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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 Name:Ostkamp, P. and Salmen, A. and Pignolet, B. and Görlich, D. and Andlauer, T.F.M. and Schulte-Mecklenbeck, A. and Gonzalez-Escamilla, G. and Bucciarelli, F. and Gennero, I. and Breuer, J. and Antony, G. and Schneider-Hohendorf, T. and Mykicki, N. and Bayas, A. and Then Bergh, F. and Bittner, S. and Hartung, H.P. and Friese, M.A. and Linker, R.A. and Luessi, F. and Lehmann-Horn, K. and Mühlau, M. and Paul, F. and Stangel, M. and Tackenberg, B. and Tumani, H. and Warnke, C. and Weber, F. and Wildemann, B. and Zettl, U.K. and Ziemann, U. and Müller-Myhsok, B. and Kümpfel, T. and Klotz, L. and Meuth, S.G. and Zipp, F. and Hemmer, B. and Hohlfeld, R. and Brassat, D. and Gold, R. and Gross, C.C. and Lukas, C. and Groppa, S. and Loser, K. and Wiendl, H. and Schwab, N.
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
Publisher:National Academy of Sciences
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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