Robert W. Motl, Grace M. Niemiro, Michael De Lisio, Sarah Sommer, Barry J. Riskin, Catherine A Best-Popescu, Ultraviolet B Phototherapy Intervention in Patients with Multiple Sclerosis: A Prospective, Randomized Pilot Trial, Journal of Neurological Research And Therapy, Volume 3, Issue 1, 2019, Pages 12-25, ISSN 2470-5020, https://doi.org/10.14302/issn.2470-5020.jnrt-19-2797.
(https://www.ijn-medicalarticles.info/neurological-research-and-therapy/article/ultraviolet-b-phototherapy-intervention-in-patients-with-multiple-sclerosis-a-prospective-randomized-pilot-trial-1145)
Abstract: Introduction There is substantial evidence, from well-conducted epidemiological studies, that decreased sun exposure and low vitamin D levels are correlated with an increased risk for multiple sclerosis (MS), and multiple case control studies have implicated the involvement of low vitamin D levels in MS etiology. However, vitamin D supplementation has not been universally successful at raising circulating vitamin D (25-hydroxy vitamin D; 25(OH)D) levels, and has not conclusively reduced MS progression. Thus, interest has turned to studying the therapeutic potential of ultraviolet B radiation (UVB, 280 - 315 nm) in MS disease regulation, because UVB initiates vitamin D synthesis. Additionally, ultraviolet radiation through vitamin-D-independent processes is being considered as an important modifiable modulator of MS pathogenesis. Objectives To investigate UVB induced vitamin D production, immunomodulation and MS symptomology following UVB phototherapy in a MS cohort. Methods Using a triple blinded, randomized placebo-controlled trial (RCT) study design, twelve individuals 18 years or older with MS were enrolled and assigned (1:1) into individualized UVB dose (10-30kJ/m) phototherapy, or into placebo treatment (fluorescent non-UVB light irradiation), delivered 3 times per week, for 8-weeks. Serum vitamin D (25-hydroxy vitamin D; 25(OH)D) levels, walking performance, strength, cognitive function, mood and circulating progenitor cells (CPCs: CD34+CD45dim), monocyte populations (Intermediate CD14+CD16+, Classical CD14+CD16-), and Regulatory T cell (CD4+/CD25+/FoxP3+Tregs) count were assessed. The data were analyzed by 2 x 3 mixed factor ANOVA.   Results A statistically significant condition (UVB phototherapy) by time interaction on vitamin D levels (F=7.14, p<.005, partial η2=.42) was identified. No significant effects of UVB phototherapy on circulating immunomodulatory cells or MS symptomology were detected. Conclusion UVB phototherapy corrects vitamin D deficiency. This study adds to the growing research investigating UVB treatment in MS.
Keywords: Multiple Sclerosis (MS); Ultraviolet B (UVB) radiation; phototherapy; Vitamin D deficiency; 25-hydroxyvitamin D (25(OH)D; and Regulatory T cells (Tregs)