Decreased human epidermal antigen-presenting cell activity after ultraviolet A exposure: dose-response effects and protection by sunscreens

Background Ultraviolet (UV) exposure of human skin causes immunosuppression that contributes to the growth of skin cancer. The contribution of UVA in these processes is still a matter of debate. Objectives The purpose of our study was first to find a dose-response effect of UVA exposure on human epidermal antigen-presenting cell (APC) activity and to evaluate the protective capacity of two sunscreen formulations against a high level of acute UVA exposure. We also tried to evaluate the protective capacity afforded by the same sunscreens against UVA-induced clinical changes such as redness and pigmentation. Methods The functional assessment of the alloantigen-presenting capacity of epidermal cells prepared from skin keratotome samples 3 days after UVA exposure was measured with a mixed epidermal cell-lymphocyte reaction (MECLR) in each healthy volunteer (n = 16). Redness and pigmentation were assessed by chromametry 24 h after exposure to a single UVA dose. Results In vivo UVA exposure to 15, 30 and 60 J cm(-2) resulted in a dose-dependent decrease in purified allogeneic T cell (CD4+ T cells) proliferation induced by UVA-irradiated epidermal cells. The epidermal APC function was significantly decreased with a suberythemal exposure corresponding to 15 J cm(-2). The decrease, partial and not statistically different between 30 and 60 J cm(-2), exhibits a plateau-response effect. There was no correlation between the decrease of the epidermal APC function and the intensity of erythema and persistent pigment darkening. Both sunscreen formulations strongly inhibited the UVA-induced reduction of MECLR at 90 J cm(-2). Conclusions Our results clearly demonstrate that UVA impairs the APC activity of the epidermal cells and thus may contribute to UV-induced immunosuppression in humans. They also indicate that erythema and immunosuppression have different dose-response curves in the UVA range. The two sunscreen formulations afforded a significant protection against the decrease in epidermal APC activity induced by exposure to a high UVA dose (90 J cm(-2)).