الفهرس | Only 14 pages are availabe for public view |
Abstract Psoriasis is one of the chronic inflammatory skin diseases with a genetic basis characterized pathologically by epidermal hyper proliferation, abnormal keratinocyte differentiation, T-lymphocyte infiltration, and increased expression of cytokine while characterized clinically by thickened, erythematous well demarcated plaques covered by silvery scales, it affects 2–4% of the general population. Advances genome wide association studies (GWAS): so far, more than 40 genetic loci have been identified as psoriasis susceptibility genes, including the human leucocyte antigen-C (HLAC), genes belonging to the interleukin (IL) 23/T helper type 17 cell (Th17) axis and those belonging to the nuclear factor kappa B pathway .have been made in understanding the genetic basis of psoriasis through. Polymorphisms of IL-17 family have been correlated with the severity and response to treatment in psoriasis, and also with the risk of inflammatory, infectious, autoimmune or neoplastic pathologies. T-cell activation results in release of pro-inflammatory cytokines leading to abnormal keratinocyte proliferation and differentiation .The pathologic hallmarks of psoriatic plaque include hyper-proliferation of keratinocytes in the epidermis and infiltration of T lymphocytes, dendritic cells, neutrophils, and other inflammatory cells. The aim of this study was to study the association of IL17F (rs763780) with susceptibility of psoriasis in Egyptian population. Summary 74 This study was included on 174 subjects (50 males and 124 females), their ages ranged between 33-65 years, the subjects were divided into two groups: group 1 (87 Patients with psoriasis who met the criteria of diagnosis), group II (87 apparently healthy subjects) as control. All Patients and controls included in the study were subjected to the followings: History taking, Clinical examination including Extent and severity of psoriatic lesion: Psoriasis Area and Severity Index (PASI) score was evaluated., Laboratory examination included: CBC, liver functions, kidney functions, CRP, ESR and FBG and Immunological tests (ANA, Anti _ dsDNA, C3 and C4) and genotyping and allelic discrimination of IL17F rs763780 gene polymorphism by real time PCR. The results was as the following: Regarding age and sex there were no statistically significant difference between cases and controls. According to CBC there were highly statistically significant difference between cases and control regarding Hb and LMPH, and there were no significant difference regarding PLT, WBCs and granulocytes. Regarding laboratory tests there were highly statistically significant difference between the studied groups as regarding uric acid, CRP and ESR Patients group was statistically significant higher in CRP, uric acid and ESR than controls group, and there were no statistically significant difference between all studied groups as regarding fasting blood glucose, Urea, Creatinine, ALT, AST. Summary 75 According to immunological markers: there was highly statistically significant difference between all studied groups as regarding ANA, Anti dsDNA, C3 and C4. Genotype distribution of IL17, CC genotype and C allele were statistically significant higher in whole psoriasis patients than in control group. The TT genotype was higher in control group than psoriasis group in addition CC genotype was higher in patients group than in controls group. regarding to univariate logistic regression analysis Hb, Lymphocytes, Uric acid, ESR 1st hr, C3, C4 and rs763780 were dependent risk factors for psoriasis ,while by multivariate C3 was independent risk for psoriasis . Regarding relation between IL-17F rs763780 and clinical data of the studied patients there was highly statistically significant relation between course of disease and genotypes of rs763780 in which course of the disease was progressive in 60 % of patients carrying C/C genotype with (P=0.041) Also, there was highly statistically significant relation between site of lesion and genotypes of (rs763780) where 97 % of patients had psoriatic lesion in axial and extremities carrying C/C genotype with (p value 0.010), There was highly statistically significant between PASI score and genotypes of rs763780 in which PASI score was higher in patients carrying CC genotype with mean±SD (11.69 ± 4.52) and (P value <0.001). Summary 76 Indeed, there was highly statistically significant relation between severity of psoriasis among the studied patients and genotypes of rs763780, severity of psoriasis increased in patients carrying CC genotype (P value <0.001). According to relation between rs763780 with Laboratory tests and Immunological markers of the patients there were no statistically significant between laboratory tests, the immunological markers and genotypes of rs763780. |