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The role of UV radiation and vitamin D in the seasonality and outcomes of infectious disease

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Abstract

The seasonality of infectious disease outbreaks suggests that environmental conditions have a significant effect on disease risk. One of the major environmental factors that can affect this is solar radiation, primarily acting through ultraviolet radiation (UVR), and its subsequent control of vitamin D production. Here we show how UVR and vitamin D, which are modified by latitude and season, can affect host and pathogen fitness and relate them to the outcomes of bacterial, viral and vector-borne infections. We conducted a thorough comparison of the molecular and cellular mechanisms of action of UVR and vitamin D on pathogen fitness and host immunity and related these to the effects observed in animal models and clinical trials to understand their independent and complementary effects on infectious disease outcome. UVR and vitamin D share common pathways of innate immune activation primarily via antimicrobial peptide production, and adaptive immune suppression. Whilst UVR can induce vitamin D-independent effects in the skin, such as the generation of photoproducts activating interferon signaling, vitamin D has a larger systemic effect due to its autocrine and paracrine modulation of cellular responses in a range of tissues. However, the seasonal patterns in infectious disease prevalence are not solely driven by variation in UVR and vitamin D levels across latitudes. Vector-borne pathogens show a strong seasonality of infection correlated to climatic conditions favoring their replication. Conversely, pathogens, such as influenza A virus, Mycobacterium tuberculosis and human immunodeficiency virus type 1, have strong evidence to support their interaction with vitamin D. Thus, UVR has both vitamin D-dependent and independent effects on infectious diseases; these effects vary depending on the pathogen of interest and the effects can be complementary or antagonistic.

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Abbreviations

1,25(OH)2D:

1α,25-Dihydroxy-vitamin D

25(OH)D:

25-Hydroxy-vitamin D

7-DHC:

7-Dehydrocholesterol

AHR:

Aryl hydrocarbon receptor

AMP:

Antimicrobial peptide

APC:

Antigen presenting cell

ARV:

Antiretroviral

BCG:

Bacillus Calmette-Guérin

CPD:

Cyclobutane pyrimidine dimers

dDC:

Dermal dendritic cell

dLN:

Draining lymph node

DC:

Dendritic cell

DTH:

Delayed type hypersensitivity

EBV:

Epstein-Barr virus

ECM:

Extracellular matrix

HIV:

Human immunodeficiency virus

HSV:

Herpes simplex virus type 1

IAV:

Influenza A virus

IL:

Interleukin

LC:

Langerhans cells

LPS:

Lipopolysaccharide

MAPK:

Mitogen-activated protein kinases

MC:

Mast Cell

MDM:

Monocyte-derived macrophages

MN:

Monocyte

mVDR:

Membrane vitamin D receptor

NK:

Natural Killer cells

NO:

Nitric oxide

nVDR:

Nuclear vitamin D receptor

PBMC:

Peripheral blood mononuclear cells

PI3K:

Phosphatidylinositol 3-kinase

PP:

Photo products

PRR:

Pattern recognition receptor

ROS:

Reactive oxygen species

RSV:

Respiratory syncytial virus (RSV)

RTI:

Respiratory tract infections

RXR:

Retinoid X receptor

TB:

Tuberculosis

Th:

T helper

TLR:

Toll-like receptors

Treg:

Regulatory T cells

UCA:

trans-Urocanic acid

UVA:

Ultraviolet A radiation

UVB:

Ultraviolet B radiation

UVR:

Ultraviolet radiation

VDRE:

Vitamin D response elements

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  1. Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa

    Abhimanyu & Anna K. Coussens

  2. Division of Medical Microbiology, Department of Pathology, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa

    Anna K. Coussens

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Correspondence to Anna K. Coussens.

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Abhimanyu, Coussens, A.K. The role of UV radiation and vitamin D in the seasonality and outcomes of infectious disease. Photochem Photobiol Sci 16, 314–338 (2017). https://doi.org/10.1039/c6pp00355a

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