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Sunlight exposure exerts immunomodulatory effects to reduce multiple sclerosis severity

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Item Type:Article
Title:Sunlight exposure exerts immunomodulatory effects to reduce multiple sclerosis severity
Creators: Ostkamp, P., Salmen, A. ORCID logoORCID: https://orcid.org/0000-0002-4751-299X, Pignolet, B., Görlich, D. ORCID logoORCID: https://orcid.org/0000-0002-2574-9419, Andlauer, T.F.M. ORCID logoORCID: https://orcid.org/0000-0002-2917-5889, Schulte-Mecklenbeck, A. ORCID logoORCID: https://orcid.org/0000-0003-3855-4706, Gonzalez-Escamilla, G. ORCID logoORCID: https://orcid.org/0000-0002-7209-1736, Bucciarelli, F., Gennero, I. ORCID logoORCID: https://orcid.org/0000-0002-8572-7852, Breuer, J., Antony, G. ORCID logoORCID: https://orcid.org/0000-0002-5367-6069, Schneider-Hohendorf, T. ORCID logoORCID: https://orcid.org/0000-0002-3717-5176, Mykicki, N., Bayas, A., Then Bergh, F., Bittner, S. ORCID logoORCID: https://orcid.org/0000-0003-2179-3655, Hartung, H.P., Friese, M.A. ORCID logoORCID: https://orcid.org/0000-0001-6380-2420, Linker, R.A., Luessi, F. ORCID logoORCID: https://orcid.org/0000-0003-4334-4199, Lehmann-Horn, K., Mühlau, M. ORCID logoORCID: https://orcid.org/0000-0002-9545-2709, Paul, F. ORCID logoORCID: https://orcid.org/0000-0002-6378-0070, Stangel, M. ORCID logoORCID: https://orcid.org/0000-0003-2504-5398, Tackenberg, B., Tumani, H. ORCID logoORCID: https://orcid.org/0000-0002-1647-6201, Warnke, C. ORCID logoORCID: https://orcid.org/0000-0002-3510-9255, Weber, F., Wildemann, B., Zettl, U.K. ORCID logoORCID: https://orcid.org/0000-0002-6348-1759, Ziemann, U. ORCID logoORCID: https://orcid.org/0000-0001-8372-3615, Müller-Myhsok, B. ORCID logoORCID: https://orcid.org/0000-0002-0719-101X, Kümpfel, T. ORCID logoORCID: https://orcid.org/0000-0001-7509-5268, Klotz, L., Meuth, S.G. ORCID logoORCID: https://orcid.org/0000-0003-2571-3501, Zipp, F. ORCID logoORCID: https://orcid.org/0000-0002-1231-1928, Hemmer, B. ORCID logoORCID: https://orcid.org/0000-0001-5985-6784, Hohlfeld, R. ORCID logoORCID: https://orcid.org/0000-0002-6302-1488, Brassat, D., Gold, R., Gross, C.C., Lukas, C. ORCID logoORCID: https://orcid.org/0000-0002-8562-9697, Groppa, S., Loser, K., Wiendl, H. and Schwab, N. ORCID logoORCID: https://orcid.org/0000-0001-5494-9885
Abstract:Multiple sclerosis (MS) disease risk is associated with reduced sun-exposure. This study assessed the relationship between measures of sun exposure (vitamin D [vitD], latitude) and MS severity in the setting of two multicenter cohort studies (n(NationMS) = 946, n(BIONAT) = 990). Additionally, effect-modification by medication and photosensitivity-associated MC1R variants was assessed. High serum vitD was associated with a reduced MS severity score (MSSS), reduced risk for relapses, and lower disability accumulation over time. Low latitude was associated with higher vitD, lower MSSS, fewer gadolinium-enhancing lesions, and lower disability accumulation. The association of latitude with disability was lacking in IFN-β-treated patients. In carriers of MC1R:rs1805008(T), who reported increased sensitivity toward sunlight, lower latitude was associated with higher MRI activity, whereas for noncarriers there was less MRI activity at lower latitudes. In a further exploratory approach, the effect of ultraviolet (UV)-phototherapy on the transcriptome of immune cells of MS patients was assessed using samples from an earlier study. Phototherapy induced a vitD and type I IFN signature that was most apparent in monocytes but that could also be detected in B and T cells. In summary, our study suggests beneficial effects of sun exposure on established MS, as demonstrated by a correlative network between the three factors: Latitude, vitD, and disease severity. However, sun exposure might be detrimental for photosensitive patients. Furthermore, a direct induction of type I IFNs through sun exposure could be another mechanism of UV-mediated immune-modulation in MS.
Keywords:Sunlight, Multiple Sclerosis, Vitamin D, Latitude, Melanocortin 1 Receptor
Source:Proceedings of the National Academy of Sciences of the United States of America
ISSN:0027-8424
Publisher:National Academy of Sciences
Volume:118
Number:1
Page Range:e2018457118
Date:5 January 2021
Additional Information:Erratum in: PNAS 118(29): e2110306118
Official Publication:https://doi.org/10.1073/pnas.2018457118
PubMed:View item in PubMed

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