الفهرس 
PsoriasisOnly 14 pages are availabe for public view
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Abstract
Psoriasis is a chronic inflammatory, immune-mediated skin condition characterized by sharply demarcated, erythematous, and scaly symmetrical plaques on the elbows, knees or scalp. Although the precise pathomechanism remains unknown, various cytokines and growth factors are involved in this disease. TNF-α is a pleiotropic inflammatory cytokine, and studies indicate that TNF-α plays a critical role in the development of psoriasis. Psoriasis vulgaris is associated with several risk factors for cardiovascular diseases namely, increased oxidative stress, dyslipidaemia, inflammation, and more recently, with overweight and obesity.
The lipocalins are a family of proteins which transport small hydrophobic molecules such as steroids, retinoids, and lipids. They share limited regions of sequence homology and a common tertiary structure architecture. Lipocalin proteins are involved in inflammation and detoxification processes caused by immune system activation in mammals. Neutrophil gelatinase-associated lipocalin (NGAL) or lipocalin 2 is a 25- kDa protein initially isolated from the specific granules of human neutrophil, also it is most abundantly produced from adipocytes .NGAL is linked to either keratin synthesis or terminal differentiation.
Strong induction of NGAL in the epidermis was seen in a variety of skin disorders characterized by dysregulated epithelial differentiation such as psoriasis. Production of NGAL was confined to spatially distinct subpopulations of keratinocytes underlying areas of parakeratosis, whereas skin samples lacking parakeratotic epithelium such as lichen planus were negative for NGAL. The biologic functions of NGAL in epithelia are not fully known. In addition, the transient interfollicular NGAL expression during skin embryogenesis along with the induction of NGAL in adult parakeratotic epidermis suggests that it plays a role in epithelial differentiation pathways. Although an immunomodulatory role in host defense has been proposed, NGAL also have a role as bacteriostatic agent through iron transportation leading to deprivation of bacteria from iron. Another role of NGAL is a survival factor through regulating of iron uptake in to cells. NGAL was isolated as a potential biomarker of acute and chronic kidney injury and protection from injury. It’s also consider key event that contribute to neaplasia
Lipocalin 2 is known to be related to insulin resistance, obesity, hyperglycemia, and hyperinsulinemia by modulating lipoxygenase and TNFα- levels in adipose tissue .So it is possible that lipocalin-2 might be a useful diagnostic and prognostic marker for patients with cardiovascular disease.
The adipose tissue has been recognized as a metabolically active organ, secreting numerous cytokines, referred as adipokines that contribute in the regulation of diverse biological processes, including inflammation and immune function. It is assumed that aberrant secretion of adipocytokines induces metabolic syndrome, which is a strong predictor of cardiovascular disease, diabetes mellitus and coronary heart disease.
Metabolic syndrome is a cluster of central obesity, hypertension, hyperlipidaemia and glucose intolerance, and there is an association between insulin resistance and psoriasis, suggesting that the metabolic syndrome is closely related to the pathogenesis of psoriasis.
Thirty patients with moderate to severe psoriasis were included in this study; 16 males and 14 females. Thirty sex and age matched apparently healthy subjects were taken as controls; 16 males and 14 females.
Peripheral venous blood samples were withdrawn from patients and controls before and after treatment of patients with NB-UVB .Serum levels of lipocalin were measured also, fasting blood sugar and lipid profile were measured and metabolic syndrome was calculated.
There was a significant increase in serum lipocalin -2 in patients with psoriasis. Also there was significant relation between psoriasis and metabolic syndrome.
Serum lipocalin level was inversely related to metabolic syndrome, which has a close association with psoriasis.
There was no change in level of serum lipocalin -2 after treatment of psoriatic patients with NB-UVB.
Otherwise, no relation was found between serum lipocalin and age, sex, duration of disease and PASI.
In conclusion;
• Patients with psoriasis are found to be at increased risk of metabolic disorders compared to the general population.
• Serum lipocalin is increased in psoriatic patients.
• Serum lipocalin carries non significant correlation with parameters of cardiovascular risk factors in our study.
• The NB-UVB have no effect on level of serum lipocalin-2.