Differential expression of decorin in localized scleroderma following ultraviolet-A1 irradiation

doi:10.1016/j.jaad.2006.10.961

Journal of the American Academy of Dermatology

Volume 56, Issue 6, June 2007, Pages 956-959

https://doi.org/10.1016/j.jaad.2006.10.961 Get rights and content

Patients with localized scleroderma underwent an 8-week course of ultraviolet A1 phototherapy. At baseline, decorin levels of lesional skin were significantly lower than those of nonlesional skin and healthy control subjects. After ultraviolet A1 phototherapy, decorin levels of lesional skin were significantly higher than baseline. Decorin may be of significance in the pathogenesis of localized scleroderma.

Section snippets

Material and method

We recruited 9 women (Fitzpatrick skin type III) suffering from plaque-type LS (Table I). The diagnosis of LS was established according to accepted clinical and histopathologic criteria.¹ The patients included in this study were also participants in a controlled trial recently published in this Journal.¹² In addition, 7 healthy women (mean age, 29 ± 4.8 years) were included as control subjects. The present study adhered to the Declaration of Helsinki and ethics approval for research was

Results

UVA1 phototherapy resulted in improvement of skin lesions as expressed in a significant reduction of the clinical score (pre-UVA1: 8.8 ± 7.8; post-UVA1: 4 ± 3.7; P < .05). There was, however, no significant correlation between the clinical score and decorin mRNA levels (r = 0.54; P > .05). At baseline, decorin mRNA levels of lesional skin were significantly lower than those of nonlesional skin (0.13 ± 0.07 vs 0.39 ± 0.24; P < .05) and healthy control subjects, respectively (0.13 ± 0.07 v. 0.43

Discussion

Proposed factors involved in the pathogenesis of LS and SSc include endothelial cell injury, immunologic and inflammatory activation, and dysregulation of collagen production. Moreover, decorin may also have a pathogenetic role. However, current data on decorin expression levels in SSc and LS are inconsistent.3, 4, 5, 6, 7, 8, 9, 10 Several authors have shown that production of decorin is altered in patients with SSc.4, 5, 6, 7 In accordance with the results of Hunzelmann et al,¹⁰ we observed

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Cited by (9)

A deep dive into UV-based phototherapy: Mechanisms of action and emerging molecular targets in inflammation and cancer
2021, Pharmacology and Therapeutics
Citation Excerpt :
Phototherapy also induces changes in components of the extracellular matrix architecture. Decorin is a leucine-rich proteoglycan involved in the structural organization of collagen fibers whose expression is altered in sclerodermic lesions (Gambichler, Skrygan, Tomi, Altmeyer, & Kreuter, 2007). After UVA1 therapy, the expression of decorin is downregulated to normal levels in the upper to middle dermis (Sawada, Isogai, & Morita, 2003).
UV-based phototherapy (including psoralen plus UVA (PUVA), UVB and UVA1) has a long, successful history in the management of numerous cutaneous disorders. Photoresponsive diseases are etiologically diverse, but most involve disturbances in local (and occasionally systemic) inflammatory cells and/or abnormalities in keratinocytes that trigger inflammation. UV-based phototherapy works by regulating the inflammatory component and inducing apoptosis of pathogenic cells. This results in a fascinating and complex network of simultaneous events–immediate transcriptional changes in keratinocytes, immune cells, and pigment cells; the emergence of apoptotic bodies; and the trafficking of antigen-presenting cells in skin—that quickly transform the microenvironment of UV-exposed skin. Molecular elements in this system of UV recognition and response include chromophores, metabolic byproducts, innate immune receptors, neurotransmitters and mediators such as chemokines and cytokines, antimicrobial peptides, and platelet activating factor (PAF) and PAF-like molecules that simultaneously shape the immunomodulatory effects of UV and their interplay with the microbiota of the skin and beyond. Phototherapy's key effects—proapoptotic, immunomodulatory, antipruritic, antifibrotic, propigmentary, and pro-prebiotic—promote clinical improvement in various skin diseases such as psoriasis, atopic dermatitis (AD), graft-versus-host disease (GvHD), vitiligo, scleroderma, and cutaneous T-cell lymphoma (CTCL) as well as prevention of polymorphic light eruption (PLE). As understanding of phototherapy improves, new therapies (UV- and non-UV-based) are being developed that will modify regulatory T-cells (Treg), interact with (resident) memory T-cells and /or utilize agonists and antagonists as well as antibodies targeting soluble molecules such as cytokines and chemokines, transcription factors, and a variety of membrane-associated receptors.
Treatment regimens, protocols, dosage, and indications for UVA1 phototherapy: Facts and controversies
2013, Clinics in Dermatology
Citation Excerpt :
Rapid production of IL-1 upon UVA1 treatment also was observed, which stimulates the production and release of IL-6. The latter then mediates the up-regulation of collagenase production by fibroblasts.14,74–80 The aforementioned data of investigations suggesting the efficacy of UVA1 phototherapy for AD through apoptotic effects in skin-infiltrating T lymphocytes have prompted investigators to evaluate also the benefit of UVA1 in the treatment of cutaneous T-cell lymphoma (CTCL), in particular mycosis fungoides (MF).11,15
During the last three decades, ultraviolet A1 (UVA1) phototherapy has emerged as a specific phototherapeutic modality with distinct modes of action and some well established indications. Atopic dermatitis, localized scleroderma, and systemic lupus erythematosus seem to be the conditions with the best evidence regarding efficacy and safety of UVA1 phototherapy. Further indications for UVA1 include subacute prurigo, lichen sclerosus, dyshidrotic dermatitis, cutaneous T cell lymphoma, urticaria pigmentosa, and pityriasis rosea; nevertheless, there are some unknowns, uncertainties, and controversies concerning short- and long-term side effects, efficacy and dosage regimens of UVA1 phototherapy in some conditions. We describe and discuss treatment regimens, protocols, dosage, and indications for UVA1 phototherapy.
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2018, Frontiers in Medicine
Phototherapy in Scleroderma
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View all citing articles on Scopus

Funding sources: None.

Conflicts of interest: None declared.

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ReportDifferential expression of decorin in localized scleroderma following ultraviolet-A1 irradiation

Section snippets

Material and method

Results

Discussion

Mayo Clin Proc

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

Methods

Methods

Lancet

Matrix Biol

J Invest Dermatol

The role of decorin in collagen fibrillogenesis and skin homeostasis

Glycoconj J

Altered decorin expression of systemic sclerosis by UVA1 (340-400nm) phototherapy: immunohistochemical analysis of 3 cases

BMC Dermatol

The association between changes in skin echogenicity and the fibroblast production of biglycan and versican in systemic sclerosis

Clin Exp Rheumatol

Report
Differential expression of decorin in localized scleroderma following ultraviolet-A1 irradiation