Should hospitals use sunbeds to prevent infections?

According to a “Naked Scientist" study, the answer is yes!

We get most of our vitamin D by the action of UVB radiation from sunshine on our skin, however, in the UK between October and March the radiation is too weak for vitamin D to be made. Consequently, our vitamin D levels are at their lowest in March. Is the winter peak in infections due to low vitamin D levels?

It is well established that vitamin D is important to the body's immune system - in the innate immune system it regulates the production of the antimicrobial peptides cathelicidin and beta-defensin 2 (http://"http://view.ncbi.nlm.nih.gov/pubmed/15322146"); in the adaptive immune system it controls the activation of T-cells (http://"http://www.citeulike.org/user/KGelling/article/6775173").

And there appears to be a correlation between vitamin D and infections:From PubMed(http://"http://www.ncbi.nlm.nih.gov/pubmed/20056018")
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'Healthcare costs of Staphylococcus aureus and Clostridium difficile infections in Veterans: role of vitamin D deficiency'.

SUMMARY
Clostridium difficile and staphylococcal infections are associated with increased morbidity, mortality and healthcare costs. Vitamin D deficiency may also contribute to increased healthcare costs. There is increasing evidence that vitamin D may have an antimicrobial role. We examined the relationship of serum 25(OH)D levels to staphylococcal and C. difficile infections to determine if vitamin D deficiency was associated with adverse outcomes.

Vitamin D deficiency is intimately linked to adverse health outcomes and costs in Veterans with staphylococcal and C. difficile infections in North East Tennessee. We recommend that vitamin D status be checked in patients with these infections and appropriate therapy be instituted to restore vitamin D level to normal in an expeditious manner.

From Digestive Disease Week 2010 conference (http://"http://www.eurekalert.org/pub_releases/2010-05/ddw-teo042910.php"):
Quote
Higher Resolution Rate of Clostridia Difficile Enteritis in Hospitalized Patients with Normal Vitamin D Levels (Abstract #T1793)

Researchers tracked 83 patients who had been admitted to the hospital who were then diagnosed with C. diff. They measured vitamin D levels in all of the patients, then followed their hospital course. Researchers noted how many patients were still alive after 30 days, and compared the outcome of patients with normal vitamin D levels to those with low levels. They found that up to 40 percent of people, especially in an older age group with multiple illnesses, died from some cause if they developed C. diff during that hospitalization.

Researchers found that those with normal levels of vitamin D had a higher resolution rate, and a lower recurrence rate than those with low vitamin D levels. These findings are consistent with what is currently understood about vitamin D — it plays a role in immune function, may be an important factor in fighting infection, low levels seem to be a marker for not resolving diseases in general and it is associated with higher mortality rates.

So improving vitamin D levels should at least improve infection outcomes, if not reduce infection rates But does anything prevent MRSA or C.Difficile infections? Beta-defensin 3 appears to be effective against MRSA (http://"http://jac.oxfordjournals.org/cgi/content/full/dkn106v1"). Beta-defensin 3 is created by UVB light.

From PubMed (http://"http://view.ncbi.nlm.nih.gov/pubmed/19342087")
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UV-B radiation induces the expression of antimicrobial peptides in human keratinocytes in vitro and in vivo

RESULTS:
Real-time PCR of normal human keratinocytes revealed a dose-dependent increase of human beta-defensin-2, -3, ribonuclease 7, and psoriasin (S100A7) after UV radiation. This was confirmed at the protein level by intracellular fluorescence-activated cell sorting and in vitro immunofluorescence analysis. Immunohistochemistry of biopsies taken from healthy volunteers exposed to different UV radiation doses revealed enhanced epidermal expression of antimicrobial peptides after UV exposure. This was also confirmed by exposing human skin explants to UV radiation.

So a NB-UVB sunbed would increase a patient's vitamin D levels and produce skin-level antimicrobial peptides including beta-defensin 3.
The Naked Scientists Forum
Life Sciences Physiology & Medicine
Topic started by: Kevan Gelling on 06/05/2010 13:39:57