الفهرس 
Evaluation of phosphorylated p38 mitogen activated kinase in pemphigus vulgaris patients
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Abstract
Background: Pemphigus vulgaris (PV) is a life-threatening autoimmune blistering disease characterized by intraepithelial blister formation due to loss of adhesions between keratinocytes induced by autoantibodies directed against desmosomal adhesion proteins, Although the exact pathogenic mechanisms leading to blister formation have not been fully elucidated, intracellular signaling following antibody binding has been found to be necessary for inducing cell-cell dissociation. The p38 Mitogen Activated Protein Kinase(p38 MAPK) signaling pathway plays a major role in the modulation of immune-mediated inflammatory responses and therefore has been linked with several autoimmune diseases. Studies showed that activation of p38 MAPK plays a role in the acantholytic process in PV through changes in the quaternary structure and cytoskeletal rearrangements. Aim of work: To determine whether the p38 MAPK is elevated in the peripheral blood mononuclear cells of pemphigus vulgaris patients or not and to determine whether it is correlated to the clinical score and the anti-desmoglein 3 antibodies. Patients and methods: Our study included 25 Egyptian PV patients recruited from Kasr Al-Aini outpatient clinic over one year and 25 healthy age and sex matched controls. Detailed history and the severity of the diseases using Pemphigus Disease Area Index (PDAI score) were documented in each patient. Blood samples were obtained from all the subjects, the expression of p38 MAPK and its substrate MAPK-activated protein kinase (MAPKAPK) on peripheral mononuclear cells were detected using flowcytometry, and the anti-desmoglein3 antibody was measured using ELISA technique. Results: We observed that the p38 MAPK and MAPKAPK were upregulated in PV patients in comparison to controls (p = 0.024) and (p = 0.002) respectively. There was a positive correlation between the anti-Dsg3 antibodies and P38 MAPK (r=0.591, p=0.004) and between the disease severity (PDAI score) and p38 MAPK (r=0.617, p-0.002) as well