الفهرس 
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Abstract
Psoriasis is a common chronic inflammatory disease that represents significant public health challenge. The pathogenesis of psoriasis is multi-factorial with involvement of several subsets of T-helper cells, mainly TH1 and TH17, and inflammatory mediators leading to keratinocyte de-differentiation and dermal inflammation and vasodilation. The concept of psoriasis as a systemic disease with inflammatory process involving almost all systems of the body leading to several closely associated co-morbidities is now well-established.
Metabolic syndrome is considered a silent epidemic affecting at least 25% of the population with increasing prevalence especially in psoriatic patients. It’s considered the most prevalent co-morbid condition associated with psoriasis. Several inflammatory mechanisms have explained the close relationship between psoriasis and metabolic syndrome including interleukins, adipokines and others.
Interleukin 38 is a member of the IL-1 family and has protective action in various inflammatory diseases like psoriasis and metabolic syndrome. It acts as a receptor antagonist to the IL-36 receptor and has anti-inflammatory action via suppressing TH17 response as well as several mediators like TNF and IL-1 and 6.
We measured and compared plasma level of IL-38 in patients with psoriasis only, patients with both psoriasis and metabolic syndrome, patients with metabolic syndrome only and healthy controls. We found significant reduction in IL-38 level in patients with both conditions compared to patients with either condition alone and compared to healthy controls. These patients have reduction in the protective properties of IL-38 and are more susceptible to complications. Also, IL-38 level was reduced in patients with psoriasis alone and metabolic syndrome alone compared to healthy controls.
IL-38 level had significant negative correlation with psoriasis severity as well as with metabolic syndrome components (obesity, dyslipidemia and blood sugar).
To conclude, psoriatic patients with MetS have significantly lower levels of the protective IL-38 than patients with either psoriasis alone or MetS alone, indicating that this interleukin plays an important role in both conditions and may be used to assess the possibility of early detection of psoriatic patients who are at a higher risk for metabolic complications
We suggest using plasma IL-38 samples as an appropriate and non-invasive marker to monitor risk for metabolic and cardiovascular complications in psoriatic patients and using serial samples to monitor disease activity .
We recommend that future studies be conducted on a greater number of psoriasis and metabolic syndrome patients to confirm the role of IL-38 in the pathogenesis of both conditions.