Amany Ibrahim Mustafa

Background: Vitiligo is an immune-mediated, chronic skin condition that affects both the innate and adaptive immune systems. Antimicrobial peptide overexpression is one of its defining characteristics. Granulysin (GNLY), an antimicrobial peptide, may play a role in the pathogenesis of various autoimmune diseases. Objectives: To estimate the serum GNLY levels in vitiligo patients and to correlate those levels with the severity and activity of the disease. Materials and Methods: This case-control study included 60 non-segmental vitiligo patients (Group A) and a control group of 60 people who were matched for age and sex, appeared to be in good health, and were not suffering from vitiligo (Group B). The serum granulysin levels of all subjects were measured using an enzyme-linked immunosorbent assay. Results: When compared to the control group, vitiligo patients had significantly higher serum GNLY levels (P = 0.001). When compared to patients with stable disease, those with active vitiligo had significantly higher serum GNLY levels (P = 0.008). Additionally, there was a positive correlation between the serum GNLY levels and the vitiligo area severity index and vitiligo disease activity scores (P = 0.004 and <0.001, respectively). Limitations: Study population was relatively small. Evaluation of serum granulysin before and after treatment could have been more beneficial. Conclusions: Blood granulysin levels could contribute to the pathogenesis of vitiligo. A higher serum granulysin level may also be a trustworthy predictor of the severity and progression of a disease.

Background: Apolipoprotein E (APOE) gene isoforms have been found to affect the risk of superficial fungal infections (SFIs). However, the data only cover a few ethnicities. Aims: The present work intended to investigate the association of APOE gene polymorphism and serum lipids with the susceptibility of SFIs among a group of Egyptian patients. Materials and Methods: Standard laboratory methods were used to estimate the serum lipid profile, and polymerase chain reaction–restriction fragment length polymorphism was used to detect APOE gene polymorphism in deoxyribonucleic acid extracted from 150 SFI patients and an equal number of apparently healthy matched controls. Results: Serum total cholesterol, triglycerides, and low-density lipoprotein cholesterol were significantly higher in the studied patients than in controls. The APOE gene ε2, ε4 alleles, and ε3/4 and ε3/2 genotypes were significantly distributed in the patients than in the controls. APOE ε3/3 genotype was predominant in dermatophytosis and tinea versicolour patients, and ε3/4 genotype was predominant in candidiasis. Conclusions: ApoE alleles ε2 and ε4, and genotypes ε2/3 and ε3/4 are linked to SFI and may be risk factors, whereas allele ε3 and genotype ε3/3 may be protective for SFI in the Egyptian population studied. The lipid profile results suggest that hyperlipidemia may provide evidence for SFI pathogenesis. However; further large-scale studies are still needed to validate our results.

Nection between some inflammatory markers and MS in vitiligo patients to evaluate their utility in predicting MS risk. Materials and Methods: The study included 100 vitiligo patients with an age range between 18 to 60 years and 100 controls with matched age, gender, and body mass index. All subjects were tested for MS components. Serum visceral adipose tissue-derived serine protease inhibitor (vaspin), fatty acid binding protein 4 (FABP4), vascular adhesion protein 1 (VAP-1), chitinase-3-like protein 1 (YKL-40), and high-sensitivity C-reactive protein (hs-CRP) were also measured. Results: Regarding MS, it was observed in 22.0% of vitiligo patients and 2.0% of control subjects (P < 0.001). Serum FABP4, VAP-1, YKL-40, and hs-CRP concentrations were higher in patients than in the control group (P < 0.05 each), and their levels showed high sensitivity and specificity to differentiate MS when using the receiver operating characteristic (ROC). Levels of these markers, except serum vaspin, were significantly positively correlated with lipid profile markers (except high-density lipoprotein cholesterol) and fasting blood glucose levels (P < 0.05 each). Conclusion: MS was more common in vitiligo patients. The levels of the biomarkers studied were significantly higher in vitiligo patients. Furthermore, their levels accurately predicted MS in vitiligo patients. According to current research, these markers may be useful in assessing MS risk in vitiligo patients. Extensive research, however, is required....

Background: Alopecia areata (AA) is an immune mediated disorder that attacks hair follicles with unknown pathophysiology. MicroRNAs (miRNAs) are small noncoding RNA molecules, and their aberrant expression or function has been involved in different autoimmune conditions.Objectives: We aimed at exploring the association between some miRNAs lesional expression and AA pathogenesis by measurement of miRNAs‐155, 146a, and 203 expression levels in the lesional skin from patchy AA patients and to evaluate their relation with the studied parameters.Subjects and Methods: Skin expression levels of miRNAs‐155, 146a, and 203 were evaluated in 50 patients with patchy AA and 25 healthy controls using reverse transcriptase‐quantitative PCR (RT‐qPCR). The activity and severity of alopecia were assessed according to AA Investigational Assessment Guidelines criteria.Results: Studied patients showed significant up‐regulation of miRNAs‐203, 146a, and 155 lesional tissue expression levels when compared to control group (p < 0.05 each). Only miRNA‐146a skin expression level was significantly higher in patients with multiple lesions (p < 0.001). However, patients with active AA had significantly higher tissue expression levels of the investigated miRNAs than those with inactive disease (P 0.001, 0.009, and 0.001, respectively).Conclusions: Investigated miRNAs seem to be role players in AA pathogenesis and may be considered potential indicators of disease activity. However, more research is needed to clarify their accurate role and clinical importance.

Background Androgenetic alopecia (AGA) is a prevalent condition with a complex etiopathogenesis. Angiotensin-converting enzyme (ACE) gene located on the chromosome 17q23 contains an insertion (I) and deletion (D) polymorphism in the intron 16. This gene polymorphism plays a role in multiple inflammatory disorders. However, there are no studies investigating its association with AGA susceptibility. Objectives In this work, we aimed at exploring the association of ACE gene I/D polymorphism in AGA susceptibility in a group of Egyptian patients. Methods This study included 100 AGA patients, and 100 apparently healthy controls. The ACE gene I/D polymorphism was analyzed by polymerase chain reaction. Results The DD, ID genotypes, and D allele showed higher frequent distribution among studied AGA patients than controls (p < 0.05 each). Positive family history and ACE gene I/D polymorphism were considered AGA susceptibility predictors in both uni- and multivariable analyses [p < 0.05 each (OR (95% CI)] on applying logistic regression analysis for risk factors prediction. Conclusions This study highlights the possible contribution of the suspected genetic polymorphism as a susceptibility indicator for AGA development in the examined group of patients.

Acne vulgaris is a cutaneous chronic inflammatory disorder with complex pathogenesis. The aim of this study was to evaluate the serum level of IMA in patients with AV to evaluate its role in AV pathogenesis and its possible relation with oxidative stress markers in the disease.This study was conducted as a case-control study and was conducted on 30 patients suffering from AV (Group A) and 18 apparently healthy individuals of matched age and sex as a control group (Group B). All studied subjects were tested for Serum level of Ischemia modified albumin (IMA), Serum level of Glutathione-S-Transferase (GST), Serum level of Catalase (CAT) and Serum level of Malondialdehyde (MDA). Serum IMA showed significant positive correlation with GAGS, GSH, MDA and significant negative correlation with CAT. AV grades showed significant positive correlation with GSH, MDA, IMA and significant negative correlation with CAT. No significant correlations were found in IMA with age and duration in AV group Serum IMA then MDA, GSH and CAT might play a role in AV pathogenesis. Moreover, its serum levels could be considered as independent predictor of AV susceptibility, activity and severity.

Background: Androgenetic alopecia (AGA) is the most common cause of hair loss affecting both men and women. There are many conflicting results about the relationship between AGA and metabolic syndrome, (MetS) and the pathogenesis of the metabolic disorders in AGA patients is not completely elucidated.Aims: Evaluation of the prevalence of MetS and the possible role of RANTES in pathogenesis of the MS among AGA patients.Methods: A total of 160 subjects were enrolled in this work; included 100 patients clinically diagnosed with AGA and 60 apparently healthy control subjects. They were evaluated for MS components according to National Cholesterol Education Program (NCEP) adult treatment panel 3 (ATP3) and measurement of serum RANTES level using ELISA kits.Results: Metabolic syndrome was present in 30.0% of AGA patients and in 10.0% of the control group (P = .038), Studied AGA patients showed significantly higher serum RANTES when compared to control group (P value < .001). Moreover, serum RANTES levels were significantly positively correlated with BMI, FBG, TC, and LDL‐c levels in AGA patients with MetS.Conclusion: Metabolic syndrome components were prevalent among AGA patients. Serum RANTES level was significantly higher in all AGA patients and specifically in those with MS as it was significantly positively correlated with some MetS components which reflects its possible role in pathogenesis of MetS in AGA patients.

Background: Although the etiopathogenesis of alopecia areata (AA) is still unclear, inflammation, oxidative stress, and subsequent DNA damage might be considered role players in disease development.Aim: We aimed at exploring the potential link between oxidative DNA damage and inflammation in AA patients through measuring 8‐hydroxy deoxyguanosine (8‐OHdG), high mobility group box 1 protein (HMGB1), and one of the inflammatory mediators, C‐reactive protein (CRP).Methods: A total of 79 subjects (49 AA patients in addition to 30 apparently healthy control subjects) were tested for serum levels of 8‐OHdG, HMBG1, and CRP.Results: Compared with the control group, serum 8‐OHdG, HMBG1, and CRP levels were significantly elevated in the studied patients group (0.031, <0.001, and <0.001, respectively). Moreover, logistic regression analysis revealed that disease course, serum levels of 8‐OHdG, and HMBG1 were considered independent predictors for AA severity in both uni‐ and multivariable analyses.Conclusion: Our results suggest a possible role of oxidative stress together with proinflammatory biomarkers in development of AA and their benefit in predicting a severe form of the disease.

Background Acne vulgaris (AV) is an inflammatory skin disorder that may be associated with metabolic disorders. The relation between lipid profile in acne is not widely investigated. Chitinase‐3‐like protein 1 (YKL‐40) has been found to be implicated in different inflammatory conditions. Aims We aimed at investigating the role YKL‐40 in acne pathogenesis and associated dyslipidemia in acne patients. Patients/Methods This study included 50 acne vulgaris patients and 30 matched control subjects. Serum YKL‐40 in addition to lipid profile were assessed in all studied subjects. Results Serum YKL‐40 level was significantly elevated in acne patients than healthy controls (P < .001). We also found a significant positive correlations between serum YKL‐40, serum TGs, TC, and LDL‐C (P value: .022, .001, .017 respectively) while, a significant negative correlation between serum YKL‐40 and HDL‐c (P value: .036) was detected. Conclusion Our study results suggest that YKL‐40 might have a role in AV pathogenesis. In addition, it could provide a new potential link between inflammation and dyslipidemia observed in acne patients.

Background: Cutaneous viral warts are benign epidermal proliferations caused by human papillomaviruses (HPVs). Despite treatment, a significant proportion of warts fail to resolve, becoming recalcitrant. Vitamin A (retinol) may disrupt the interplay of HPV replication and epithelial cell differentiation, allowing normal tissue to replace warts. Circulating retinol‐binding protein (RBP) concentrations highly correlate with retinol levels.Aim: We aimed at evaluation of serum RBP level in patients with recalcitrant cutaneous warts in order to assess its correlation with disease pathogenesis.Methods: Serum RBP level was measured by an ELISA technique in 50 patients with recalcitrant cutaneous warts and 30 apparently healthy controls.Results: Serum RBP level was significantly lower in patients with recalcitrant warts than the control group (P < 0.001). However, it did not differ regarding different clinical parameters in studied patients (P > 0.05 each). RBP is a reliable biomarker for significant early detection and discrimination between patients and healthy controls (P < 0.001) at a cutoff value ≤1034.6 μg/ml, with sensitivity and specificity (100% each).Conclusion: Our results revealed that low serum RBP as a relatively cheap biomarker with high specificity and sensitivity is a reliable indicator of vitamin A (retinol) deficiency that may play a role in the pathogenesis of recalcitrant cutaneous warts among our studied patients.