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Complexities in ETS-domain transcription factor function and regulation: lessons from the TCF (ternary complex factor) subfamily. The Colworth Medal Lecture.

The ETS-domain transcription factor family can be divided into a series of subfamilies. Elk-1 represents the founding member of the ternary complex factor (TCF) subfamily. By focusing on the TCF subfamily, we can demonstrate the complexities that exist in the function and regulation of ETS-domain transcription factors. This article focuses on Elk-1 in detail and summarizes the functions of other TCFs. The key themes covered include the domain structure of the TCFs, the mechanisms of complex formation with serum response factor, regulation of TCFs by mitogen-activated protein kinase cascades, and transcriptional regulatory properties of the TCFs. Finally, the emerging role of the TCFs in vivo is discussed. A picture is developing indicating that, while these proteins exhibit significant sequence and functional conservation, key differences in their structure and regulation are being identified which may relate to unique functions of these proteins in vivo.

Amino Acid Sequence↗

Adverse effects with PUVA and UVB phototherapy.

PUVA and UVB phototherapy are very effective and popular treatments for a variety of dermatological problems. This article gives an overview of the possible acute and chronic adverse effects of these therapies.

Humans↗

Therapy of psoriasis: comparison of photochemotherapy and several variants of phototherapy.

Four treatments involving light were compared in two series of patients with severe psoriasis. The first series consisted of ten patients, who were treated by the method of paired comparisons. The treatments given were: (1) exposure to fluorescent sunlamps (B); (2) the same, supplemented by fluorescent UV-A lamps (A + B); (3) the same as (2) with the addition of the radiation from germicidal lamps (A + B + C); (4) photochemotherapy with oral 8-MOP followed by UV-A (PUVA); (5) one of the fields served as control, receiving no light at all. The second series consisted of thirty patients. They were treated either with PUVA or with a placebo capsule followed by A + B (pUVAB). The phototherapies examined differed from many previous attempts in that the increments in dose were made sufficiently large to overcome the increasing tolerance of the skin to light during the treatment. It is concluded (a) that phototherapy, if conducted in this way, is as effective as PUVA, and (b) that the effectiveness achieved with the phototherapies examined is due to the light from the fluorescent sunlamps (B).

Clinical Trials as Topic↗

Unscheduled DNA synthesis in normal human skin after single and combined doses of UV-A, UV-B and UV-A with methoxsalen (PUVA).

The aim of this study was to measure unscheduled DNA synthesis (UDS) by autoradiography in normal human skin (I) after high dose UV-A, (2) after low dose UV-A applied before or after erythemogenic doses of UV-B, (3) after high dose PUVA and (4) after therapeutic doses of PUVA applied before and after erythemogenic doses of UV-B. Single high dose UV-A exposure induced roughly 60% of the amount of UDS induced by equally erythemogenic doses of UV-B. Single low dose UV-A exposure did not induce UDS, nor did it significantly alter the amount of UV-B induced UDS when combined with UV-B exposure. Single high dose PUVA did not lead to UDS and had no influence on UV-B induced UDS when combined with UV-B exposure. Our findings indicate: (I) erythemogenic doses of UV-A induce a considerable DNA excision repair; (2) low dose UV-A neither augments UV-B induced DNA repair nor does it inhibit the repair process; (3) no UDS was shown to occur after eight high or therapeutic doses of PUVA. This was unexpected since psoralen-DNA monoadducts have been shown to be repairable by a mechanism similar to excision repair of pyrimidine dimers. It is therefore assumed that PUVA as performed for therapeutic purposes either preferentially induced interstrand crosslinks not repairable via the classical repair mechanism or the repair of monoadducts was below resolution in this study; (4) therapeutic PUVA doses apparently do not interfere with excision repair of UV-B induced DNA lesions.

Adult↗

Abnormal lymphocyte function following long-term PUVA therapy for psoriasis.

The surface markers and function of peripheral blood lymphocytes were examined in patients on long-term therapy with methoxsalen and UV-A radiation (PUVA). Ten patients with psoriasis were selected because they had received a high exposure to PUVA therapy, i.e., more than 200 treatments over 2-6 years with cumulative exposure doses of 1700-6000 J/cm2 UV-A radiation. Results were compared to those obtained with lymphocytes from untreated patients and UV-B treated patients with psoriasis. The PUVA-treated patients had low levels of E rosette-forming cells in the peripheral blood and markedly impaired lymphocyte responses following stimulation with optimal and suboptimal doses of mitogens. The sensitivity of lymphocytes to in vitro treatment with PUVA was similar in the three groups of patients. The results of this study indicate that long-term PUVA therapy alters the function and cell-surface markers or distribution of lymphocytes.

Adolescent↗

UVB phototherapy and photochemotherapy (PUVA) in the treatment of polymorphic light eruption and solar urticaria.

Forty subjects (36 with polymorphic light eruption and four with solar urticaria) were treated during the spring and early summer of the years 1982 to 1985 with either UVB phototherapy (a total of 54 treatment courses in subjects with polymorphic light eruption) or photochemotherapy (PUVA) (18 treatment courses in polymorphic light eruption and eight in solar urticaria patients). Both forms of prophylactic therapy were found to be effective in 90% of those with polymorphic light eruption, and PUVA in all those with solar urticaria. The optimum duration of treatment was 5 weeks. Adverse reactions, although common, were usually slight and rarely required alteration of the treatment regimen.

Adolescent↗

A comparison of the efficacy and relapse rates of narrowband UVB (TL-01) monotherapy vs. etretinate (re-TL-01) vs. etretinate-PUVA (re-PUVA) in the treatment of psoriasis patients.

Forty-five patients with extensive chronic plaque or guttate psoriasis were treated with either narrowband (TL-01) phototherapy, etretinate TL-01 combination therapy (re-TL-01) or etretinate and PUVA (re-PUVA) (15 patients in each group). Re-PUVA was the most effective therapy with 100% satisfactory clearance rate. TL-01 monotherapy had an 80% success rate; the relapse rate compared favourably with re-PUVA (50% in remission after 6 months). In the etretinate-TL-01 group, there was a 93% success rate and a one-third reduction in the total irradiation dose (8.0 J/cm2 vs. 12.7 J/cm2) but the relapse rate was higher, only 33% remaining in remission after 6 months.

Adult↗

Phototherapy: how does UV work?

Phototherapy has been largely empirical. Thus, despite the long term use its mechanisms of action are quite unclear. Because of the recent achievements in photoimmunology and molecular photobiology we are now beginning to understand some of the mechanisms. Many of the effects are certainly mediated via induction of apoptotic cell death. Another major mechanism is the induction of immunosuppression. This review primarily focuses on recent advances in photoimmunology which will contribute to the further understanding how phototherapy acts.

Animals↗