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Review
. 2022 Mar;142(3 Pt B):849-856.
doi: 10.1016/j.jid.2021.05.007. Epub 2021 Jun 22.

Mechanisms of Photosensitivity in Autoimmunity

Shannon N Estadt  1 , Mitra P Maz  1 , Jon Musai  2 , J Michelle Kahlenberg  3
Affiliations
Review

Mechanisms of Photosensitivity in Autoimmunity

Shannon N Estadt et al. J Invest Dermatol. 2022 Mar.

Abstract

Aberrant responses to UV light frequently lead to the formation of skin lesions and the activation of systemic inflammation in some autoimmune diseases, especially systemic lupus erythematosus. Whereas the effects of UV light on the skin have been studied for decades, only recently have some of the mechanisms that contribute to abnormal responses to UV light in patients with autoimmune diseases been uncovered. This review will discuss the biology of UV in the epidermis and discuss the abnormal epidermal and inflammatory mechanisms that contribute to photosensitivity. Further research is required to fully understand how to normalize UV-mediated inflammation in patients with autoimmune diseases.

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Conflict of interest statement

Conflict of Interest: JMK has received Grant support from Q32 Bio, Celgene/BMS and Janssen. JMK has served on advisory boards for AstraZeneca, Eli Lilly, GlaxoSmithKline, Bristol Myers Squibb, Avion Pharmaceuticals, Provention Bio, Aurinia Pharmaceuticals, Ventus Therapeutics, and Boehringer Ingelheim. All other authors have nothing to disclose.

Figures

Figure 1:
Figure 1:. Overview of differential effects of UV light on healthy vs. lupus skin.
In healthy skin (left), UV light generates an immunosuppressive environment characterized by efficient clearance of apoptotic cells, immune cell activation, and secretion of protective/suppressive cytokines including type I interferons (IFNs) and IL-10. In lupus skin, UV light exposure is inflammatory secondary to increased immune cell infiltration, inhibition of negative regulatory mechanisms, and amplified production of type I IFNs that enhance keratinocyte apoptosis. Apoptotic cells are not efficiently cleared resulting in increased autoantigen exposure, immune complex formation, and lesion development.
See this image and copyright information in PMC

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