الفهرس 
HUMAN PAPILLOMA VIRUSOnly 14 pages are availabe for public view
 |  | from | 147 |  |  |
| | | from | 147 | | |
Abstract
Background: Verrucae vulgaris are benign epithelial proliferations caused by
double stranded DNA virus called human papillomavirus (HPV). Clinically,
Verruca vulgaris appears as a hyperkeratotic, dome-shaped papule. During the
early stages of an HPV infection, on the level of epithelial cells, the host innate
immune response becomes the first line of defence against the infection.
Dendritic (DC), Langerhans (LC), natural killer (NK), natural killer T (NKT)
cells and keratinocytes, among others, are important cells involved in
promoting a good adaptive immune response against HPV infection. CD40 is a
48-kDa transmembrane glycoprotein surface receptor also known as the tumor
necrosis factor receptor superfamily member 5 (TNFRSF5). It is expressed at
the cell surface of many different types of cells one of them is epithelial cells
(ECs). Normally epithelial cells show a coordinated response to CD40 ligation,
mainly inducing the expression of genes involved in leukocyte migration, cell-
to-cell signalling and interaction, as well as cell death and survival. The HPV
was found to attenuate the extent of CD40 signaling, resulting in lower
amounts of chemo attractants produced and a failure to enhance immune cell
migration.
Objectives: the aim of this study is to estimate level of CD40 expression in
both serum and tissue of verruca vulgaris patients in comparison to matched
heathy control group to understand the role of CD40 in such disease.
Patients & Methods: this case control study was done on 44 subjects (22
verruca vulgaris patients and 22 healthy matched controls). Serum and tissue
levels of CD40 were estimated by ELISA technique. All patients were
subjected to full history taking, general examination and local examination.
Results: In this study serum and tissue levels of CD40 were higher in verruca
vulgaris patients than controls. Also, serum levels were significant to local
characteristics of lesions as regard size, duration of illness, age of wart and
associated symptoms (pain& itching). While tissue levels showed only
significance in relation to disease onset. The receiver operating characteristic
(ROC) analysis revealed that serum CD40 shows 81% sensitivity and 95%
specificity comparing to 68% sensitivity and 100% specificity of tissue CD40
in diagnosing verruca vulgaris.
Conclusion: CD40 levels plays important role immune response elicited
against HPVs causing verruca vulgaris.
Key words: serum CD40, tissue CD40, verruca vulgaris, warts