Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2011
Student: IŞIL BULUR
Supervisor: AYLA GÜLEKON
Abstract:Psoriasis is a chronic, hyperproliferative and inflammatory skin disease with an unknown etiology. The IL23/Th17 axis is an exciting new pathway in the pathogenesis of psoriasis. OPN is a recently defined phosphorylated acidic glycoprotein which has an effect on psoriasis especially over Th1/Th17 cells. We aimed to understand the role of OPN and Th1/Th2 pathway in the immunopathogenesis of psoriasis, assess its relationship with disease severity and introduce the potential target molecules for therapeutic intervation in psoriatic patients. Our study included 34 psoriatic patients. 17 patients were treated with corticosteroid/calsiporiol in topical treatment group and 17 patients were treated with methotrexate in the systemic treatment group. Serum and skin samples were taken from the patients, when pre and post treatment PASI 75 results were reached or at the third month of the treatment. OPN and TNF-α, IFN-g, IL-12, IL-23, IL-17 levels were evaluated at the serum and skin samples. The results were compared between topical and systemic treatment groups, before and after treatment. OPN, TNF-α, IFN-g, IL-23, IL-17 levels in serum and skin samples were statistically insignificant before treatment in psoriatic patients (p˃0,05). No correlation was found between the severity of psoriasis with serum cytokin levels and OPN. IFN-γ and IL-17 levels were decreased significantly in each of the two patient groups after treatment (p<0,025). OPN, TNF-α, IL-23 levels did not change with treatment (p˃0,025). The posttreatment serum levels of OPN were decreased statistically in the systemic treatment group, whereas OPN levels were decreased in skin samples in topical treatment group after treatment. It was observed that, IL-23 level and OPN-K, IFN-γ and OPN-D increased directly proportionally, before and after the treatment respectively (p<0,025). The increase of OPN, TNF-α, IFN-g, IL-23, IL-17, IL-12 levels together with the accompanied comorbidities were not found to be statistically significant. All of these results showe that IFN-γ, TNF-α, IL-23, IL-12, IL-17 and OPN levels increase both in the lesion and serum in psoriasis patients, however further investigation should be made in order to assess their role in the immunupatogenesis of psoriasis and their relationship with the disease and comorbidities.