الفهرس 
Hypoxia inducible factor 1-alphaOnly 14 pages are availabe for public view
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Abstract
Psoriasis is a chronic disease affecting 1-3% of the population worldwide.Although many theories have been involved in the pathogenesis of psoriasis.It has an important genetic component and its incidence may be influenced by non genetic risk factors,particularly stressful life events,smoking,obesity and there is a role of immune system activation.
Metabolic Syndrome (MetS) is interrelated group of metabolic abnormalities, characterized by abdominal obesity, hypertension, impaired lipoprotein metabolism and glucose intolerance. Abdominal obesity is associated with elevated triglycerides (TGs) and low high density lipoprotein (HDL) level. The glucose level may be normal early but insulin resistance develops over time and the pancreas fails to secrete insulin and type 2 diabetes develops.
The pathophysiological mechanisms involved in metabolic syndrome are complex in nature and involved dysregulation of many biochemical and physiological regulatory systems in the body .
HIF is a heterodimeric DNA-binding complex composed of two basic helix-loop-helix proteins of the PAS family (PER, AHR, ARNT and SIM family): the constitutive HIF-1β and one of either hypoxia-inducible α-subunits, HIF-1α or HIF-2α but HIF-1α is much more studied due to its major role in psoriasis and other diseases in which tissue hypoxia occurs as cancers.
When activated it upregulates the expression of the proangiogenic genes as “vascular endothelial growth factor” (VEGF) ,VEGF receptors 1 & 2 which are called Fms-like tyrosine kinase 1 (FLT-1) and Fetal liver kinase 1 (FLK-1), plasminogen activator inhibitor-1 (PAI-1), angiopoietins, TIE-2 (cell-surface receptors that bind to and are activated by the angiopoietin1), matrix metalloproteinases (MMP-2) and calcitonin receptor-like receptor, semaphorin4D (Sema4D) and cytokine stem cellfactor (SCF). Moreover, inducible nitric oxide synthase, an enzyme producing nitric oxide (NO) that induces cutaneous vasodilatation in response to local heat, injury, or hypoxia is a target of HIF-1α. All participates in angiogenesis and inflammation accounting for the main pathogenesis of psoriasis.
It also help in differentiation of both T-Regs and Th17 playing a major role in the cellular component of pathogenesis.
The present study included 50 patients suffering from psoriasis. In addition to 30 apparently healthy individuals of matched age and sex were served as a control group.Each patient was subjected to full history taking, complete general examination and complete dermatologic examination. Investigating fasting blood glucose, lipid profile (TGs, TC, LDL and HDL), serum hypoxia inducible factor 1 alpha levels, measuring blood pressure, BMI and WC in comparison with age-and sex- matched healthy controls.
Metabolic syndrome component were evaluated both clinically and laboratory in all studied subjects in addition to estimating serum level of HIF-1alpha using ELISA technique.
The obtained data was tabulated and statistically analyzed. The results of the current study revealed that the serum levels of HIF1α was significantly higher in patients than in controls (p=0.005) with sensitivity 88% and specificity 46.7% .
The current study results showed that there was significant positive correlation between serum HIF-1 alpha level regarding TC, TG, LDL and FBG (p value = .005 , .049 , .021 , .019 respectively) while it showed significant negative correlations with HDL in psoriasis with MetS.
Higher HIF-1α was significantly associated with those patients who had psoriasis and Mets when compared to those who had psoriasis without Mets (p>0.001) with sensitivity 85.7% and specificity 89.4%