Blyumin, Marianna L.

Hu, Shasa

Kirsner, Robert S.

Elsevier - Publisher Connector 

journal club
2700	 Journal	of	Investigative	Dermatology	(2007),	Volume	127	 ©	2007	The	Society	for	Investigative	Dermatology
For the article: http://dx.doi.org/10.1038/sj.jid.5701001
For discussion and answers: http://network.nature.com/group/jidclub
Insight into Photocarcinogenesis
Marianna	L.	Blyumin1,	Shasa	Hu1	and	Robert	S.	Kirsner1
Journal of Investigative Dermatology (2007),	127,	2700.	doi:10.1038/sj.jid.5701158
QUESTIONS
1.	What	are	the	major	findings	of	the	study?
2.	What	is	the	benefit	of	using	different	strains	of	mice	in	this	study?
3.		Why	 would	 NB-UVB	 be	 more	 carcinogenic	 than	 BB-UVB,	 considering	 that	 BB-UVB	 encompasses	 a	 wider	 spectrum	
of	wavelengths?
4.	Was	the	choice	of	dose	(energy)	important	in	the	outcome	of	the	study?
5.		Because	sarcomas	may	develop	in	mice	after	UV	exposure,	does	UV	play	a	role	in	sarcoma	development	in	humans?
6.	What	are	the	clinical	implications	of	this	article?
1Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
Advances in phototherapy have led to significant improvement in the 
care of patients with a variety of skin disorders, ranging from psoriasis 
to vitiligo. The use of narrow-band ultraviolet radiation B (NB-UVB), with 
peak fluence at 311 nm, has been one such advance. Superior in efficacy 
to broad-band UVB (BB-UVB), it combines added efficacy similar to that of 
photochemotherapy (PUVA), with less inconvenience (van Weelden et al., 
1988; Coven et al., 1997; Gathers et al., 2002). However, experimental data 
suggest that the use of NB-UVB is not without cost. Several investigative 
studies have determined that NB-UVB possesses greater potential for 
skin carcinogenesis (Flindt-Hansen et al., 1991; Wulf et al., 1994; Gibbs et 
al., 1995) than BB-UVB, already a known carcinogen (Kraemer, 1997).
In a follow-up to recent work linking BB-UVB with oxidative DNA 
damage and tumor formation (Kunisada et al., 2005), Kunisada et al. pursue 
the question of photocarcinogenesis by NB-UVB in greater detail in this issue (Kunisada et al., 2007). The investigators 
employed comparable (in terms of MED) doses of NB-UVB and BB-UVB in three susceptible mouse strains, examining 
tumor formation and three types of DNA damage. In two of the three strains of mice, they found a higher number of 
malignant tumors following exposure to NB-UVB. This was associated with increased cyclobutane pyrimidine dimer 
formation and decreased formation of 6-4 photoproducts and 8-oxoguanine. Only in Ogg1 knockout mice, which lack 
the gene that codes for 8-oxoG–DNA glycosylase, a repair enzyme, did BB-UVB exposure lead to similar numbers 
of malignant tumors. These results suggest that photocarcinogenesis is greater with NB-UVB and that it is related to 
cyclobutane pyrimidine dimer formation. Through the following questions we will delve into this article in greater 
detail. For brief answers, refer to http://network.nature.com/group/jidclub.
references
Coven	TR,	Burack	LH,	Gilleaudeau	R,	Keogh	M,	Ozawa	M,	Krueger	JG	(1997)	Narrowband	UV-B	produces	superior	clinical	and	histopathological	resolution	of	
moderate-to-severe	psoriasis	in	patients	compared	with	broadband	UV-B.	Arch Dermatol	33:1514–22
Flindt-Hansen	H,	McFadden	N,	Eeg-Larsen	T,	Thune	P	(1991)	Effect	of	a	new	narrow-band	UVB	lamp	on	photocarcinogenesis	in	mice.	Acta Dermatol Venereol 
71:245–8
Gathers	RC,	Schershun	L,	Malick	F,	Fivenson	DP,	Lim	HW	(2002)	Narrowband	UVB	phototherapy	for	early-stage	mycosis	fungoides.	J Am Acad Dermatol	
47:191–7
Gibbs	NK,	Traynor	NJ,	MacKie	RM,	Campbell	I,	Johnson	BE,	Furguson	J	et al.	(1995)	The	phototumorigenic	potential	of	broad-band	(270–350	nm)	and	narrow-
band	(311–313	nm)	phototherapy	sources	cannot	be	predicted	by	their	edematogenic	potential	in	hairless	mice	skin.	J Invest Dermatol	104:359–63
Kraemer	KH	(1997)	Sunlight	and	skin	cancer:	another	link	revealed.	Proc Natl Acad Sci USA	94:11–4
Kunisada	M,	Sakumi	K,	Tominaga	Y,	Budiyanto	A,	Ueda	M,	Ichihashi	M	et al.	(2005)	8-Oxoguaninie	formation	induced	by	chronic	UVB	exposure	makes	Ogg1	
knockout	mice	susceptible	to	skin	cancer.	Cancer Res	65:6006–10
Kunisada M, Kumimoto H, Ishizaki K, Sakumi K, nakabeppu Y, nishigori c (2007) narrow-band uVb induces more carcinogenic skin tumors than broad-
band uVb through the formation of cyclobutane pyrimidine dimer. J Invest Dermatol 127:2865-71
van	Weelden	H,	De	La	Faille	HB,	Young	E,	van	der	Leun	JC	(1988)	A	new	development	in	UVB	phototherapy	for	psoriasis.	Br J Dermatol	119:11–9
Wulf	HC,	Hansen	AB,	Bech-Thomsen	N	(1994)	Differences	in	narrow-band	ultraviolet	B	and	broad-spectrum	ultraviolet	photocarcinogenesis	in	lightly	
pigmented	hairless	mice.	Photodermatol Photoimmumol Photomed	10:192–7


Insight into Photocarcinogenesis 

Blyumin, Marianna L

Hu, Shasa

Kirsner, Robert S

University of Miami: Scholarship Miami

Journal of Investigative Dermatology

Insight into photocarcinogenesis

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Insight into Photocarcinogenesis

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