الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Abstract Psoriasis is a multifactorial skin disease with a complex pathogenesis that still needs to be clarified. IL-33 plays a role in several biologic processes as well as in the pathogenesis of different diseases, including skin pathologies. It acts as an alarmin that can either exert beneficial cell housekeeping functions, leading to tissue repair, or provoke deleterious uncontrolled inflammation. IL-33 is a pro-inflammatory cytokine that, although originally defined as an inducer of Th2-mediated responses, it was found to be involved in Th1/Th17-mediated diseases. Although IL-33 expression is increased in skin lesions of patients with psoriasis, there are limited studies on serum level of IL-33 in such patients. Consequently, the aim of this study was to evaluate serum level of IL-33 in patients with psoriasis vulgaris, and to explore their correlation with disease severity and activity. Methods : All patients were subjected to: History taking: 1. Name, age, gender, occupation, residence, special habits. 2. Age at onset, disease duration. 3. Disease activity: opinion of the patient (progressive, regressive, stable over the last 3 months). 4. Family history of psoriasis. 5. Type and duration of previous treatment. 6. Other diseases and treatment. Clinical examination: 1. Full general examination to exclude systemic disease: blood pressure, pulse rate, respiratory rate and BMI (weight in Kg/height in meters2). 2. Full body dermatologic examination in adequately-illuminated examining room (skin, mucous membrane, nail, hair). 3. Diagnosis of psoriasis vulgaris by clinical picture, dermoscopy or biobsy for suspected cases. 4. The disease activity of psoriasis was assessed by psoriasis area and severity index (PASI), which scores both involved body area and clinical appearance of psoriatic lesions (Fredriksson and Petterson, 1978). Measurement of serum IL-33 levels: The serum IL-33 levels were measured by an enzyme linked immunosorbent assay (ELISA), as instructed by the manufacturer, using kits provided by QUANTA Lite ® ELISA, INOVA Diagnostic, Inc (9900 Old Grove Road, San Diego, CA 92131-1638, USA). Inclusion criteria: • Patients of both sexes with active and stable psoriasis. • Age between 18 and 60 years. • Healthy weight: body mass index (BMI) between 18.5 – 24.9. • Active psoriasis: patients reporting worsening of already existent lesions as well as the development of new lesions during the previous 1 month. • No treatment for psoriasis has been received in the past 1month. • Healthy controls with no previous, current or family history neither of psoriasis nor autoimmune disease. Exclusion criteria: • Patients treated with narrowband ultraviolet B irradiation or systemic treatment in the past one month. • Healthy controls having personal or family history of psoriasis. • Pregnant women or women on hormonal contraception. • Subjects with immune-mediated comorbidities. • systemic disease. • Refusal to participate. Results: In this study, serum IL-33 showed statistically significant higher mean value among psoriasis patients as compared to control group. The level of IL-33 in active psoriasis was significantly higher than its level in inactive psoriasis. In addition, there was a statistically significant correlation between IL-33 and PASI score. Receiver operating characteristics (ROC) curve detected the validity of serum IL-33 in differentiating psoriasis patients from controls. The best cut off point for IL-33 was determined to be ≥ 22.72 pg ∕ ml, which was able to predict psoriasis with 96.67% sensitivity and 93.33% specify. Serum IL-33 was a statistically significant predictor of PASI score with 63.5% of PASI score can be predicted by serum IL-33. Conclusion These results indicate that serum IL-33 may represent a new marker for psoriasis diagnosis, and measurement of its level may be a tool to assess the disease severity as it generally reflects increased inflammation in patients with psoriasis. This may open new perspectives for understanding the mechanisms and developing a new therapeutic approach for psoriasis.