الفهرس | Only 14 pages are availabe for public view |
Abstract Psoraisis is an immune-mediated inflammatory disease that typically follows a relapsing and remitting course, characterized by sharply demarcated red scaly plaques mostly in extensor surface of extremities. Genetic and immunological advances have greatly increased understanding the pathogenesis of psoriasis as a chronic, immune mediated inflammatory disorder. Hyperproliferation and incomplete differentiation of epidermal keratinocytes as well as by inflammatory infiltrates of T lymphocytes in dermis and epidermis are characteristic features of psoriasis. Although the exact cause of psoriasis remains unknown, it is believed to be triggered by combination of genetic, epigenetic and environmental influences, and its genetic diversity and epigenetic modifications can be influenced by environmental factors. These environmental factors include trauma, smoking, alcohol, sunlight, and some infections as Staphylococcus aureus, Streptococcus pyogenes, viruses and fungi Helicobacter pylori is one of the most common pathogens affecting human, infecting approximately 50% of the world‘s population. It is found more frequently in developing countries than in industrialized countries, presumably due to poor sanitary conditions. It is a gram negative, microaerophilic, spiral-shaped bacterium that can inhabit various areas of the stomach, particularly the antrum. It causes a chronic low level inflammation of the stomach lining and is strongly linked to the development of duodenal and gastric ulcers as well as gastric cancer. Although the infection is non-invasive, it triggers a marked local inflammatory response and a systemic immune response. H.pylori of the stomach could conceivably produce effects elsewhere by altering levels of systemic inflammatory mediators . Helicobacter pylori might be a triggering factor in psoriasis. Prolonged interaction between the bacterium and host immune mechanisms makes H. pylori a possible infectious agent for triggering autoimmunity The aim of the current study was to determine the prevalence of H.pylori seropositivity in patients with psoriasis and to correlate its level with disease severity. This study included 80 subjects; 40 patients with plaque psoriasis from Outpatient Dermatology Clinic, Menoufia University Hospitals and 40 apparently healthy age and gender matched volunteers as a control group. Exclusion criteria included, dermatological diseases other than psoriasis, autoimmune or systemic diseases and patients receiving any treatment. After signing an informed consent form, patients were subjected to history taking, general and dermatological examination. PASI score was calculated and anti Summary 68 H. pylori IgG titre was assessed in their serum using Novalisa ELISA Kit, purchased from Nova Tec immunodiagnostica Company from Germany. This study demonstrated that there was non-significant difference between cases and controls regarding to prevalence of H.pylori infection (p=0.28) but there was significant relation between anti H.pylori IgG titre and severity of cases regarding to PASI score (p=0.03). The current study displayed that serum levels of anti H.pylori IgG titre were not increased in patients with psoriasis vulgaris than age and gender matched controls but was positively correlated with the disease severity according to PASI score. In the current study, H.pylori infection was more prevalent in non-itching patients and it showed significant correlation (P=0.0). H.pylori infection was less prevalent among patients who manifested palm and sole affection (P=0.02). In the current study, there was statistically significant relationship between mean of anti H.pylori Ig G and nail affection (P=0.05) Data suggested that H.pylori may play a role in the severity of psor. |