الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Warts are cutaneous and mucosal lesions caused by human papilloma virus infection (HPV).
Mannose-binding lectin (MBL) is an essential component of the innate immune system, and it can identify a wide range of common microorganisms through binding to certain carbohydrate structures on the microbial surface, activating the complement system and enhancing complement-independent opsonophagocytosis.
MBL deficiencies may be associated with a wide spectrum of infectious diseases, including viral infections.
Despite the presence of many destructive and immunotherapeutic modalities for treatment of warts, treatment of multiple, recalcitrant, or recurrent warts still represents a real challenge for the physicians.
No single treatment modality is completely effective in all patients has been explored to date.
Intralesional immunotherapy has promising results so it is one of the most important therapeutic approach for treatment of different types of warts.
In this study, we evaluated the efficacy and safety of purified protein derivative immunotherapy in the treatment of warts, and the impact of MBL codon 54 gene polymorphism in the response of warts to PPD immunotherapy.
Our study was case-control study that was enrolled with 100 participants: 50 patients with warts and 50 healthy controls.
Blood samples were obtained from each participant and collected in EDTA containing tube.
MBL2 gene exon 1 codon 54 polymorphism was detected by using restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR).
Response to treatment was evaluated by photographic comparison at baseline and the end of treatment sessions, and dermoscopy of the lesions at baseline and the end of treatment sessions.
In the existing work, we found statistically significant association between MBL 2 exon1 codon 54 polymorphism and susceptibility to HPV infection and warts development. Carriage of heterozygous MBL genotype (AB) was more frequent in wart cases (42%) than in controls (18%).
28 out of the 50 patients (56 %) showed complete response, four patients (8 %) achieved partial response and 18 patients (36 %) didn’t respond to the intralesional injection of PPD.
No statistically significant association was found between the therapeutic response to PPD and the demographic data of patients as regards age and sex.
Statistically significant association was found between the therapeutic response to PPD and number and duration of warts (The less the number and duration of warts, the more liability for complete clinical clearance)
No statistically significant association could be found between the therapeutic response to PPD immunotherapy in wart cases and MBL genotypes.
Regarding side effects, pain during injection was constant finding in all patients. Other local reactions such as burning sensation, erythema and edema were reported, but they were mild and transient.
No recurrence of the lesions was observed after the 6 month follow up period after PPD immunotherapy.
Intralesional immunotherapy with PPD is simple, safe, and effective for treatment of injected and distant warts. It has promising results so it is one of the most important therapeutic approach for treatment of different types of warts.