الفهرس 
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Abstract
Psoriasis is a common chronic immune-mediated disease that affects 1–3% of the population. Psoriasis is now classified as a systemic immune-mediated inflammatory disease of the skin which is mediated mainly by Th1 and Th17 cells with production of large amounts of proinflammatory cytokines (such as TNF-α, IL6, IL17and IL22) which reach the general circulation creating a systemic chronic inflammatory state. Multiple epidemiological studies have demonstrated elevated rates of cardiovascular diseases in psoriasis patients. Inflammation is a prime factor in linking psoriasis to atherosclerosis. They both are principally mediated by T-helper (Th 1) cells and characterized by a systemic overexpression of adhesion molecules, inflammatory markers, and neoangiogenesis factors. Fetuin-A is a glycoprotein that is known as α2 Heremans-Schmid and can attach to the cationic calcium ions .Fetuin-A can prevent calcification by forming soluble complexes with calcium and phosphate, which are called ‘‘calciprotein particles’’. For this reason, Fetuin-A has been proposed as an endogenous inhibitor of pathological mineralization or calcification of soft tissues .Studies with mice devoid of fetuin-A suggested that more soft tissue calcification has occurred. Osteoprotegerin is a glycoprotein from the family of TNF receptors (TNFR) which are defined in the regulation of bone resorption. Osteoprotegerin can be found soluble in both circulation and wall of vessels. The function of this molecule is known as inhibition of osteoclastic differentiation and activation. Large artery calcifications are determined in osteoprotegerin-deficient mice. The aim of this study is to determine serum levels of fetuin-A and osteoprotegerin in patient with psoriasis, and its association with disease severity. This study was conducted on (40) patients with chronic plaque psoriasis and (40) healthy individuals as a control group. Serum levels of fetuin-A and osteoprotegrin were measured in both groups using ELISA. Final results were compared between psoriasis patients and controls and correlated with psoriasis severity. The mean serum fetuin-A level in the psoriasis patients was 380±160mg/l which was statistically significant lower as compared with the control group 960±360mg/l (p <0.001). The mean serum osteoprotegerin level was 230.74±48.28ng/l in the psoriasis group while in the control group the mean level was 239.43±67.99ng/l with no significant difference between the two groups (p=0.512). There was statistically significant negative correlation between serum fetuin-A level with PASI (P=0.035) score and duration of the disease (P=0.011) while there was no significant correlation between serum fetuin-A with age (P=0.691), gender (P=0.616), occuption and family history. The mean serum fetuin-A level in the cases with previous systemic therapy was 270±110mg/l while the cases with no previous systemic therapy, the mean level was significantly higher 410±170mg/l (p= 0.043). The mean serum osteoprotegerin level was 230.74±48.28ng/l in the psoriasis group while in the control group the mean level was 239.43±67.99ng/l with no significant difference between the two groups (p=0.512). There was no significant correlation between serum osteoprotegrin level with PASI score, duration of the disease, age, gender, occupation, family history and previous systemic therapy.