الفهرس 
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Abstract
SUMMARY
This present study aimed to detect effect of PUVA on MAPK pathway and its relationship with the pathogenesis of Vitiligo.
The study was a Case-Control study conducted from Abril 2019 to June 2021 in the Dermatology outpatient clinic at Beni-Suef University Hospital. This study included 30 patients that had Vitiligo disease distributed as 13 males and 17 female patients, their age ranged from 20 to 50 years, the average age was, 36.3±16.1. And 30 healthy controls were taken, they were age and sex matched to the Vitiligo cases. All participants were subjected to full clinical and laboratory investigations. Skin biopsies had been taken from all studied participants (Vitiligo cases and healthy controls) to study effect of PUVA on MAPK pathway and its relationship with the pathogenesis of vitiligo.
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. Skin biopsies had been taken from all studied participants (vitiligo cases and healthy controls) to study the expression of MAPK pathway and its relationship with the pathogenesis of Vitiligo.
Our data analyses reveled that:
- Tissue expression of MAPK was significantly lower in Vitiligo skin lesions as compared with healthy skin biopsies taken from controls; the mean MAPK values (0.354 ±0.167 vs. 1.04 ±0.066) in Vitiligo skin lesions and healthy skin from controls respectively with a statistically significant p-value< 0.001.
- Tissue expression of MAPK was still significantly lower in Vitiligo skin lesions as compared with healthy skin from controls even after exposure to PUVA; the mean MAPK tissue expression values (0.64 ±0.164 vs. 1.04 ±0.066) in Vitiligo skin lesions and healthy skin respectively with a statistically significant p-value< 0.001.
- Tissue expression of MAPK increased significantly after exposure to PUVA in Vitiligo skin lesions; the mean tissue expression values (0.354 ±0.167 vs. 0.64 ±0.164) before and after exposure to PUVA in Vitiligo skin lesions respectively with a statistically significant p-value< 0.001. PUVA increased the level of MAPK but due to the significant difference between patients of vitiligo after PUVA and controls, it can be concluded that PUVA improve the MAPK p38 but can’t return it to the normal level.
- There was a non-statistically significant linear correlation between tissue expression of MAPK and Vitiligo disease activity (VIDA) score among studied Vitiligo patients.
- After PUVA treatment there was a significant improvement of MAPK among patients with previous treatment (particularly topical and phototherapy).
We concluded that:
MAPK levels in Vitiligo patients were lower than in normal controls and these levels were up regulated after treatment with PUVA. So, we suggest that MAPK plays an important role in the pathogenesis of the Vitiligo disease. This could also open a new era for treatment of Vitiligo disease by targeting the MAPK p38 pathway.