Narrowband Ultraviolet B Exposures Maintain Vitamin D Levels During Winter : A Randomized Controlled Trial

Exposure to solar ultraviolet B radiation during the summer months is the main source of vitamin D (VD) for people living in northern latitudes. The aim of this study was to determine whether artificial narrowband ultraviolet B (NB-UVB) whole-body exposures could maintain VD levels in winter. The intervention group received 2 standard erythema doses (SEDs) of NB-UVB exposures every second week from October 2013 to April 2014. In October 2013 serum 25-hydroxyvitamin D concentrations were 78.3 nmol/l in the intervention group (n=16) and 76.8 nmol/l in the control group (n=18). By April 2014 the concentrations had increased by 11.7 nmol/l (p=0.029) in the intervention group and decreased by 11.1 nmol/l (p=0.022) in the control group. The baseline VD concentration showed a negative correlation (p=0.012) with body mass index (BMI). In conclusion, a suberythemal NB-UVB dose of 2 SED every second week maintains and even increases serum VD concentrations during the winter. A high BMI seems to predispose subjects to low levels of VD.Peer reviewe

The effect of vernal solar UV radiation on serum 25-hydroxyvitamin D concentration depends on the baseline level : observations from a high latitude in Finland

Humans obtain vitamin D from conversion of 7-dehydrocholesterol in the skin by ultraviolet B (UVB) radiation or from dietary sources. As the radiation level is insufficient in winter, vitamin D deficiency is common at higher latitudes. We assessed whether vernal solar UVB radiation at latitudes 61 degrees N and 67 degrees N in Finland has an impact on serum 25-hydroxyvitamin D [S-25(OH) D] concentrations. Twenty-seven healthy volunteers participated in outdoor activities in snow-covered terrain for 4-10 days in March or April, with their face and hands sun-exposed. The personal UVB doses and S-25(OH) D levels were monitored. A mean UVB dose of 11.8 standard erythema doses (SED) was received during an average of 12.3 outdoor hours. The mean S-25(OH) D concentration in subjects with a baseline concentration below 90.0 nmol/L (n=13) increased significantly, by 6.0 nmol/L from an initial mean of 62.4 nmol/L (pPeer reviewe

Narrow-band Ultraviolet B Treatment Boosts Serum 25-hydroxyvitamin D in Patients with Psoriasis on Oral Vitamin D Supplementation

Peer reviewe

Selvitys lasten kasvuhormonihoidosta TAYS:ssa vuosina 1985 - 1999 - hoidon indikaatiot ja saavutettu kasvun nopeutuminen.

Syventävä työ ei kirjastoss

Selvitys lasten kasvuhormonihoidosta TAYS:ssa vuosina 1985 - 1999 - hoidon indikaatiot ja saavutettu kasvun nopeutuminen.

Syventävä työ ei kirjastoss

Kapeakaistainen Ultravioletti B Valotus Parantaa D-vitamiinitasoa - Tutkimuksia Ihotauti- ja Hemodialyysipotilailla sekä Terveillä Henkilöillä

Tarkistettava väitöskirjatyö tutkii mahdollisuutta parantaa D-vitamiinitasoa ihotautien hoidossa käytettävällä valohoidolla, kapeakaistaisella UVB-valotuksella (aallonpituus 311 ± 2 nm). Väitöskirjan ensimmäisessä osatyössä tutkittiin kapeakaistaisen UVB-valotuksen vaikutusta atooppista ihottumaa ja psoriaasia sairastavien ihottumapotilaiden D-vitamiinitasoihin. Toisessa osatyössä verrattiin kapeakaistaisen UVB-valotuksen ja suun kautta otettavan D-vitamiinilisän tehoa D-vitamiinitasapainoon terveillä henkilöillä talvella. Muissa osatöissä tutkittiin kapeakaistaisen UVB-valotuksen vaikutusta D-vitamiinitasoihin dialyysihoidossa käyvillä munuais-potilailla, joista osalla oli ja osalla ei ollut käytössä suun kautta otettava D-vitamiinilisä. Väitöskirjan osatöissä todettiin, että kapeakaistainen UVB-valotus on nopea ja tehokas tapa parantaa D-vitamiinitasapainoa talvella ihotauti- ja dialyysipotilailla sekä terveillä henkilöillä. Kapeakaistaista UVB-valotusta voidaan käyttää myös munuaispotilailla, joilla on matalat D-vitamiinitasot käytössä olevasta suun kautta otettavasta D-vitamiinilisästä huolimatta. Teho kestää parin kuukauden ajan. Tutkimuksissa todettiin, että D-vitamiinin muodostusta tapahtuu maksan ja munuaisten lisäksi ihossa kapeakaistaisen UVB-valotuksen vaikutuksesta.Narrow-band ultraviolet B (NB-UVB) phototherapy is used to treat dermatological diseases such as psoriasis and atopic dermatitis. Some previous studies have suggested that it also increases serum 25-hydroxyvitamin D (25(OH)D) concentrations. On the other hand, most patients with chronic kidney disease (CKD) requiring dialysis are known to have insufficient vitamin D. We therefore conducted trials to assess how short NB-UVB courses could affect serum 25(OH)D concentrations in dermatological and haemodialysis patients in winter, when little UVB from the sun is available for vitamin D synthesis. In addition, we compared the effects of an NB-UVB course and oral vitamin D supplementation on serum 25(OH)D concentrations in healthy subjects. In the first trial 89% of the patients with psoriasis, 94% of those with atopic dermatitis and 53% of the healthy subjects were found to have baseline vitamin D insufficiency (serum 25(OH)D <50 nmol/L). A course of 15 whole body NB-UVB exposures significantly increased serum 25(OH)D (p <0.001), by 59.9 nmol/L in the psoriasis patients, 68.2 nmol/L in the atopic dermatitis patients and 90.7 nmol/L in the healthy subjects. PASI (psoriasis area and severity index) and SCORAD (severity scoring of atopic dermatitis) improved significantly (p <0.001), but no correlation with the increase in serum 25(OH)D was found. Expression of antimicrobial peptides (AMPs), cathelicidin and human β-defensin 2 (HBD2) was high in the psoriasis skin lesions. After 6 NB-UVB treatments cathelicidin had increased further, while HBD2 expression had decreased. NB-UVB caused a marked but non-significant decrease in the cytokines interleukin (IL)-1β and IL-17 in the psoriasis lesions. It was concluded that, in addition to a significant improvement of psoriasis and atopic dermatitis, NB-UVB treatment effectively corrects vitamin D insufficiency. It also increases cathelicidin and lowers HBD2 levels in healing psoriasis and atopic dermatitis skin lesions. This effect may be mediated by the improved vitamin D balance and the local cytokine network. In the second trial healthy adult hospital employees and medical students having serum 25(OH)D below 75 nmol/L were randomly given either a course of 12 whole body NB-UVB exposures or 20 µg of oral cholecalciferol daily for 4 weeks. The baseline serum 25(OH)D concentrations were similar in both groups: 52.9 nmol/L in the 33 NB-UVB-treated subjects and 53.5 nmol/L in the 30 treated with oral cholecalciferol. The mean increase in serum 25(OH)D was 41.0 nmol/L in the NB-UVB group and 20.2 nmol/L in the cholecalciferol group, the difference being significant at 2 weeks (p = 0.033) and at 4 weeks (p <0.001). Two months after the treatments the 25(OH)D concentrations had decreased in both groups but were still clearly higher than the baseline values. It was concluded that 12 NB-UVB exposures given over 4 weeks increase the serum 25(OH)D concentration significantly more than do daily doses of 20 µg oral cholecalciferol. A short, low-dose NB-UVB course is therefore an effective way of improving the vitamin D balance in winter, and the response is still evident 2 months after the course. In the third trial fifteen haemodialysis patients and twelve healthy subjects received nine upper body NB-UVB exposures. Mean serum 25(OH)D levels before NB-UVB were 32.5 nmol/L in the dialysis patients and 60.2 nmol/L in the healthy subjects (p <0.001). After eight NB-UVB exposures serum 25(OH)D had increased by 13.8 nmol/L (43%; p <0.001) in the dialysis patients and 1,25-dihydroxyvitamin D (1,25(OH)2D) by 3.3 pmol/L (27%; p = 0.002). Serum 25(OH)D in the dialysis patients was still 10% higher two months after NB-UVB exposures than initially. The mRNA expression level of CYP27B1, an enzyme needed for the final hydroxylation of vitamin D to its active metabolite, was examined in skin biopsy specimens and was found to have increased after NB-UVB exposures relative to the level in non-treated healthy subjects (p = 0.04). It was concluded that a short course of NB-UVB exposures significantly increases serum 25(OH)D and 1,25(OH)2D in dialysis patients, but the effect is short-lasting suggesting that patients need cyclic NB-UVB exposures to maintain their improved vitamin D concentrations. In the fourth trial fourteen haemodialysis patients and fifteen healthy subjects receiving oral cholecalciferol supplements of 20 µg daily were given nine whole body NB-UVB exposures. Given baseline serum 25(OH)D concentrations of 57.6 nmol/L in the dialysis patients and 74.3 nmol/L in the healthy subjects the NB-UVB course increased serum 25(OH)D significantly (p <0.001), by 14.0 nmol/L in the former and 17.0 nmol/L in the latter. The dialysis patients showed significantly increased baseline CYP27B1 levels and decreased CYP27A1 levels in the skin relative to the healthy subjects. It was concluded that a short NB-UVB course is an efficient way of improving the vitamin D balance in dialysis patients who are receiving oral vitamin D supplementation. The increased cutaneous CYP27B1 levels in the dialysis patients suggest that the loss of the renal activity of this enzyme is at least partially compensated for in the skin. To conclude, NB-UVB exposures were shown to be an efficient way of increasing the serum 25(OH)D concentration in dermatological and dialysis patients and in healthy subjects in winter. A short NB-UVB course was shown to increase serum 25(OH)D in healthy subjects significantly more than did daily supplementation with 20 µg oral cholecalciferol. NB-UVB courses offer a new possibility for improving the vitamin D balance in dialysis patients who have an insufficiency of this vitamin

Kapeakaistainen Ultravioletti B Valotus Parantaa D-vitamiinitasoa - Tutkimuksia Ihotauti- ja Hemodialyysipotilailla sekä Terveillä Henkilöillä

Tarkistettava väitöskirjatyö tutkii mahdollisuutta parantaa D-vitamiinitasoa ihotautien hoidossa käytettävällä valohoidolla, kapeakaistaisella UVB-valotuksella (aallonpituus 311 ± 2 nm). Väitöskirjan ensimmäisessä osatyössä tutkittiin kapeakaistaisen UVB-valotuksen vaikutusta atooppista ihottumaa ja psoriaasia sairastavien ihottumapotilaiden D-vitamiinitasoihin. Toisessa osatyössä verrattiin kapeakaistaisen UVB-valotuksen ja suun kautta otettavan D-vitamiinilisän tehoa D-vitamiinitasapainoon terveillä henkilöillä talvella. Muissa osatöissä tutkittiin kapeakaistaisen UVB-valotuksen vaikutusta D-vitamiinitasoihin dialyysihoidossa käyvillä munuais-potilailla, joista osalla oli ja osalla ei ollut käytössä suun kautta otettava D-vitamiinilisä. Väitöskirjan osatöissä todettiin, että kapeakaistainen UVB-valotus on nopea ja tehokas tapa parantaa D-vitamiinitasapainoa talvella ihotauti- ja dialyysipotilailla sekä terveillä henkilöillä. Kapeakaistaista UVB-valotusta voidaan käyttää myös munuaispotilailla, joilla on matalat D-vitamiinitasot käytössä olevasta suun kautta otettavasta D-vitamiinilisästä huolimatta. Teho kestää parin kuukauden ajan. Tutkimuksissa todettiin, että D-vitamiinin muodostusta tapahtuu maksan ja munuaisten lisäksi ihossa kapeakaistaisen UVB-valotuksen vaikutuksesta.Narrow-band ultraviolet B (NB-UVB) phototherapy is used to treat dermatological diseases such as psoriasis and atopic dermatitis. Some previous studies have suggested that it also increases serum 25-hydroxyvitamin D (25(OH)D) concentrations. On the other hand, most patients with chronic kidney disease (CKD) requiring dialysis are known to have insufficient vitamin D. We therefore conducted trials to assess how short NB-UVB courses could affect serum 25(OH)D concentrations in dermatological and haemodialysis patients in winter, when little UVB from the sun is available for vitamin D synthesis. In addition, we compared the effects of an NB-UVB course and oral vitamin D supplementation on serum 25(OH)D concentrations in healthy subjects. In the first trial 89% of the patients with psoriasis, 94% of those with atopic dermatitis and 53% of the healthy subjects were found to have baseline vitamin D insufficiency (serum 25(OH)D <50 nmol/L). A course of 15 whole body NB-UVB exposures significantly increased serum 25(OH)D (p <0.001), by 59.9 nmol/L in the psoriasis patients, 68.2 nmol/L in the atopic dermatitis patients and 90.7 nmol/L in the healthy subjects. PASI (psoriasis area and severity index) and SCORAD (severity scoring of atopic dermatitis) improved significantly (p <0.001), but no correlation with the increase in serum 25(OH)D was found. Expression of antimicrobial peptides (AMPs), cathelicidin and human β-defensin 2 (HBD2) was high in the psoriasis skin lesions. After 6 NB-UVB treatments cathelicidin had increased further, while HBD2 expression had decreased. NB-UVB caused a marked but non-significant decrease in the cytokines interleukin (IL)-1β and IL-17 in the psoriasis lesions. It was concluded that, in addition to a significant improvement of psoriasis and atopic dermatitis, NB-UVB treatment effectively corrects vitamin D insufficiency. It also increases cathelicidin and lowers HBD2 levels in healing psoriasis and atopic dermatitis skin lesions. This effect may be mediated by the improved vitamin D balance and the local cytokine network. In the second trial healthy adult hospital employees and medical students having serum 25(OH)D below 75 nmol/L were randomly given either a course of 12 whole body NB-UVB exposures or 20 µg of oral cholecalciferol daily for 4 weeks. The baseline serum 25(OH)D concentrations were similar in both groups: 52.9 nmol/L in the 33 NB-UVB-treated subjects and 53.5 nmol/L in the 30 treated with oral cholecalciferol. The mean increase in serum 25(OH)D was 41.0 nmol/L in the NB-UVB group and 20.2 nmol/L in the cholecalciferol group, the difference being significant at 2 weeks (p = 0.033) and at 4 weeks (p <0.001). Two months after the treatments the 25(OH)D concentrations had decreased in both groups but were still clearly higher than the baseline values. It was concluded that 12 NB-UVB exposures given over 4 weeks increase the serum 25(OH)D concentration significantly more than do daily doses of 20 µg oral cholecalciferol. A short, low-dose NB-UVB course is therefore an effective way of improving the vitamin D balance in winter, and the response is still evident 2 months after the course. In the third trial fifteen haemodialysis patients and twelve healthy subjects received nine upper body NB-UVB exposures. Mean serum 25(OH)D levels before NB-UVB were 32.5 nmol/L in the dialysis patients and 60.2 nmol/L in the healthy subjects (p <0.001). After eight NB-UVB exposures serum 25(OH)D had increased by 13.8 nmol/L (43%; p <0.001) in the dialysis patients and 1,25-dihydroxyvitamin D (1,25(OH)2D) by 3.3 pmol/L (27%; p = 0.002). Serum 25(OH)D in the dialysis patients was still 10% higher two months after NB-UVB exposures than initially. The mRNA expression level of CYP27B1, an enzyme needed for the final hydroxylation of vitamin D to its active metabolite, was examined in skin biopsy specimens and was found to have increased after NB-UVB exposures relative to the level in non-treated healthy subjects (p = 0.04). It was concluded that a short course of NB-UVB exposures significantly increases serum 25(OH)D and 1,25(OH)2D in dialysis patients, but the effect is short-lasting suggesting that patients need cyclic NB-UVB exposures to maintain their improved vitamin D concentrations. In the fourth trial fourteen haemodialysis patients and fifteen healthy subjects receiving oral cholecalciferol supplements of 20 µg daily were given nine whole body NB-UVB exposures. Given baseline serum 25(OH)D concentrations of 57.6 nmol/L in the dialysis patients and 74.3 nmol/L in the healthy subjects the NB-UVB course increased serum 25(OH)D significantly (p <0.001), by 14.0 nmol/L in the former and 17.0 nmol/L in the latter. The dialysis patients showed significantly increased baseline CYP27B1 levels and decreased CYP27A1 levels in the skin relative to the healthy subjects. It was concluded that a short NB-UVB course is an efficient way of improving the vitamin D balance in dialysis patients who are receiving oral vitamin D supplementation. The increased cutaneous CYP27B1 levels in the dialysis patients suggest that the loss of the renal activity of this enzyme is at least partially compensated for in the skin. To conclude, NB-UVB exposures were shown to be an efficient way of increasing the serum 25(OH)D concentration in dermatological and dialysis patients and in healthy subjects in winter. A short NB-UVB course was shown to increase serum 25(OH)D in healthy subjects significantly more than did daily supplementation with 20 µg oral cholecalciferol. NB-UVB courses offer a new possibility for improving the vitamin D balance in dialysis patients who have an insufficiency of this vitamin

Operation of Gas Electron Multiplier (GEM) with Propane Gas at Low Pressure

Background/Aims: Chronic kidney disease (CKD) patients on dialysis areprone to vitamin D insufficiency despite oral vitamin D supplementation.Here, we studied whether narrow-band ultraviolet B (NB-UVB) exposuresimprove vitamin D balance. Methods: 14 haemodialysis patients and 15healthy subjects receiving oral cholecalciferol 20 mu g daily got nineNB-UVB exposures on the entire body. Serum 25-hydroxyvitamin D (25(OH)D)was measured by radioimmunoassay. Cutaneous mRNA expression levels ofCYP27A1 and CYP27B1, two enzymes required for hydroxylation of vitamin Dinto its active metabolite, were also measured. Results: The baselineserum 25(OH)D concentration was 57.6 +/- 18.2 nmol/l in the CKD patientsand 74.3 +/- 14.8 nmol/l in the healthy subjects. The NB-UVB courseincreased serum 25(OH)D by 14.0 nmol/l (95% CI 8.7-19.5) and 17.0nmol/l (CI 13.7-20.2), respectively. At baseline the CKD patients showedsignificantly increased CYP27B1 levels compared to the healthy subjects.Conclusions: A short NB-UVB course is an efficient way to improvevitamin D balance in CKD patients on dialysis who are receiving oralvitamin D supplementation. The increased cutaneous CYP27B1 levels in theCKD patients suggest that the loss of renal activity of this enzyme isat least partially compensated for by the skin