الفهرس 
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Abstract
Psoriasis is a chronic inflammatory immune mediated skin disease. It has a negative impact on the patient’s quality of life. The prevalence of psoriasis is now on an increase. It is considered a systemic disease affecting not only the skin, but also associated with other comorbidities.
Autophagy, an intracellular homeostatic mechanism, plays a pivotal role in inflammation, autoimmunity, and cellular differentiation. The exact pathogenesis of psoriasis is still poorly understood. The role of autophagy in psoriasis is a great topic of interest.
Light chain 3 (LC3) is a good marker for autophagosome formation. Therefore, this study aimed to investigate whether LC3 has a role in psoriasis.
The current study was conducted on 60 subjects; 30 cases of psoriasis and 30 age and gender matched apparently normal subjects as a control group. All studied individuals were subjected to complete history taking and physical examination. The severity of the disease was assessed by PASI score.
Skin biopsies from the perilesional and lesional skin as well as from the control group were subjected to LC3 immunohistochemical staining. Immunohistochemical expression of LC3 in relation to the clinical data and histopathological parameters was investigated.
Lesional psoriatic skin possessed different degrees of epidermal histopathological changes. Epidermal acanthosis, psorisiform hyperplasia, hyperkeratosis, parakeratosis, Munro microabcesses, suprapapillary thinning, hypogranulosis, spongiosis, coalescent rete ridges, and exocytosis were noted with variable percentage. Most of these changes were also observed in the perilesional skin of psoriatic patients but with less percentage.
There were significant differences between lesional and perilesional skin regarding the presence of acanthosis and its degree, psoriasiform hyperplasia and hyperkeratosis as well as significant differences regarding the degree of psorisiform hyperplasia and degree of hyperkeratosis. A significant difference regarding the parakeratosis, the suprapapillary thinning, granular cell layer, the morphology of the tips of rete ridges, and spongiosis were also recorded. Moreover, there was a significant difference between lesional and perilesional skin regarding the presence of exocytosis and its type.
Dermis of lesional skin showed elongation of papillary dermis, papillary edema, tortuous blood vessels, dilated blood vessels, and perivascular inflammatory infiltrate. All these changes were present in different degrees, varying from mild to severe. Dermis of perilesional skin showed most of these changes but with less percentage.
There was a significant difference between lesional and perilesional skin regarding the presence of elongation of papillary dermis, degree of papillary edema, dilated blood vessels, and tortuosity of the blood vessels. There was a significant difference between lesional and perilesional skin regarding the degree and types of inflammatory infiltrate.
Regarding LC3 immunoreaction, there was a significant difference between the 3 studied groups regarding the epidermal and dermal LC3 pattern of expression, intensity, H score, H score category, and distribution. Nucleocytoplasmic expression was prominent in psoriatic skin either lesional or perilesional in comparison with normal skin. A stepwise increase in LC3 expression from normal to perilesional and lesional skin was detected.
There was a non-significant correlation between the epidermal/dermal LC3 H score in the lesional skin and PASI score. Moreover, a significant negative correlation between the disease duration and the epidermal H score of LC3 expression in the perilesional epidermal skin was recorded. There was a non-significant relation between the H score and most of histopathological data. A significant relation was noted between the epidermal H score and the degree of papillary edema.
There were significant positive correlations between the lesional and perilesional epidermal LC3 expression and between the lesional epidermal and perilesional dermal LC3 immunoreaction. Moreover, significant positive correlations between the lesional and perilesional dermal LC3 expression, between epidermal and dermal LC3 expression in the lesional and perilesional skin as well as between epidermal LC3 H score in the lesional skin and dermal LC3 H score in the perilesional skin were recorded.