الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 143 |  |  |
| | | from | 143 | | |
Abstract
Psoriasis is a chronic, non-infectious; immune-mediated inflammatory skin disease, that affects people of all ages, with no predilection for sex.
Plaque psoriasis is the most common and well-recognized form of psoriasis. It can be easily diagnosed by presence of characteristic red colored plaques with well-defined borders and silvery white dry scale. Other less common types of psoriasis also occur, such as guttate, inverse, pustular and erythrodermic.
A range of co-morbidities are associated with psoriasis, including metabolic diseases, there are overlapping genetic predispositions with psoriasis. Psoriasis may serve as initiator of the systemic inflammatory process, or considered as the amplifier of systemic inflammatory march.
Etiology of psoriasis is not fully understood, it is generally believed that factors in the immune system that regulate skin cell division become impaired. KCs are activated and deviate from the normal differentiation cycle, leading to the excessive proliferation and expression of immune-related molecules.
High mobility group box 1 is one of the most important DAMP molecules, which exert their actions through differential engagement of multiple surface receptors, including TLR2, TLR4, and RAGE; these receptors may mediate its effects, including chemotactic cell movement and release of proinflammatory cytokines, so HMGB1 is consider a critical mediator of inflammation.
An inflammatory environment caused by injury or infection leads to the release of HMGB1. Once released, the inflammatory effects of HMGB1 contribute to an inhibition of phagocytosis by macrophages, a differentiation of anti-inflammatory regulatory T cells to pro-inflammatory Th17-cells and an activation of TLRs and RAGE on the cell surface which contribute to progression of psoriasis.
The aim of the present work was to investigate serum level of HMGB1 in patients with psoriasis compared with healthy controls. The present study included 60 subjects; 30 patients with psoriasis vulgaris and 30 age and gender matched healthy subjects as a control group.
Exclusion criteria included patients with any dermatological diseases other than psoriasis, patients with autoimmune diseases as SLE, patients with chronic diseases as chronic renal failure, patients having infectious conditions at the time of blood sampling as bacterial infection.
Patients were subjected to thorough history taking clinical, general and dermatological examination including assessment of PASI score and serum HMGB1 level was measured using human HMGB1 ELISA kits.
In the current study, there was a highly significant difference in the levels of serum HMGB1 between patients and controls (P=0.00).
Also serum HMGB1 increased in psoriatic patients in relation to the severity of the disease as there was a highly significant difference between mild, moderate, severe groups regarding the mean serum HMGB1 levels (P=0.00). There was a highly significant positive correlation between PASI score and mean of serum HMGB1 levels in the patients group (P =0.00).
There was statistically significant difference between level of HMGB1 and course of disease (P=0.024).