الفهرس 
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Abstract
Psoriasis is a common dermatologic disorder with variable degrees of inflammatory severity, including several harmful inflammatory events at which their effects are not limited to the skin but also responsible for initiation of several coexisting disorders as cardiovascular, gastrointestinal diseases, arthritis, mental health issues, and metabolic syndrome (MetS).
Metabolic syndrome is a complex of abnormalities enclose abdominal obesity, elevation of arterial blood pressure, hyperlipidemia in addition to glucose intolerance.
YKL-40 commonly referred to as chitinase-3-like-1, is one member of the 18 glycosyl hydrolase gene family called chitinase-like proteins. This glycoprotein is produced by numerous types of cells including activated neutrophils and macrophages in addition to endothelial cells, vascular smooth cells and fibroblasts. The blood levels ofYKL-40 were shown to be elevated in a wide range of human malignancies, autoimmune and chronic disease patients.
This work aimed to evaluate the serum level and immunohistochemical expression of the chitinase-3-like protein 1 (YKL40) in psoriatic patients in relation to the available clinico-pathologic parameters including cardiovascular risk factors .
This case-control study was carried out on 70 subjects who were divided into 2main groups: 35patients with psoriasis vulgaris as patient‘s group and35 age, gender and site matched volunteers as a non-psoriatic control group.
Cases were selected from the Outpatient Clinic of Dermatology and Andrology Department Menoufia University. Control subjects were selected with no past history or present clinical manifestations of psoriasis and collected from Plastic Surgery Department, Menoufia University hospitals.
A written informed consent form approved by Committee of Human Rights in Menoufia University was obtained from every participant before the study initiation.
Diagnosis of psoriasis was based on patient‘s history; typical clinical features consisting of dusky red erythematous plaques covered by silvery scales in addition to histopathological examination by hematoxylin and eosin (H&E) stain.
In this study, there was significant difference between cases and controls regarding laboratory investigations for metabolic syndrome and dyslipidemia, all parameters were higher in cases than controls except HDL-c was significantly lower in cases than controls (P < 0.001).
CIMT was significantly higher in patients than controls (P < 0.001). And abnormal degree of CIMT was significantly higher in cases than controls (P < 0.001). In the current study, YKL-40 immunostaining showed cytoplasmic localization in epidermis and dermal components of lesional and perilesional skin samples. In control cases YKL-40 was observed in basal cell layer of epidermis.
There was a statistical significant difference between cases and control regarding YKL-40 expression as up regulation of YKl-40 protein expression was observed in lesional skin samples in comparison to perilesional biopsies in addition to controls identified by increased percentage and H score values of its expression.
This work has detected that patients of decreased granular layer showed significantly lower H score of YKL-40 expression in epidermis when compared to those with absent granular layer (P value =0.001). In the same line, H score values of YKL-40 in epidermal and dermal components (fibroblasts, blood vessels and inflammatory cells) showed pronounced elevation in cases with increased dermal vascularity and inflammation.