Gunnar Volden

Combined UVB and UVA Phototherapy of Atopic Eczema

The effect of combined UVB-UVA treatment in a group of 23 patients with severe atopic eczema was compared to UVB therapy alone in 33 patients. Mean age and number of treatments were approximately the same in the two groups. With UVB-UVA treatment, 48% achieved complete remission and in another 48% good improvements were obtained as compared to 27 and 58%, respectively, in the group treated with UVB alone. A few failures were recorded in the UVB group. Some possible explanations for the better effect of the combined UVB-UVA treatment are given.

CHARACTERIZATION OF ANTIBODIES SPECIFIC FOR UV‐DAMAGED DNA BY ELISA

Abstract— The specificity of affinity purified antibodies raised against UV‐irradiated DNA was examined using an enzyme‐linked immunosorbent assay. DNA irradiated with UV doses higher than needed for saturation with pyrimidine dimers bound increasing amounts of antibody. Photosensitized DNA, containing high amounts of pyrimidine dimers, showed very poor binding of antibody. When UV‐irradiated DNA was given a second dose of 340‐nm UV light, the binding of antibodies was abrogated. Taken together, this indicates a major specificity for (6‐4)‐photoproducts, which are photochemically reversed by UV light in the 340‐nm region. The antibodies also showed little but detectable binding to pyrimidine glycols produced in DNA by oxidation with OsO4. Previously, we have used these antibodies for the detection of UV‐induced DNA damage and its repair in human skin in vivo. These findings indicate that (6‐4)‐photoproducts, considered highly mutagenic, are repaired in human skin.

Light penetration of normal and photokeratitis induced rabbit cornea.

The passage of light through photokeratitic and normal corneas was investigated using a grating monochromator. The energy output was measured at each selected central wavelength from 280 to 700 nm. The absorption by epithelial and stromal suspensions was continuously registered over the total light spectrum in a recording spectrophotometer. The penetrating quantity of the physiologically effective middle wave ultraviolet (UVB) rays varies according to wavelengths from about 11 % at 290 nm up to 50% at 320 nm. Photokeratitis did not alter the transmission characteristics at wavelengths below 310nm. At longer wavelengths transmission was significantly decreased in photokeratitic corneas compared to normal. No difference was found between the light absorption of the supernatants of photokeratitic and normal corneas.

A Case of Chronic Urticaria and Vitiligo, Associated with Thyroiditis, Treated with PUVA

A case of chronic urticaria and vitiligo, associated with thyroiditis is described. Significantly elevated thyromicrosomal antibodies were found. Autoimmune reaction is a possible cause of the patients thyroid disease, vitiligo and chronic urticaria. Following PUVA treatment with a total dose of 300 J/cm2 the patients urticaria subsided in all irradiated areas, only to relapse 2 weeks later. Subsequently courses of PUVA gave periods of remission. The treatment also induced repigmentation in the vitiliginous spots. The results indicate a local PUVA effect upon mediators or mediator-containing cells.

The production of tumour necrosis factor, tissue thromboplastin, lactoferrin and cathepsin C during lipopolysaccharide stimulation in whole blood

The release of tumour necrosis factor (TNF), lactoferrin (LF) and cathepsin C (CC) into plasma and production of thromboplastin (TPL) in monocytes were studied in lipopolysaccharide (LPS) stimulated heparinized whole blood from 10 healthy donors. The influence of dextran 70, haemaccel and methylprednisolone on levels of these parameters were examined. TNF concentration in plasma 5 min after the addition of LPS (0 h) was 250 pg/ml (median), 520 pg/ml after 1 h and 1300 pg/ml after 3 h. The addition of dextran 70 to the blood in addition to LPS at the same intervals gave significantly higher values of 740 pg/ml and 1800 pg/ml after 1 h and 3 h respectively. Unstimulated cells had no TPL but after 1 h with LPS, the TPL activity in incubated cells was 2.3 mU/10(6) monocytes and after 3 h, 2.7 mU/10(6) monocytes. LPS induced the secretion of LF from granulocytes (PMN) and the levels 5 min after the addition of LPS (0 h) were 2.1 mg/l (control 0.2 mg/l) and after 1 h, 5.3 mg/l (control 1.3 mg/l) in plasma after LPS stimulation. Haemaccel enhanced the LPS-induced generation of TPL in monocytes and production of CC. The LPS-induced secretion of LF was, to a small extent, influenced by the three reagents tested. Methylprednisolone (1 mmol/l) reduced the production and appearance of TNF in plasma and the generation of TPL activity in monocytes. This model for stimulating heparinized whole blood is suitable for examination of the production and appearance of cellular factors and the influence of drugs on this production.

Phototoxicity from furocoumarins (psoralens) of Heracleum laciniatum in a patient with vitiligo. Action spectrum studies on bergapten, pimpinellin, angelicin and sphondin

Investigations on light reactions in a patient with vitiligo are presented. The minimal erythema dose (MED)in the UVB area was approximately 1/1 of that in persons of skin type II. The application of furocoumarins (psoralens) increased light tolerance by 1 MED at 300–310 mm. Action spectrum studies with furocoumarins from Heracleum laciniatum showed the following order of potency: bergapten, Pimpinellin, angelicin and sphondin. The efficacy was highest at 325–350nm, with maxima at 330–335 nm. Pimpinellin was recently found to be phototoxic, but an action spectrum of sphondin is reported for the first time.

Furocoumarins of Heracleum Laciniatum: isolation, phototoxicity, absorption and action spectra studies

Isolation of the furocoumarins (psoralens) bergapten, isobergapten, sphondin, isopimpinellin and pimpinellin from the Umbilliferous plant Heracleum laciniatum was carried out by column chromatography, and the structure and absorption spectra for the 5 furocoumarins isolated are described. Photoepicutaneous testing showed the strongest phototoxic effects from bergapten, marked effects from pimpinellin, weak effects from sphondin and none from the others. These in vivo findings were confirmed by the in vitro Candida test. Action spectrum studies demonstrated peak photosensitivity in the range 330–335 nm. bergapten being more than twice as phototoxic as pimpinellin.

Remissions of Mycosis Fungoides Induced by Nitrogen Mustard (HN2)

In this study 12 patients with mycosis fungoides were treated with whole body topical application of HN2. In addition 4 of these patients had gauzes moistened with the same HN2 solution placed upon plaques and tumours. 4 patients developed in allergic contact dermatitis, and this complication was overcome by percutaneous desensitizing in 3 of them. After starting hydration of plaques and tumours with HN2, the average time to obtain complete clinical remission was shorted from 4.4 to 2.5 months. A little later at the optimal histologic response, there was no or almost no cellular infiltration in 5 cases, while in 6 cases there was only a slight, unspecific, lymphocytic infiltrate in the dermis.

Enzymatic repair of premutagenic DNA lesions in human epidermis Quantitation of O6-methylguanine-DNA methyltransferase and uracil-DNA glycosylase activities

Extracts of human epidermis prepared by the suction blister method were used to measure O6-methylguanine-DNA methyltransferase and uracil-DNA glycosylase activities. Although both activities were detected in all extracts examined, a 4-5-fold interindividual variation in activity was found. No obvious correlation of the two enzyme activities with the age of the patient was observed. Neither was there any correlation between the level of uracil-DNA glycosylase activity and O6-methylguanine-DNA methyltransferase activity.

In vivo and in vitro phototoxicity of different parts of Heracleum Laciniatum

Experimental phytophotodermatitis was produced using homogenates from different parts of Heracleum laciniatum and long‐wave ultraviolet light. The homogenates of leaves and flowers produced strong phototoxic reactions, fruit slightly less. Stems were either non‐phototoxic or only slightly phototoxic. The roots or young plants did not evoke photosensitivity reactions, whereas the roots of older plants were strongly phototoxic; even roots collected from the frozen ground in December elicited strong reactions. Abdominal and midback skin were more photosensitive than skin of the lateral aspects of the underarms and legs. The in vivo findings were continued in vitro with the Candida albicans test.