Ultraviolet Light in Human Health, Diseases and Environment

367 Pages·2017·9.28 MB·English

by  Shamim I. Ahmad (eds.)

Advances in Experimental Medicine and Biology 996
Shamim I. Ahmad Editor
Ultraviolet Light
in Human Health,
Diseases and
Environment
Advances in Experimental Medicine
and Biology
Volume 996
Editorial Board
IRUN R. COHEN, The Weizmann Institute of Science, Rehovot, Israel
ABEL LAJTHA, N.S. Kline Institute for Psychiatric Research,
Orangeburg, NY, USA
JOHN D. LAMBRIS, University of Pennsylvania, Philadelphia, PA, USA
RODOLFO PAOLETTI, University of Milan, Milan, Italy
NIMA REZAEI, Tehran University of Medical Sciences Children’s Medical
Center, Children’s Medical Center Hospital, Tehran, Iran
More information about this series at http://www.springer.com/series/5584
Shamim I. Ahmad
Editor
Ultraviolet Light in
Human Health, Diseases
and Environment
Editor
Shamim I. Ahmad
Faculty of Science and Technology
Nottingham Trent University
Nottingham, UK
ISSN 0065-2598 ISSN 2214-8019 (electronic)
Advances in Experimental Medicine and Biology
ISBN 978-3-319-56016-8 ISBN 978-3-319-56017-5 (eBook)
https://doi.org/10.1007/978-3-319-56017-5
Library of Congress Control Number: 2017954385
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The editor dedicates this book to his late father, Abdul Nasir,
and mother, Anjuman Ara, who played very important roles to
bring him to this stage of academic achievements with their
esteemed love, sound care, and sacrifice. Dedication also goes
to his wife Riasat Jan for her patience and persistent
encouragement to produce this book and also to the Ahmad
family, Farhin, Mahrin, Tamsin, Alisha, and Arsalan, especially
the latter two for providing him great pleasure with their
innocent interruptions leading to his energy revitalization.
Dedication also goes to skin cancer patients who innocently,
due to lack of knowledge, may have overexposed themselves
under the sun or man-made UV lamps.
Preface
Ultraviolet (UV) light is sometimes referred to as UV radiation. In this sec-
tion, I will be using UV light which would mean the same. There are two
major sources of this light – our sun and the man-made UV lamps. The UV
light from the sun ranges from 180 to 400 nm. This light is classified in three
main types: UVA (320–400 nm), UVB (290–320 nm), and UVC (180–290
nm). Recently UVA and UVB bands are subclassified into narrowband UVB
(311–313 nm), UVA2 (320–340 nm), and UVA1 (340–400 nm). Also a vari-
ety of UV lamps of different wavelengths and different capacities and filters
are available for various applications.
Solar UV light has been exerting major impacts on almost all forms of life
including its useful roles in photosynthesis and the production of vitamin
D. On the other hand, it plays damaging roles on human health including
promoting various forms of skin diseases, the most devastating being skin
cancers. The UVC light in laboratory conditions has been shown to be the
most damaging to biological systems especially to DNA, leading to various
forms of cancers. Fortunately most of it is absorbed by the stratospheric
ozone layer. Some UVB however can reach us, and this appears to play roles
in inducing skin cancers including melanoma, basal cell carcinoma, and
squamous cell carcinoma. Out of these three types, melanoma is the most
dangerous, and if not attended soon, its metastasis can occur fairly rapidly in
the body. The gradual depletion of the atmospheric ozone layer during the
past few years, increasing the incidence of solar UVC radiation on the Earth’s
surface, is one of the environmental concerns, because of the harmful effects
of this radiation in all forms of life.
The indirect effect of UV light on human health is when it photoactivates
biological or nonbiological compounds and the reaction products are reactive
oxygen species (ROS). A large number of photolyzing chemicals have been
identified to react with the UV light generating ROS. These chemically gen-
erated highly reactive species are hydrogen peroxide, superoxide, hydroxyl
radical, and singlet oxygen. In vivo, ROS are formed as a natural by-product
of the normal metabolism of oxygen and have important roles in cell signal-
ing and homeostasis. ROS have also been implicated in a variety of inflam-
matory responses including cardiovascular disease, hearing impairment via
cochlear damage, and mediation of apoptosis and ischemic injury. ROS also
play important positive roles in driving certain biochemical reactions as well
eliminating invading microbial pathogens.
vii
viii Preface
For readers’ easy reading, the contents of the chapter have been sectional-
ized below.
Part I: Chapter 1 includes the introduction, historical aspects, and sources of
the UV light and their applications.
Part II: Chapters 2 and 3 cover the photoactive products of biological and
nonbiological compounds, impacts of UVA and UVB on a biological sys-
tem, and what we have learned from the UV studies on microorganisms.
In Chap. 4 the author presents a detailed account of the impacts of UVA
and UVB light on living organisms and human health and diseases.
Part III: This section covers a major area of UV studies combining Chaps. 5,
6, 7, 8, 9, 10, 11, 12 and 13 describing a number of human diseases induced
by UV light. In Chap. 5 a detailed analysis of various forms of skin can-
cers is covered, and in Chap. 6, extreme UV sensitivity of children suffer-
ing from xeroderma pigmentosum and the precautionary measures
required to reduce its effect are highlighted. Due to its prominent pheno-
type, coupled with the chronic and incurable nature, vitiligo has a signifi-
cant negative impact on the quality of life of patients suffering from it.
This has been critically highlighted in Chap. 7; also discussed is the
supremacy of UV light in vitiligo as an established therapeutic option over
and above several treatment modalities instituted over the years, with
varying efficacy. Polymorphous light eruption, the commonest immuno-
mediated photodermatosis, occurs after solar or artificial UV light expo-
sure, and because the reaction mostly appears on exposed areas, the
exclusive association of this light in inducing this kind of skin problem is
emphasized. Apart from shedding light on the mechanism involved in its
development, in Chap. 8, broad-spectrum sunscreens and antioxidants,
PUVA, and narrowband UVB have been recommended to prevent the dis-
ease. A detailed description of UV damage mechanism to skin cells and
the defense mechanism is depicted in Chaps. 9, 10 and 11. Generalized
photobiology in dermatology and the roles of UVA1 in dermatological
effects and diseases such as sunburn, immunosuppression, skin aging, car-
cinogenesis, and photoprotection are comprehensively described. Also
highlighted is that when used under controlled conditions, UV radiation
can be helpful in the diagnosis and treatment of many skin conditions.
The differences seen between the pigmented- and non-pigmented-type
skins when exposed to UV light can be read in Chap. 12. Psychoneuroendocrine
immunology is a new and novel field of study that investigates the link
between bidirectional communications among the nervous system, the endo-
crine system, and the immune system and the correlations of this cross-talk
with physical health. This unusual field of UV studies has been addressed in
Chap. 13.
Part IV: This section provides the information we reap from the UV light.
Vitamin D in recent years drew considerable attention from researchers
and medics, playing important roles in a number of biochemical reactions;
in Chap. 14, the author, a leading player in vitamin D synthesis, describes
Preface ix
the historical aspect as well as the detailed mechanism of the synthesis of
vitamin D when a human body is exposed to UVB light. As mentioned
above, UV is also an inducer of skin cancer, thus raising the question of
how much sun exposure should a human have to synthesize the required
amount of vitamin D without risking cancer development. The biochemi-
cal aspect of vitamin D in health and diseases has also been adequately
described at different angles in Chap. 15. Further importance of vitamin D
in human health has been made clear in Chaps. 16, 17, 18, 19, 20, 21, and
22 where it has been shown that its deficiency can lead to rheumatoid
arthritis (Chap. 16) and asthma and allergy (Chap. 17). Vitamin D levels
and its metabolism also play roles in the development of atherosclerosis
leading to cardiovascular disease (Chap. 17); also in this chapter, the
authors discuss both normal and disordered vitamin D metabolism and
major clinical trials regarding vitamin D levels and effects of its supple-
mentation. Although the importance of vitamin D in type 2 diabetes
remains a controversial issue, the authors in Chap. 19 have discussed this
issue fairly critically. Some of the remaining diseases triggered by vitamin
D deficiency have been pooled in Chap. 20 in the form of metabolic syn-
drome; these include obesity, dyslipidemia, and cardiovascular diseases
including myocardial infarction, coronary artery disease, and stroke. Also
highlighted is the role of vitamin D in skeletal growth and maintenance.
Furthermore the ubiquitous expression of vitamin D receptor in body cells
such as immune, vascular, and myocardial cells, pancreatic beta cells, neu-
rons, and osteoblasts points to an involvement of vitamin D-mediated
effects on metabolic syndrome. Chapter 21 focuses on how important
genome stability is for human health and, when genomes are damaged by
UV exposure, what overall effects can be seen on health. In Chap. 22 the
author presents a comprehensive treatise of the current knowledge of vita-
min D effects from a cardiovascular health perspective and roles of vita-
min D in relation to cardiovascular diseases such as ischemic heart disease
and stroke; the traditional cardiovascular risk factors such as hypertension,
abnormal blood lipids, and obesity; and the emerging risk factors such as
hyperparathyroidism, microalbuminuria, chronic obstructive pulmonary
diseases, and nonalcoholic fatty liver disease due to vitamin D
deficiency.
Part V: Chapters 23, 24, 25 and 26 have been dedicated to understand the
roles of UV light in sterilization and their impacts on human health. Out of
several different ways that food and common-use materials are sterilized,
it is suggested that exposure to UV light is one cheap, clean, and efficient
method to get rid of unwanted pathogenic and nonpathogenic contamina-
tions. Some microbial species have evolved their mechanisms to produce
biofilms to protect themselves from the killing effect of UV light. UV
treatment of water, besides eliminating the pathogenic microbes, can have
the side effects of photoactivation of certain organic compounds leading to
the production of mutagenic/genotoxic by-products including certain
nitrogen-containing aromatic compounds; these are formed by the photo-
lytic products of nitrate with natural organic matter. Hence, while treating
the water by UV light, precaution must be taken to filter out such
x Preface
by-products before water is supplied for consumption; this has been
addressed in Chap. 24. Chapter 26 comprehensively addresses that the
presence of bacteria, viruses, and other pathogens in municipal wastewater
can adversely affect the environment, human health, and economic activ-
ity. One way to mitigate these effects is a terminal disinfection step using
UV light. The advantage of this method of disinfection, when compared to
traditional chlorine disinfection, is that no chlorinated by-products and no
chemical residues are produced by the former method. Chapter 25 empha-
sizes that the UV disinfection method holds promise for reducing the level
of contamination in operating rooms and thereby lowering the risk of
infection to patients. In Chap. 23 the production of biofilm and its use in
adaptation against UV radiation are presented, and also the application of
UV light to monitor and destroy biofilms in man-made surfaces is
addressed.
Part VI: In this section, various methods of UV phototherapy of different
skin diseases, which have been in use for many years, are highlighted; for
this it is either that UV light is employed on its own or in combination with
certain photolyzing compounds. Chapter 27 addresses atopic dermatitis
which is one of the most common chronic inflammatory skin diseases that
are treated by a variety of methods including exposure of the affected
areas to broadband UVB (290–320 nm), narrowband UVB (311–313 nm),
UVA1 therapy (340–400 nm), UVA therapy plus 8-methoxypsoralen
(PUVA), 308 nm excimer laser (EL), and full-spectrum light (FSL).
Currently, narrowband UVB phototherapy is the most employed treatment
due to its availability, security, ease of administration, and efficacy.
Chapter 28 emphasizes that phototherapy remains the only therapeutic
option for certain patient groups where modification of the systemic
immune reactions is contraindicated, such as HIV, internal malignancy, or
pregnancy, and for this the UVB treatment is highly cost-effective. Chapter
32 addresses the safety and efficacy of phototherapy in the management of
eczema treatment, and in Chap. 29 it has been claimed that the UV light
can be used to decontaminate blood. This process was extensively used in
the 1940s and 1950s to treat blood for diseases such as septicemia, pneu-
monia, tuberculosis, arthritis, asthma, and even poliomyelitis, but then for
some reason, it could not prevail. The author suggests that ultraviolet
blood irradiation is a valuable process to eliminate any pathological con-
tamination and hence must be revitalized. Chapter 30 addresses the sun-
screen commonly used to prevent or reduce the damaging effects of UV
light on skin especially during holiday period at the seaside places as well
to those working in the open field. A number of sunscreens with variable
composition and strength (known as SPF or sun protection factor) are
available in the market, and their effective use and possible abuse is
included in the discussion. In Chap. 31, the author has presented a novel
weed Parthenium hysterophorus found to grow ubiquitously in various
continents with warmer climates; it has been found to induce contact der-
matitis and possible mechanisms of photosensitization. The influence of
UV light on the pattern of parthenium dermatitis is also discussed.