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Narrowband UVB Phototherapy for Clinically Isolated Syndrome: Delivering the Benefits of All UVB-Induced Molecules

Kermode, A.G., Hart, P.H., Fabis-Pedrini, M.J., Lucas, R.M., Booth, D.R., Carroll, W.M., Nolan, D., Cole, J.M., Jones, A.P. and Trend, S. (2018) Narrowband UVB Phototherapy for Clinically Isolated Syndrome: Delivering the Benefits of All UVB-Induced Molecules. Multiple Sclerosis Journal, 24 (3). pp. 376-377.

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Background: Trials of vitamin D supplementation have to date lacked definitive outcomes in MS patients. Narrowband UVB can induce vitamin D production, but also other important immune-regulatory molecules in skin.

Objective: The PhoCIS trial (Phototherapy for Clinically Isolated Syndrome) was established in Perth, Australia (32 degrees S), to investigate the clinical, radiological and immunological effects of narrowband UVB phototherapy on MS development in CIS.

Patients and Methods: Nineteen individuals with CIS have been recruited with 53% of them given narrowband UVB phototherapy of 3 sessions per week for 8 weeks. All 19 participants were supplemented when necessary with vitamin D to 25(OH)-vitamin D levels of approximately 80 nmol/L. MRI was performed after 3, 6 and 12 months, and extensive blood cell phenotyping at 1 week, 1, 2, 3, 6 and 12 months after recruitment. No participant was taking any disease modifying drugs at recruitment.

Results: After 6 months, 7 of 9 participants (78%) without phototherapy converted to MS (McDonald criteria). Only 5 of 10 participants (50%) who received phototherapy converted to MS (P=0.22). UVB therapy prevented the increase in memory B cells in the blood of non-phototherapy CIS participants, and produced a significant increase in immunoprotective IgG4.

Conclusion: These interim results demonstrate UVB effects slowing the progression of individuals with CIS to MS. The PhoCIS trial provides a fresh approach to re-defining the reported associations of 25(OH)-vitamin D levels with MS development and progression. The outcomes suggest that UVB-irradiation of skin is immunomodulatory independent of Vitamin D, and can regulate CIS to MS progression.

Item Type: Journal Article
Murdoch Affiliation(s): Institute for Immunology and Infectious Diseases
Publisher: Sage Publications
Copyright: © 2018 by SAGE Publications
Other Information: Poster presentation PACTRIMs 2017
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