Professor Prue Hart
People at risk of developing multiple sclerosis (MS) have been offered a beacon of hope thanks to research into UV exposure.
Led by The Kids Research Institute Australia researcher Professor Prue Hart, a trial delivered narrowband Ultraviolet-B treatment to a small group of people with Clinically Isolated Syndrome, who had shown a first sign of the disease but had not yet progressed.
Half of the 20 participants received the UV-B phototherapy three times a week for eight weeks. Of those, 30 per cent had their progression of MS halted. All those who did not receive phototherapy went on to develop MS.
Professor Hart, Head of the Institute’s Inflammation team, said it was the first time the therapy – an effective treatment for people with the skin condition psoriasis – had been shown to delay MS in high-risk people.
“This is clinically significant and an example of where UV is not all bad,” she said.
“We’ve been too strict with the messaging around exposure to the sun and people are not getting enough UV exposure because of a fear of skin cancer.”
She said further studies were needed to determine the balance between the risks and benefits of sun exposure.
Professor Hart has been studying the effects of ultraviolet radiation (UVR) on health for the past two decades and hopes to translate the work she has done into innovative approaches for patient treatments.
With mice studies having shown that UVR can regulate immune responses, she believes phototherapy may also help people who have had a stroke or type 1 diabetes.
“As UVR exposure is proposed as an immunosuppressive, the results are relevant for all autoimmune conditions,” she said.
It could also signal that MS patients may be advised to get more sun exposure. Vitamin D supplementation trials for MS and many non- skeletal disorders had not shown the reduced disease progression that was hoped for.
Professor Hart said the findings from the small-sample trial had been received with excitement in Scotland, where researchers were heading into a replication study.
“Scotland is an ideal place for follow- up, as there are more cases of MS there and background UV radiation exposure is low,” she said. “The further one lives from the equator, the less ambient UV and the higher the incidence of MS.”
Professor Hart said for patients showing early signs of MS, UVR was a good alternative to strong disease- modifying therapies that could have side effects.
Researchers also took blood samples to find markers to understand why some people developed MS.
“We have a very extensive ongoing program studying changes in biobanked blood cells and serum,” Professor Hart said.
“Do they tell us something about disease progression from pre-MS to MS? The studies are important as it is very rare to have studies of drug-naive pre-MS individuals. Most investigators study patients once diagnosed with MS, and their progression from a relapsing-remitting phase to progressive disease. Importantly, our participants are totally drug- free.”
What's Next
- Studying the biobanked blood samples. “We are not only studying pre-MS to MS progression but also how does UV exposure affect immune cells even if they are unrelated to MS disease. Perhaps what we identify may be related to other conditions.”