الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Verrucae vulgaris are benign epithelial proliferations caused by double stranded DNA virus called human papillomavirus (HPV). Clinically, Verruca vulgaris appears as a hyperkeratotic, dome-shaped papule. During the early stages of an HPV infection, on the level of epithelial cells, the host innate immune response becomes the first line of defence against the infection. Dendritic (DC), Langerhans (LC), natural killer (NK), natural killer T (NKT) cells and keratinocytes, among others, are important cells involved in promoting a good adaptive immune response against HPV infection. CD40 is a 48-kDa transmembrane glycoprotein surface receptor also known as the tumor necrosis factor receptor superfamily member 5 (TNFRSF5). It is expressed at the cell surface of many different types of cells one of them is epithelial cells (ECs). Normally epithelial cells show a coordinated response to CD40 ligation, mainly inducing the expression of genes involved in leukocyte migration, cell- to-cell signalling and interaction, as well as cell death and survival. The HPV was found to attenuate the extent of CD40 signaling, resulting in lower amounts of chemo attractants produced and a failure to enhance immune cell migration. Objectives: the aim of this study is to estimate level of CD40 expression in both serum and tissue of verruca vulgaris patients in comparison to matched heathy control group to understand the role of CD40 in such disease. Patients & Methods: this case control study was done on 44 subjects (22 verruca vulgaris patients and 22 healthy matched controls). Serum and tissue levels of CD40 were estimated by ELISA technique. All patients were subjected to full history taking, general examination and local examination. Results: In this study serum and tissue levels of CD40 were higher in verruca vulgaris patients than controls. Also, serum levels were significant to local characteristics of lesions as regard size, duration of illness, age of wart and associated symptoms (pain& itching). While tissue levels showed only significance in relation to disease onset. The receiver operating characteristic (ROC) analysis revealed that serum CD40 shows 81% sensitivity and 95% specificity comparing to 68% sensitivity and 100% specificity of tissue CD40 in diagnosing verruca vulgaris. Conclusion: CD40 levels plays important role immune response elicited against HPVs causing verruca vulgaris. Key words: serum CD40, tissue CD40, verruca vulgaris, warts |