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Aim To evaluate quantitatively the effects of the Epi-Off-CXL irradiance dose on the stromal stiffening of pig corneas. Setting Laboratory of Biological structures (LaBS), Politecnico di Milano, Milano, Italy. Methods Inflation tests have been carried on 90 excised and de-epithelized pig corneas, monitoring the change of configuration of the corneal dome at specific pressures. Test have been carried out twice on each cornea, once before and once after Epi-Off-CXL performed at a constant irradiance of 9 mW/cm2 and variable UV-A exposure times. Corneas were grouped according to the exposure time (2.5, 5, 10, 15 and 20 min), proportional to the irradiation dose (1.35, 2.7, 5.4, 8.1, and 10.8 J/cm2). A theoretical model based on linearized shell theory has been used to estimate the increment of the corneal stiffness. Results The linearized shell theory allowed to establish a quantitative relation between the increment of the stiffness parameters and the irradiation dose. Relative to the pre-treatment values, in all experiments the post-treatment corneal stiffness revealed a pronounced increase. In general, the stiffness gain increased with the exposure time. No significant differences in stiffening was observed between tests conducted at 2.5, 5, and 10 min exposure. Conclusions Qualitatively, the effectiveness of accelerated CXL treatments observed in pig corneas complies very well with in-vivo clinical results in humans, suggesting that experimental data in pigs can be very useful for the design of the procedure in humans. A larger irradiation dose provides a larger increment of the corneal stiffness. Due to the biological variability of the tissues, however, it is difficult to distinguish quantitatively the level of the reinforcement induced by accelerated protocols (low doses with < = 10 min exposure), less prone to induce damage in the corneal tissue. Therefore, the definition of personalized treatments must be related to the actual biomechanics of the cornea.

BACKGROUND Oxidized phlorotannin can be used as a protein crosslinking agent to produce high-quality fish gel products. Phlorotannin can be easily induced to form quinone compounds in an oxidizing environment, while o-quinone has been proven to be a reactive, electrophilic intermediate that easily reacts with proteins to form rigid molecular crosslinking networks. The objective of this study was to investigate the synergistic effects of ultraviolet A (UVA) irradiation (1 h, 15 W m-2 ) and various concentrations of Laminaria japonica phlorotannin extracts (PTE) on the gel properties of grass carp myofibrillar protein (MP). RESULTS UVA treatment and PTE could synergistically improve the MP gel properties more than PTE alone (P

Light has attracted special attention as a stimulus for triggered drug delivery systems (DDS) due to its intrinsic features of being spatially and temporally tunable. Ultraviolet A (UVA) radiation has recently been used as a source of external light stimuli to control the release of drugs using a “switch on- switch off” procedure. This review discusses the promising potential of UVA radiation as the light source of choice for photo-controlled drug release from a range of photo-responsive and photolabile nanostructures via photo-isomerization, photo-cleavage, photo-crosslinking, and photo-induced rearrangement. In addition to its clinical use, we will also provide here an overview of the recent UVA-responsive drug release approaches that are developed for phototherapy and skin photoprotection.

Purpose: The study was performed to analyze the prevalence of the conjunctival ultraviolet autofluorescence (CUVAF) area in keratoconic eyes and changes caused by UVA-irradiation as a component of accelerated corneal cross-linking (aCXL). Methods: The study group involved 20 keratoconic patients subjected to aCXL surgery in one eye. The comparative group consisted of 111 age- and sex-matched patients with healthy corneas. The images of the anterior segment in both patient groups were taken using a Coroneo camera. In the study group the photos were taken before and immediately after the surgery, and 7 and 30 days following the procedure. Results: Nasal and temporal autofluorescence area (AN+T) were significantly smaller in a keratoconic patients group compared to control group (p = 0.0001). Patients with the third stage of keratoconus had significantly higher AN+T (p = 0.0277) compared with individuals with lower stage keratoconus. No statistically significant CUVAF changes were observed after the aCXL procedure. In keratoconic patients with primary CUVAF undergoing aCXL, a temporary fast enlargement of the autofluorescence area was observed. Conclusions: The eyes undergoing the aCXL procedure showed no difference in the size of the CUVAF area but such patients should be in strict follow-up in order to reveal UV-related ocular surface diseases.

To provide data on risk of respiratory droplets from common otolaryngologic procedures during the COVID-19 pandemic, a novel simulation of droplet exposure from flexible laryngoscopy was performed. After completion of a nasal symptom questionnaire, topical fluorescein spray was administered into the nasal and oropharynx of 10 healthy volunteers, who then underwent flexible laryngoscopy under 2 conditions: routine without provoked response and with prompted sneeze/cough. After each, droplets on the proceduralist and participant were counted under ultraviolet A light. Droplets were observed on 1 of 10 volunteers after routine laryngoscopy and 4 of 10 during laryngoscopy with sneeze/cough. A nasal symptom score based on congestion and rhinorrhea was significantly elevated among droplet producers after sneeze/cough (P = .0164). No droplets were observed on the provider. Overall, with adequate personal protective equipment, flexible laryngoscopy poses minimal droplet risk to providers. Nasal symptoms can identify patients more likely to produce droplets after sneeze/cough.

Antimicrobial-resistant and novel pathogens continue to emerge, outpacing efforts to contain and treat them. Therefore, there is a crucial need for safe and effective therapies. Ultraviolet-A (UVA) phototherapy is FDA-approved for several dermatological diseases but not for internal applications. We investigated UVA effects on human cells in vitro, mouse colonic tissue in vivo, and UVA efficacy against bacteria, yeast, coxsackievirus group B and coronavirus-229E. Several pathogens and virally transfected human cells were exposed to a series of specific UVA exposure regimens. HeLa, alveolar and primary human tracheal epithelial cell viability was assessed after UVA exposure, and 8-Oxo-2'-deoxyguanosine was measured as an oxidative DNA damage marker. Furthermore, wild-type mice were exposed to intracolonic UVA as an in vivo model to assess safety of internal UVA exposure. Controlled UVA exposure yielded significant reductions in Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis, Clostridioides difficile, Streptococcus pyogenes, Staphylococcus epidermidis, Proteus mirabilis and Candida albicans. UVA-treated coxsackievirus-transfected HeLa cells exhibited significantly increased cell survival compared to controls. UVA-treated coronavirus-229E-transfected tracheal cells exhibited significant coronavirus spike protein reduction, increased mitochondrial antiviral-signaling protein and decreased coronavirus-229E-induced cell death. Specific controlled UVA exposure had no significant effect on growth or 8-Oxo-2'-deoxyguanosine levels in three types of human cells. Single or repeated in vivo intraluminal UVA exposure produced no discernible endoscopic, histologic or dysplastic changes in mice. These findings suggest that, under specific conditions, UVA reduces various pathogens including coronavirus-229E, and may provide a safe and effective treatment for infectious diseases of internal viscera. Clinical studies are warranted to further elucidate the safety and efficacy of UVA in humans.

International audience; Satellite estimates of surface ultraviolet A (UVA) (315–400 nm) from the Global Ozone Monitoring Experiment (GOME)‐2 were compared to ground‐based measurements at four stations in South Africa for 2015. The comparison of daily exposure and daily maximum irradiance was completed for all‐sky and clear‐sky conditions. There is a strong linear correlation between the satellite and ground‐based data with a correlation coefficient (r) between 0.86 and 0.97 for all‐sky conditions. However, at three of the stations the satellite data are underestimated compared to ground‐based data with a mean bias error (MBE) between −8.7% and −20.6%. A seasonal analysis indicated that there is a link between the bias in ground‐based and GOME‐2 UVA and cloud fraction. Factors such as aerosols, surface albedo, altitude and data resolution may contribute to the underestimations found at the three sites. These results indicate that satellite estimates of surface UVA over South Africa do not exhibit the same behavior as other stations around the world and therefore require further validation.

Background Pathogen reduction (PR) of platelet concentrates (PCs) contributes to the safety of platelet (PLT) transfusion by reducing the risk of transfusion‐transmitted infections and transfusion‐associated graft‐versus‐host disease. In vitro quality of pathogen‐reduced double‐dose PC (PR‐PC) made of eight whole blood (WB)‐derived buffy coats (BCs) were evaluated. Methods Eight small‐volume WB BCs from donors with at least 200 × 109 PLT/L were pooled with an additive solution to produce double‐dose PCs (DD‐PCs), which were treated with amotosalen/ultraviolet A light in a dual storage processing set, yielding 2 units of PR‐PC. Quality controls were undertaken as per European Directive for the Quality of Medicines (EDQM) guidelines. PLT recovery rates were measured. Production costs and savings were compared over the 3 years before and after PR implementation. Results In the pre‐PR period, 19 666 PCs were produced, compared to 17 307 PCs in the PR period. Single BC in the PR period had 41 ± 2 mL, hematocrit 0.39 ± 0.04 and 1.06 ± 0.18 × 1011 PLTs, and showed a recovery of 91% ± 8%. After pooling, separation, PR treatment of DD‐PC, and splitting, each single PC had 189 ± 6 mL with 2.52 ± 0.34 × 1011 PLTs, compared to 2.48 ± 0.40 in the pre‐PR period. The PLT recovery rate after PR was 87% ± 14%. EDQM requirements were met. An increase of about €12 (+7.5%) per PC from the pre‐PR to the PR period was identified. Conclusion A new production method resulting in two PR‐PCs made from pools of 8 BCs with use of one PR set was successfully introduced, and our experience of nearly 3 years demonstrated the high efficacy and in vitro quality of the PR‐PCs obtained.

To comparatively evaluate the long-term visual, refractive, topographic and aberrometric outcomes of conventional corneal collagen crosslinking (CXL) in the management of pediatric versus adult progressive keratoconus patients.Retrospective, cross-sectional review of consecutive progressive keratoconus cases of corneal standard CXL using a standardized protocol for treatment and examinations was performed. Best spectacle-corrected distance visual acuity (CDVA), manifest refraction, slit lamp biomicroscopy, corneal tomography, corneal aberrometry and endothelial cell counts were evaluated at baseline and yearly at all postoperative follow-up examinations after month-12. The outcomes were analyzed by dividing the patients into 2 age groups; pediatric (≤18 years) versus adult (18 years).Eighty-eight eyes (54 patients) in the pediatric and 104 eyes (68 patients) in the adult age groups completed 3 years follow-up. Compared to baseline, the mean CDVA, manifest refraction, keratometric readings, tomographic and aberrometric parameters improved statistically significantly in both groups at postoperative year-3 and year-4, without any statistically significant between-group differences. No change in the mean endothelial cell density (Conventional corneal CXL effectively halts the progression of keratoconus in both pediatric and adult age groups in long-term follow-up with similar visual, refractive, tomographic and aberrometric efficacy in both groups.

Objective The aim of this study is to evaluate the cellular biomechanical properties and MMP-2 expression changes in rabbit scleral fibroblasts using two modes of riboflavin and ultraviolet A (UVA) collagen cross-linking (CXL). Methods Twenty-four New Zealand white rabbits were randomly divided into two groups, A and B. The left eye was chosen for the experimental group and the right eye for the control group. In group A, the eyes were irradiated for 30 min, with a power density of 3.0 mW/cm2. In group B, the eyes were irradiated for 9 min, with a power density of 10.0 mW/cm2. One week after CXL, full-field electroretinography was performed. Sixty days after CXL, the rabbits were sacrificed, and scleral fibroblasts were extracted from the CXL-treated sclera area and corresponding parts of control sclera and cultured. Cellular biomechanical properties were evaluated using the micropipette aspiration technique, and the MMP-2 protein expression was determined by Western blot analysis. Results There was no statistical difference in the amplitude and latency of the dark adaptation 3.0 and light adaptation 3.0 between the CXL and control eyes of groups A and B (P > 0.05). Compared with the control groups, the Young's modulus of the fibroblasts and apparent viscosity of the experimental eyes in groups A and B were increased after CXL (P 0.05). The MMP-2 expression in scleral fibroblasts from experimental eyes was significantly higher than that in scleral fibroblasts from control eyes in groups A and B. Under the two different irradiation modes, the MMP-2 expression in the scleral fibroblasts from experimental eyes in group A was significantly higher than that in the scleral fibroblasts from experimental eyes in group B. Conclusion The riboflavin-UVA scleral CXL conducted in two different modes produced no significant side effects on the retina and could strengthen the cell biomechanical properties as well as increase the MMP-2 expression of scleral fibroblasts significantly.

Subungual squamous cell carcinoma (SCC) is a rare malignant tumour with an indolent course and unknown aetiology. It is usually misdiagnosed as a benign lesion, resulting in delayed treatment. Although psoriasis is not a precancerous skin condition, the treatment modalities cyclosporine and psoralen with ultraviolet A (PUVA) might increase the risk of developing cutaneous SCC, although a relationship has not been confirmed. We describe a patient with psoriasis who had been treated with cyclosporine and PUVA 6 years previously. He developed back SCC 2 years later, a subungual skin lesion after another 2 years and presented to us 1 year later, when nail elevation and biopsy revealed SCC. LEARNING POINTS: Subungual squamous cell carcinoma (SCC) is often misdiagnosed as a benign condition so most cases are invasive by the time of diagnosis; nail elevation and biopsy are recommended in all suspicious cases. Although psoriasis is not an independent risk factor for subungual SCC, the cyclosporine and PUVA used to treat psoriasis are risk factors for cutaneous SCC. The aetiology for subungual SCC is still unclear, but it should be suspected in patients with psoriasis and a suspicious presentation.

Psoriasis is a chronic, multisystem inflammatory disease, predominantly affecting the skin and joints, which is present in 2−3% of the world's population. Narrow band ultraviolet B (NB-UVB) and Psoralen + ultraviolet A (PUVA) are recognised, effective and, in the case of UVB, economical second-line treatments for psoriasis where topical therapies fail to control the disease or are an impracticable option due to the extent of skin involvement. This article examines the history of phototherapy and photochemotherapy and looks at current phototherapy treatments used for psoriasis. It discusses side effects of treatment and regimens that can be followed to increase effectiveness of treatment and minimise risks. The role of the nurse phototherapist is also discussed.

Background The INTERCEPT Blood System pathogen reduction technology (PRT), which uses amotosalen and ultraviolet A light treatment (amotosalen/UV-PRT), inactivates pathogens in plasma and platelet components (PCs). This review summarizes data describing the inactivation efficacy of amotosalen/UVA-PRT for a broad spectrum of viruses and parasites. Methods Twenty-five enveloped viruses, six nonenveloped viruses (NEVs), and four parasites species were evaluated for sensitivity to amotosalen/UVA-PRT. Pathogens were spiked into plasma and PC at high titers. Samples were collected before and after PRT and assessed for infectivity with cell cultures or animal models. Log reduction factors (LRFs) were defined as the difference in infectious titers before and after amotosalen/UV-PRT. Results LRFs of ≥4.0 log were reported for 19 pathogens in plasma (range, ≥4.0 to ≥7.6), 28 pathogens in PC in platelet additive solution (PC-PAS; ≥4.1-≥7.8), and 14 pathogens in PC in 100% plasma (PC-100%; (≥4.3->8.4). Twenty-five enveloped viruses and two NEVs were sensitive to amotosalen/UV-PRT; LRF ranged from >2.9 to ≥7.6 in plasma, 2.4 or greater to greater than 6.9 in PC-PAS and >3.5 to >6.5 in PC-100%. Infectious titers for four parasites were reduced by >4.0 log in all PC and plasma (≥4.9 to >8.4). Conclusion Amotosalen/UVA-PRT demonstrated effective infectious titer reduction for a broad spectrum of viruses and parasites. This confirms the capacity of this system to reduce the risk of viral and parasitic transfusion-transmitted infections by plasma and PCs in various geographies.

BackgroundThe skin provides a predominant barrier against chemical, physical and microbial incursion. The intemperate exposure to ultraviolet A (UVA) radiation can cause excessive cellular oxidative stress, leading to skin damage, proteins damage and mitochondrial dysfunction. There is sufficient evidences supporting the proposal that mitochondria is highly implicated in skin photo-damage.MethodsIn the present study, a polysaccharide isolated from Astragalus membranaceus was further purified to be an α-glucan, which was further investigated its beneficial influence on UVA-induced photo-damage in HaCaT cells.ResultsOur results showed that the purified Astragalus membranaceus polysaccharide (AP) can protect HaCaT cells from UVA-induced photo-damage through reducing UVA-induced intracellular ROS production and mitochondrial membrane potential, thereby altering ATP content. It was found that the UVA induced damage in HaCaT cells could be effectively restored by co-treatment with AP.ConclusionsAP exhibited promising potential for advanced application as multifunctional skin care products and drugs.

Purpose: To evaluate the long-term outcomes of collagen crosslinking in early keratoconus. Methods: Thirty eyes of twenty patients with early keratoconus were enrolled. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), objective refraction, subjective refraction, corneal topography and pachymetry were assessed before and 3, 6, 12 months and 9 years after performing collagen crosslinking surgery. Results: The patients' mean age was 31.2 ± 5.59 years at nine-year follow-up (range, 25–44 years). The means of preoperative UCVA and BSCVA were 0.57 ± 0.34 and 0.15 ± 0.12 logMAR, respectively, and these values remained stable at the final follow-up (P = 0.990 and P = 0.227, respectively). The mean objective spherical equivalent decreased considerably from –6.00 ± 4.05 D preoperatively to –5.22 ± 3.71 D at the final follow-up (P < 0.05). The mean subjective spherical equivalent was –4.25 ± 2.87 D preoperatively and this value was stable at the last follow-up (P = 0.92). No considerable difference was found between the post- and preoperative mean objective cylinder values (P = 0.34). The mean subjective cylinder value changed significantly from –4.05 ± 1.85 D preoperatively to –3.1 ± 1.42 D at the final follow-up (P < 0.05). The mean central corneal thickness was 496.97 ± 45.95 µm preoperatively and this value was stable at nine-year follow-up (P = 0.183). No significant difference was found between the pre- and postoperative mean maximum and mean minimum corneal curvature values (P = 0.429 and P = 0.248, respectively). There were no significant postoperative complications. Conclusion: Corneal crosslinking in early keratoconus seems to be a safe procedure that can effectively stabilize UCVA, BSCVA, subjective SE and CCT, while improving objective spherical equivalent.

In this study, we established an experimental human corneal stroma model of simulated cornea tissue composed of thin anterior cornea strips layers obtained from small incision lenticular extraction (SMILE) surgery. We investigated the biomechanical effect of ultraviolet-A- riboflavin cross-linking at different depths of corneal stroma model and correlated it with stromal microstructural changes examined by transmission electron microscopy (TEM). Corneal strips were harvested from fresh human corneal lenticules obtained after SMILE surgery. Experimental models (n = 34) were established by superimposing the corneal lenticule strips until their thickness reached close to 500 μm. Corneal cross-linking (CXL) was performed subsequently using standard or accelerated protocol. Elasticity and viscosity were quantified using stress-strain extensometer. TEM was used to visualize the collagen fiber diameter and interfibrillar spacing. The relative change in Young's modulus (rel. ΔE) decreased nonlinearly with increasing stromal depth both in the standard and accelerated groups. Compared to the sham controls, the rel. ΔE in standard and accelerated CXL groups increased significantly in the anterior 400 μm and 275 μm depth, respectively. Also, the relative change in stress (rel. ΔS) was significantly lower after standard and accelerated CXL compared to sham controls. Depth analysis showed similar results for the elastic effect. TEM images showed a small, non-significant increase in fibril diameter. The interfibrillar spacing decreased significantly after standard and accelerated CXL in the anterior-mid stromal region. We noted that the increase of corneal stiffness correlated with decrease in interfibrillar spacing after CXL. The stiffening effect was depth dependent. The effect of accelerated CXL was less in the deep corneal stromal regions compared to standard CXL.

Non-melanoma skin cancer (NMSC) has a high and increasing incidence all over the world. Solar radiation is the main aetiology for humans. Although most research into photocarcinogenesis uses UVB as a source of radiation, UVA is also carcinogenic in long term. Pomegranate (PGE) and cocoa (CE) extracts have been used for medicinal purposes for time immemorial. Recently, it has been claimed that some of their properties may be an effective preventative measure against photocarcinogenesis and photoaging, but to date in vivo models have not been tested using RUVA, the objective of the present work. A lower incidence of lesions was observed in SKH-1 mice treated with PGE (p

Grover’s disease (GD) is an acquired dermatosis called transient acantholytic dermatosis. The exact cause is unknown, but the factors blamed for the etiology include ultraviolet (UV), sweating, temperature rise, radiation, medications, and malignancies. Topical corticosteroids, topical retinoids, and topical calcipotriol are usually sufficient for treatment, and systemic retinoids, systemic steroids, phototherapy, and methotrexate are rarely used. The current report describes the case of GD in a female patient, which was aggravated by the psoralen and UVA phototherapy. WOS:000519583900006 2-s2.0-85100183084

Purpose To determine the prevalence of cataract and its association with sun exposure and other environmental risk factors in three different geographically diverse populations of India. Design Population based cross sectional study during 2010–2016 Participants People aged ≥ 40 years residing in randomly sampled villages were enumerated (12021) and 9735 (81%) underwent ophthalmic evaluation from plains, hilly and coastal regions (3595, 3231, 2909 respectively) Methods A detailed questionnaire-based interview about outdoor activity in present, past and remote past, usage of sun protective measures, exposure to smoke, and detailed ophthalmic examination including assessment of uncorrected and best corrected visual acuity, measurement of intraocular pressure, slit lamp examination, lens opacities categorization using LOCS III and posterior segment evaluation was done. Lifetime effective sun exposure was calculated using Melbourne formula and expressed as quintiles. These were supplemented with physical environmental measurements. Main outcome measures Lifetime sun exposure hours, smoking, indoor kitchen smoke exposure and their association with cataract and subtypes. Prevalence of cataract calculated based on lens opacities or evidence of cataract surgery. Results Cataract was identified in 3231 (33.3%) participants. Prevalence of cataract in males (32.3%) and females (34.1%) was similar. Nuclear cataract was the commonest sub-type identified in 94.7% of affected eyes. Sun exposure had a significant association with cataract with odds ratio (OR) increasing from 1.6 (95% Confidence Intervals [CI]: 1.4, 1.9) in 3rd quintile, to 2.6 (CI: 2.2, 3.1) in 4th quintile and 9.4 (CI: 7.9, 11.2) in 5th quintile (p

To evaluate the safety and efficacy of mitomycin C (MMC) in haze formation after ultraviolet A/riboflavin corneal crosslinking (CXL) for progressive keratoconus.A total of 60 keratoconic eyes of 48 patients were enrolled in this prospective comparative study after obtaining informed consent. In the CXL group, standard corneal CXL was performed, whereas in the CXL+MMC group, 0.02% MMC was used for 30 s soon after CXL. Comprehensive ophthalmologic examinations were performed on all patients before surgery and at 1, 3, 6, and 12 months after surgery.The epithelium recovered within 3 to 4 days after CXL, and the healing time was comparable in the two groups. There was no significant endothelial cell density loss after CXL in both groups. Eyes in both groups showed improvement of uncorrected distance visual acuity (Snellen) and best-corrected visual acuity (Snellen; P0.05), and there was a decrease in K-max, cylinder degree, and central corneal thickness (CCT) (P0.05). There was no significant statistical difference between the groups regarding postoperative K-max reduction, refraction, and CCT (P0.05). Corneal haze scores were significantly higher in the CXL group at 1 and 3 months after CXL (P=0.012 and P=0.028, respectively), but were similar to the MMC group at 6 and 12 months after surgery (P=0.329 and P=0.543, respectively).Prophylactic intraoperative use of 0.02% MMC can significantly reduce CXL-associated haze formation, especially in the early postoperative period, and no signs of weakening CXL efficacy were observed.

Reactive oxygen species (ROS) caused by ultraviolet A (UVA) can be reduced by treating with antioxidants and photoprotective reagents. Here we reported a real-time chemiluminescence (CL) imaging method which was simple, non-invasive and sensitive to evaluate UVA-induced ROS generation and the efficacy of sunscreens and antioxidants in vivo. The in vitro experiments indicated that l-ascorbic acid, live SPSC01 yeast, and its intracellular metabolites can suppress the intensity of CL signals in the presence of hydrogen peroxide, which proved the good antioxidant ability of them. Meanwhile, we used 8-amino-5-chloro-7-phenylpyrido[3,4-d] pyridazine-1,4(2H,3H) dione (L-012) as a high sensitive CL probe for in vivo imaging of ROS generated by UVA irradiation. The CL intensity was reduced after treated with l-ascorbic acid and SPSC01 yeast intracellular metabolites, consistent with the in vitro results. Additionally, the in vivo protective capability of two azobenzene compounds as sunscreens was confirmed further through the suppression of CL signals of UVA-induced ROS in mouse skin by this method.

Data on the treatment of early folliculotropic mycosis fungoides, a recently defined clinicopathological subgroup of folliculotropic mycosis fungoides with an indolent course, is limited. Treatment outcomes were studied in a retrospective cohort of 47 adults with early folliculotropic mycosis fungoides, with a focus on psoralen plus ultraviolet A (PUVA) monotherapy, including dosimetric data, and the findings were compared with data for PUVA in 18 adults with early-classic mycosis fungoides. PUVA was given to 27 patients with early folliculotropic mycosis fungoides: 70% achieved complete response and 26% partial response. Significantly more treatments were needed to achieve complete response in stage IB compared with stage IA. There was no significant difference in the complete response rate from classic plaque-stage disease, although the early folliculotropic mycosis fungoides group required more treatments to achieve complete response, and a higher cumulative dose of UVA. Thus, PUVA is an effective treatment for early folliculotropic mycosis fungoides. Its complete response rate might be equal to early-classic mycosis fungoides; however, a longer induction phase is needed to achieve complete response.

UVA and UVB can be applied to solar disinfection of water. In this study, the inactivation and photoreactivation of viruses and bacteria in the UVA-B range were analyzed. MS2 and T4 bacteriophages, and Escherichia coli were used as surrogates to quantify dose-response behaviors. Inactivation in UVC was used to validate the methodology and to expand the inactivation action spectra. The results showed log-linear inactivation for MS2 and T4 in the 254–320 nm wavelength range. T4 inactivation was consistently faster than MS2 (except at 320 nm), and for both phages, inactivation decreased with increasing wavelength. The dose-response of bacteria exhibited a lag at low doses, possibly because the photons must strike a discrete number of critical targets before growth stops. A tail was present at high doses for some wavelengths, perhaps due to clumping or the presence of subgroups with higher resistance. The inactivation action spectra for bacteria exhibited a reduction in inactivation as wavelength increased. No bacterial inactivation was observed beyond 320 nm at doses applied. After inactivation at 297 nm (UVA), bacteria regained viability through photoreactivation, and repair increased with increase in photoreactivating light exposure time. This implies additional doses above inactivation thresholds are required to cause irreversible damage. These results are useful for designing solar disinfection systems.

Corneal cross-linking (CXL) is a noninvasive therapeutic procedure for keratoconus that is aimed at improving corneal biomechanical properties by induction of covalent cross-links between stromal proteins. It is accomplished by ultraviolet A (UVA) radiation of the cornea, which is first saturated with photosensitizing riboflavin. It has been shown that standard epithelium-off CXL (S-CXL) is efficacious, and it has been recommended as the standard of care procedure for keratoconus. However, epithelial removal leads to pain, transient vision loss, and a higher risk of corneal infection. To avoid these disadvantages, transepithelial CXL was developed. Recently, iontophoresis has been adopted to increase riboflavin penetration through the epithelium. Several clinical observations have demonstrated the safety and efficacy of iontophoresis-assisted epithelium-on CXL (I-CXL) for keratoconus. This review aimed to provide a comprehensive summary of the published studies regarding I-CXL and a comparison between I-CXL and S-CXL. All articles used in this review were mainly retrieved from the PubMed database. Original articles and reviews were selected if they were related to the I-CXL technique or related to the comparison between I-CXL and S-CXL.

Background: Topical agents used in combination with phototherapy or photochemotherapy may have both blocking or enhancing effects in ultraviolet rays. Objective: In this in vivo study, the effects of topical petrolatum, basis cream, glycerine, and olive oil on the transmission of ultraviolet A radiation were investigated. Methods: A test was performed to determine the minimal phototoxic dose on 29 volunteers with only psoralen plus ultraviolet A (PUVA) and then the same test was repeated with white petrolatum, basis cream, glycerine, olive oil, and sunscreen (0.3cc/25cm2). The effects of each agent on the minimal phototoxic dose were determined after 72 h. Results: When compared to pure PUVA, there was a statistically significant increase in the mean minimal phototoxic dose values by the application of white petrolatum (P = 0.011), but there was no significant increase or decrease in the mean minimal phototoxic dose values after the application of basis cream (P = 0.326), glycerine (P = 0.611) or olive oil (P = 0.799). Study limitations: Low number of patients Conclusion: The application of white petrolatum, which has a blocking effect, and also of basis cream immediately before PUVA therapy should not be recommended. Although we specify that glycerine and maybe olive oil can be used before photochemotherapy, there is a need for further research in larger series.

To determine whether the pulsed-light ultraviolet-A (UVA) accelerated corneal crosslinking (CXL) procedure is more efficacious and selective than its continuous-light counterpart in rabbits.School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.Experimental study.Fifty-four rabbits were divided into 2 groups. Group 1 had continuous-light accelerated CXL using 9 mW/cmThe mean stromal demarcation line depth was 254.7 μm ± 47.4 (SD) in Group 1 and 341.1 ± 36.1 μm in Group 2 (P .01). One day after CXL, confocal analysis and histological staining identified keratocyte apoptotic fragments in the anterior stroma in the Group 2 corneas whereas all cells were obliterated in Group1. Seven days after treatment, the thicknesses in Group 1 were significantly greater than those in Group 2 (P .05). Endothelial cell losses were reversible; however, in Group 1, some losses were still evident on day 7. Increases in both the stress-strain relationship and tangent modulus in Group 2 were greater than those in Group 1.The pulsed-light accelerated CXL protocol was less injurious and more efficacious at inducing CXL than the continuous-light accelerated CXL protocol in rabbit corneas.

Purpose: The present study aimed to define the epidermal moisturizing effects of human dermal stem/progenitor cell-derived conditioned medium (hDSPC-CM) on normal human epidermal keratinocytes (NHEKs). Methods: To investigate the epidermal moisturizing effects of hDSPC-CM on NHEKs, I measured 2,2-di...

Purpose To evaluate the effect of accelerated corneal cross-linking with photoactivated chromophore (PACK-CXL) as additional treatment for therapy-resistant infectious keratitis. Methods In this interventional cohort study, 20 patients (11 men and 9 women), aged 65.5 (interquartile range = 21.5-78.5) years, who were hospitalized for moderate-sized therapy-resistant bacterial corneal ulcers (11/20 microbiologically confirmed) were treated with hypoosmolar 0.1% riboflavin solution and Ultraviolet A (UVA) irradiation for 3 minutes at 30 mW/cm (5.4 J/cm) as additional therapy to standard antimicrobial treatment. Results We did not observe any adverse effects of accelerated PACK-CXL on the corneal stroma or limbus. The median ulcer size was 3.00 (2.63-4.50) mm, the median time to reepithelialization was 6.50 (5.00-18.0) days, and the mean hospitalization period was 8.5 ± 4.5 days. Tectonic keratoplasty became necessary in 1 patient (5%). Conclusions Our results suggest that accelerated PACK-CXL may provide an antimicrobial effect similar to the 1 low-intensity, slow setting (30 minutes at 3 mW/cm) and may be used as additional treatment in moderate-sized therapy-resistant infectious keratitis.

Background & objectives: Though Unani medications have been used for centuries to treat psoriasis, there is paucity of published studies which have systematically evaluated their efficacy and safety. This study was conducted to establish non-inferiority of Unani medications (oral UNIM-401 and topical UNIM-403) vs psoralen plus ultraviolet A (PUVA) sol in treatment of moderate-severe chronic plaque psoriasis (CPP) in achieving psoriasis area severity index (PASI) 75 at 12 wk and to estimate proportion of patients who relapsed in follow up period of 12 weeks, after having achieved PASI 50. Methods: In this randomized, controlled trial patients with CPP were block randomized to receive either Unani treatment (147 patients) or PUVA sol (140 patients) for 12 weeks. Percentage reduction in PASI was determined in each patient at 12 wk to calculate number of patients who achieved PASI 75 as also to estimate median of percentage reduction in PASI in each group. All patients who achieved PASI 50 at 12 weeks were followed up for another 12 wk to determine proportion of patients who relapsed. Results: Of the 287 patients randomized, 84 of 147 in Unani group and 67 of 140 in PUVA sol group completed 12 weeks of treatment. On intention-to-treat (ITT) analysis, the response in patients on Unani medication was not inferior to those receiving PUVA sol, in attaining PASI 75 (16.3% in Unani group vs 15.7% in the PUVA sol group). Median of percentage reduction of PASI at 12 wk from baseline in Unani group (68.2%; −60, 100) and PUVA sol group (63%; −15.7, 100) was comparable. Proportion of patients who relapsed at 24 wk was comparable in both groups. However, frequency of clinical side effects was significantly higher (P =0.001) in PUVA sol group (16.4%) compared to Unani group (2%). Interpretation & conclusions: The findings of the present study indicated that oral UNIM-401 and topical UNIM-403 were effective and well tolerated therapeutic options in patients with moderate-severe CPP.

Ultraviolet-A (UVA) (365 nm) irradiation with intensity of solar irradiance on a sunny day was detrimental to the culturability of Enterococcus faecalis in stormwater matrices. qPCR analysis revealed that the UVA-treated E. faecalis cells remained viable despite the loss of culturability.

The catalytic properties of small-molecule proteolysis targeting chimeras (PROTACs) may lead to uncontrolled degradation. Therefore, the main disadvantages of PROTACs are non-cancer specificity and relatively high toxicity, which limit the clinical application of PROTACs. The photocontrolled PROTACs (photoPROTACs) were proposed to overcome this issue, in which they can be triggered by ultraviolet A (UVA) or visible light to induce the degradation of the target protein. Herein, we designed several photoPROTACs to cause the degradation of bromodomain-containing protein 4 (BRD4) on-demand using 365 nm light. The representative compound N2 is proved to induce the degradation of BRD4 upon irradiation. Moreover, compound N2 was successfully applied in vivo to inhibit tumor growth in a zebrafish xenograft model of skin cancer tongue squamous cell carcinoma (TSCC) in a photocontrol manner.