur every 3-4 h. Studies have demonstrated that both UVB and UVA are involved in the elicitation of certain forms of photosensitive cutaneous lupus erythematosus, and the same concept is thought to apply to DM, although studies are lacking [16]. One study did find that DM patients, similar to those with lupus erythematosus, showed a significantly reduced minimal erythema dose to UVB irradiation compared with healthy individuals [17].…”

Section: Photoprotectionmentioning

confidence: 98%

Dermatomyositis: current and future treatments

Vleugels

Callen

2009

Expert Review of Dermatology

View full text Add to dashboard Cite

Photoimmunology of Lupus Erythematosus and Dermatomyositis: A Speculative Review

Cited by 75 publications

References 141 publications

Global surface ultraviolet radiation intensity may modulate the clinical and immunologic expression of autoimmune muscle disease

Global surface ultraviolet radiation intensity may modulate the clinical and immunologic expression of autoimmune muscle disease

Accumulation of apoptotic cells in the epidermis of patients with cutaneous lupus erythematosus after ultraviolet irradiation

Dermatomyositis: current and future treatments

Contact Info

Product

Resources

About