الفهرس 
Review of the literatureOnly 14 pages are availabe for public view
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Abstract
Psoriasis is a chronic and debilitating inflammatory disease with cycles of remissions and exacerbations. It characterized by infiltration of inflammatory cells into the epidermis and altered keratinocyte differentiation. It affects 1-3% of the world population, causing a significant impact on a patient’s quality of life. Psoriasis affects both sexes equally and can appear at any age.
Clinical manifestations of psoriasis are heterogeneous, ranging from limited to extensive disease. May varieties of clinical presentation can occur; plaque, pustular, guttate and erythrodermic. chronic plaque-type psoriasis is the classical pattern of psoriasis characterized by red, sharply demarcated, erythematous plaques with loosely adherent silvery-white scales, which preferentially affects the elbows, Knee and scalp. The disease is variable in extent, duration and periodicity of flare.
The etiology of psoriasis in unknown, but evolving evidence suggests that it is complex disorder caused by interaction of multiple factors including immunological, environmental and genetic factors. It is also believed to be associated with other cellular, biochemical and metabolic defects.
SMAD7 is a protein that in human is encoded by the (SMAD7 ) gene. It belongs to the (SMAD) family of proteins, which belong to the transforming growth factor beta (TGF β) superfamily of ligands. TGF-β signaling is modulated temporally and spatially by diverse regulators, among which SMAD7 acts as a key negative regulator. SMAD7 antagonizes TGF- β signaling through multiple mechanisms.
The aim of this work was to study possible role of SMAD7 Protein in plaque psoriasis by immunohistochmeical study of its expression in skin biopsies of psoriatic patients and to correlate its expression with the available clinico-pathological data.
This case-control study was carried out on 30 patients with psoriasis vualgaris, their age ranged from 23 to 56 years, with different clinical types of psoriasis. They were selected from Dermatology outpatient clinic, Menoufia University Hospital. Twenty age and gender matched healthy subjects were also included in this study as a control group.
All patients were subjected to complete history taking, clinical examination, full dermatological examination and assessment of the disease severity by Psoriasis Area and Severity Index (PASI) score.
Three millimeters punch biopsy was taken under complete aseptic condition, preceded by 2% lignocaine local anesthesia from psoriatic skin lesion and a skin biopsy was also taken from control subjects. Biopsies was fixed in neutral formalin 10% and was submitted to routine tissue processing ending with paraffin embedded blocks formation in Pathology Department, Faculty of Medicine, Menoufia University.
Several paraffin sections, each 4μm thick was cut from each block, one of them was stained with hematoxylin and eosin (H&E) stain and the other sections was immunostained by SMAD7 .
The present results demonstrated SMAD7 expression in dermis and epidermis of lesional skin was positive in all cases and nuclear localization with moderate intensity in 60 % of cases0.
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Summary
Positive SMAD7 expression in epidermis, moderate intensity, higher percent of positive cells in lesional skin of studied cases were statistically significant compared with perilesional skin of studied cases. Positive expression of SMAD7 and moderate intensity were statistically significant in lesional skin of studied cases compared with perilesional skin of studied cases. Positive SMAD7 expression, moderate intensity, higher percent of positive cells and higher range of H-score in epidermis of lesional skin of studied cases were statistically significant compared with control skin. Positive SMAD7 expression, moderate intensity, higher percent of positive cells and higher range of H-score of SMAD7 in dermis of lesional skin of studied cases were statistically significant compared with control skin.