الفهرس 
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Abstract
SUMMARY
Vitiligo is a multifactorial disorder that associated with the destruction of melanocytes resulting from immune and inflammatory mediators. The most important theory about the pathogenesis of vitiligo is the autoimmune theory in which cytokines and inflammatory mediators such as GM-CSF, TNFα, IL6, IL1 and IL8 play a key role. YKL-40 is one of the major secreted proteins from human articular chondrocytes, synovial cells, endothelial cells and macrophages, and expressed by mature neutrophils.It is suggested that it participates in many physiological and pathological processes such as proliferation, angiogenesis, mitogenesis and remodelling.
This present study aimed to measure serum level of YKL-40 (CH3L1) protein as an inflammatory biomarker in vitiligo patients using enzyme-linked immunosorbent assay (ELISA) method.
The study was a Case-Control study conducted over a period of six months from July 2021 to the end of February 2022 in the Dermatology outpatient clinic at Beni-Suef University Hospitals. This study included 40 patients that had vitiligo disease distributed as 27 females and 13 males’ patients, their age ranged from 18 to 59 years. And 40 healthy controls were taken, they were sex matched to the vitiligo cases.
Written Informed consent had been taken from all studied participants prior to beginning of the study. All participants were subjected to full clinical and laboratory investigations. Blood samples had been taken from all studied participants (vitiligo cases and healthy controls) to study the serum level of Chitinase 3-like 1 (CHI3L1), (YKL-40).
from the current study, we can sum up the following points:
• There was significant difference found between two groups regarding age .Mean duration of vitigo among our patients was 9.43 ± 8.35 years ranging between 0.1 and 40 years. While the mean duration of last lesion was 4.53 ± 3.02 months ranging between 1 and 10 months.
• The median VASI score was 2.25 ranging between 0.5 and 1.5, and the VETI score ranged from 0.5 to 20 with median 5.04. As regards the site of distribution results, there were 22 (55.0%) patients had vitiligo in hand, 19 (47.0%) with feet, 11 (27.5%) with all over the body, 6 (15.0%) with face, 5 (12.5%) with abdominal, 4 (10.0%) with neck, and 3 (7.5%) patients with trunk and 2 with genitalia.
• There was significant difference found between two groups regarding age, and there was no significant difference between two groups regarding Sex.
• All of our patients had progressive vitiligo. All of our patients had no associated skin or systemic diseases.
• Regarding the comparison of YKL-40 serum level between vitiligo cases and healthy controls, the presented study demonstrated that the serum level of YKL-40 in vitiligo patients is significantly elevated.
• There was no significant difference found between YKL 40 and family history. Moreover, there was no significant correlation between YKL 40 and age, duration of vitiligo disease (years), duration of last lesion (months), VASI score and VETI score.
• Receiver operating characteristic curve shows that the best cut off point of YKL 40 to detect patient group was found > 98.55 ng/ml with sensitivity of 100%, specificity of 100.0%, positive protective value of 100.0%, negative protective value of 100% and total accuracy of 100.0%,.
Taken together, our data analyses reveled that serum level of Chitinase 3-like 1 (CHI3L1), (YKL-40) was significantly higher in vitiligo serum as compared with healthy controls serum. serum level of Chitinase 3-like 1 (CHI3L1), (YKL-40) showed non-statistically significant association with participants’ age, gender, disease duration, family history, VASI score or VETI score.