الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Psoriasis is a disease of multifactorial origin where certain environmental factors acting on individuals with specific genetic predisposition lead to an immune dysregulation and abnormal keratinization which results in the appearance of typical cutaneous lesions (Ghosh and Panda, 2017). Psoriasis is a chronic inflammatory skin disease with a genetic basis characterized by epidermal hyperproliferation, abnormal keratinocyte differentiation, T-lymphocyte infiltration, and increased expression of cytokines, which results in the formation of inflamed plaques (Azfar and Gelfand, 2008& Spa, 2008).Histologically, psoriasis is characterized by epidermal hyperproliferation with disordered keratinocyte differentiation, dermal inflammatory cell infiltration and increased vascularity (Lowes et al., 2014).The relationship between psoriasis, oxidative stress, inflammation and alteration of lipoprotein functions is supported by several studies, which have demonstrated that drug treatments decrease inflammation, lipid peroxidation and recover high density lipoprotein ( HDL) functions in psoriatic adult patients (Bacchetti et al. 2013& Holzer et al. 2014). Paraoxonase-1 (PON1) is a multitasking protein localized at the HDL surface and is associated with protection against oxidative stress- related diseases (Chambers, 2008 & Mackness et al. 2015).In fact PON1 exerts a protective role against lipid peroxidation of biological membranes, HDL and low density lipoprotein (LDL), this suggest that whenever the activity of the antioxidant enzyme PON1 is lowered, it will be unable to prevent oxidation of membranes and LDL and could be involved in the higher oxidative stress in psoriasis (Chambers,2008&Ferretti et al.2010& Mackness et al. 2015 ).The activity of PON1, a multitasking enzyme associated to HDL is significantly lower in adult patients with psoriasis and a relationship with disease activity has been observed (Ferretti et al. 2012 & Bacchetti et al. 2013& Mackness et al. 2015). The Aim of this study: To evaluate serum level of paraoxonase-1 in Egyptian patients with psoriasis vulgaris and compare it with its level in healthy people and Correlation between level of Paraoxonase-1 and severity of disease by psoriasis Area and Severity Index (PASI) score. Materials and methods: this study included Ninety persons were chosen from the out-patient clinic of Dermatology, Andrology & STDs department, Mansoura University Hospitals. Patient group included 50 patients with psoriasis vulgaris and 40 healthy people; cross matched as regard the age and sex were included as a control group. Results: The current revealed that: Psoriasis cases were significantly associated with higher frequency of smokers (p=0.040). No significant differences were found regarding family history among studied groups. Psoriatic cases were classified according to PASI score into mild (10%), moderate (30%), severe (38%) and very severe (22%) grades. Psoriasis group showed significantly lower level of Paraoxonase-1 when compared to control group (median=35.6 versus 54.5; p<0.001). Median paraoxonase-1 level decreased gradually with increased psoriasis grades (p<0.001). No significant associations were found regarding Paraoxonase-1 level according to gender, smoking, and family history in psoriasis group (p>0.05 for each). Paraoxonase-1 level showed significant negative correlation with PASI score (p<0.001); but not with age, onset, or duration (p>0.05 for each). Lower Paraoxonase-1 level was considered as independent predictor of psoriasis development. Lower Paraoxonase-1 level was considered as independent predictor of psoriasis severity (p<0.001). Conclusion: The current study has revealed that, Paraoxonase-1 level in psoriasis patients had substantially lower levels than healthy controls. Paraoxonase-1 level showed significant negative correlation with PASI score (p<0.001). Lower baseline Paraoxonase-1 level was suggested to be independent risk predictor for psoriasis occurrence and severity.