| Autor: |
Narbutt, J., Philipsen, P.A., Harrison, G.I., Morgan, K.A., Lawrence, K.P., Baczynska, K.A., Grys, K., Rogowski‐Tylman, M., Olejniczak‐Staruch, I., Tewari, A., Bell, M., O'Connor, C., Wulf, H.C., Lesiak, A., Young, A.R. |
| Zdroj: |
British Journal of Dermatology; Mar2019, Vol. 180 Issue 3, p604-614, 11p |
| Abstrakt: |
Summary: Background: Sun protection factor (SPF) is assessed with sunscreen applied at 2 mg cm−2. People typically apply around 0·8 mg cm−2 and use sunscreen daily for holidays. Such use results in erythema, which is a risk factor for skin cancer. Objectives: To determine (i) whether typical sunscreen use resulted in erythema, epidermal DNA damage and photoimmunosuppression during a sunny holiday, (ii) whether optimal sunscreen use inhibited erythema and (iii) whether erythema is a biomarker for photoimmunosuppression in a laboratory study. Methods: Holidaymakers (n = 22) spent a week in Tenerife (very high ultraviolet index) using their own sunscreens without instruction (typical sunscreen use). Others (n = 40) were given SPF 15 sunscreens with instructions on how to achieve the labelled SPF (sunscreen intervention). Personal ultraviolet radiation (UVR) exposure was monitored electronically as the standard erythemal dose (SED) and erythema was quantified. Epidermal cyclobutane pyrimidine dimers (CPDs) were determined by immunostaining, and immunosuppression was assessed by contact hypersensitivity (CHS) response. Results: There was no difference between personal UVR exposure in the typical sunscreen use and sunscreen intervention groups (P = 0·08). The former had daily erythema on five UVR‐exposed body sites, increased CPDs (P < 0·001) and complete CHS suppression (20 of 22). In comparison, erythema was virtually absent (P < 0·001) when sunscreens were used at ≥ 2 mg cm−2. A laboratory study showed that 3 SED from three very different spectra suppressed CHS by around ~50%. Conclusions: Optimal sunscreen use prevents erythema during a sunny holiday. Erythema predicts suppression of CHS (implying a shared action spectrum). Given that erythema and CPDs share action spectra, the data strongly suggest that optimal sunscreen use will also reduce CPD formation and UVR‐induced immunosuppression. What's already known about this topic? Sun protection factors (SPFs) are determined with sunscreen application at 2 mg cm−2, but people typically use much less.Suboptimal sunscreen application is often associated with sunburn, which is a risk factor for skin cancer.Erythema is a biomarker of cyclobutane pyrimidine dimers (CPDs), which may initiate skin cancer.The suppression of the sensitization phase of the contact hypersensitivity (CHS) response is a model for photoimmunological events in skin cancer. What does this study add? Typical sunscreen use during a week's holiday in Tenerife, with a very high UV index, resulted in erythema, epidermal CPD formation and almost complete suppression of CHS.There was no erythema, on five exposed body sites, when sunscreen (SPF 15) was applied three times daily at ≥ 2 mg cm−2.Erythema is predictive of immunosuppression, irrespectively of the ultraviolet radiation (UVR) emission spectrum. What is the translational message? People can learn to use sunscreens correctly to achieve the labelled SPF.The laboratory study demonstrated that erythema is a clinical and spectral biomarker for UVR‐induced suppression of CHS.Prevention of holiday erythema is likely to reduce CPDs and photoimmunosuppression, which are critical risk factors for skin cancer.Avoidance of erythema is therefore a very important public health strategy. Respond to this article Linked Comment:Hart. Br J Dermatol 2019; 180:462–463. Plain language summary available online [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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