Page 38 - Read Online

Philips et al. Plast Aesthet Res 2022;9:4 https://dx.doi.org/10.20517/2347-9264.2021.83 Page 7 of 10

prevention of photoaging and carcinogenesis.

CONCLUSION
VD facilitates skin health through its action on dermal fibroblasts and/or melanoma cells by preventing
oxidative DNA damage, membrane damage, and lipid peroxidation, and by stimulating superoxide
dismutase expression ameliorating the effects of oxidative stress [34,35] . In addition, VD reduced the expression
of IL-1, TNF-α, IL-8, TGF-β, and VEGF, decreasing inflammation [35,53,54] and also preventing cell death in
UVB-irradiated fibroblasts, increasing p53 promoter activity [34,35] . At the extracellular level, VD stimulated
the expression of type I collagen and inhibited elastase, elastin, and MMPs, particularly MPP-1 and MPP-2,
with beneficial ECM effects [68,69] .

In summary, the data reviewed here suggested that VD supported the maintenance of skin health with anti-
aging and anti-carcinogenic effects. The currently recommended doses of VD (as cholecalciferol, D ) are
[70]
3
400 units (1 unit = 0.025 μg VD) for children until one year of age, 600 units for people ranging from 1 year
through 70 years of age, and 800 for people over 70 years of age [28,71,72] . The physiological dose of VD is 2.5-
10 μg (1 μg = 40 units), and the pharmacological dose of VD (as cholecalciferol, D , or ergocalciferol, D ) is
2
3
[73]
0.625-5 mg for 1-3 months to treat VD deficiency . The other commonly used VD metabolites or analogs,
paricalcitol, doxercalciferol, and calcitriol, are used to treat secondary hyperparathyroidism . The current
[47]
research on VD effects strongly advocates for dietary supplementation with VD. Further, the anti-
photoaging and anti-carcinogenic effects of VD could be potentiated by non-steroidal anti-inflammatory
drugs (NSAIDs). The cyclooxygenase-2/prostaglandin E2 pathway, which is inhibited by NSAIDs, has been
implicated in the etiology of cancer, along with the inflammatory cytokines. Piroxicam and Diclofenac
(NSAIDs) inhibit MMP-2 activity in a fibrosarcoma cell line. Both NSAIDS are suitable for field
cancerization treatment of actinic keratosis. It is inferred that the combination of Diclofenac, or other
NSAIDS, with VD, would provide added benefit.

DECLARATIONS
Authors’ contributions
Conceptualization: Philips N
Writing - original draft preparation: Philips N, Portillo-Esnaola M
Writing - review and editing: Philips N, Portillo-Esnaola M
Figures: Portillo-Esnaola M, Samuel P, Gallego-Rentero M
Initial bibliographic research: Keller T, Franco J

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.