A Notorious Trio! Inflammation, Metabolic Syndrome and Vitiligo.

Background: There is evidence to support that vitiligo is linked to metabolic syndrome (MS), confirming its systemic nature. However, the underlying pathogenic mechanisms remain unknown. Objectives: To reveal the possible association of MS with vitiligo. We also attempted to study the connection 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.

Apolipoprotein E Gene Polymorphism, Serum Lipids, and Risk of Superficial Fungal Infections in Egyptian Patients - A Preliminary Case-Controlled Study.

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.

Mac-2 binding protein glycan isomer as noninvasive tool to assess liver fibrosis in children with chronic liver disease.

AIM: This study is aimed to measure the value of serum Mac-2 binding protein glycan isomer (M2BPGI) in children with chronic liver diseases in comparison with liver biopsy and serum biomarkers. METHODS: Comparative cross-sectional study included 100 children with chronic liver diseases and 50 healthy age/sex-matched control group. All subjects were evaluated via medical history, clinical, radiological and laboratory examinations. Liver biopsy was performed for studied patients and serum M2BPGI level was measured by Enzyme Linked Immune Sorbent Assay (ELISA) in all studied subjects. RESULTS: Serum M2BPGI level increased more significantly in chronic liver disease patients (6.04 ± 2.72 ng/ml) than in healthy controls (1.12 ± 0.83 ng/ml) (P < 0.001). M2BPGI level was significantly elevated with progressive fibrosis (P < 0.001), and differed significantly between high and low Child-Pugh score, pediatric end-stage liver disease score and model for end-stage liver disease score score. Serum M2BPGI was correlated with serum biomarkers and degree of fibrosis in patients. CONCLUSION: M2BPGI could be used as one of noninvasive tools for detecting and staging of hepatic fibrosis in Egyptian children with chronic liver disease.

IL1A (-889) gene polymorphism is associated with the effect of diet as a risk factor in Acne Vulgaris.

BACKGROUND: Despite the several studies suggesting the genetic basis of acne vulgaris, the exact genetic architecture of this very common condition is not yet clear. AIM OF THE WORK: This study aimed to investigate the association between IL-1A (-889) gene polymorphism and acne vulgaris in a sample of patients. SUBJECTS AND METHOD: Blood samples from 100 patients with acne vulgaris and 100 healthy age, sex, and BMI matched controls were obtained. DNA samples were isolated from blood cells, and the PCR-RFLP method was used for genotyping. RESULTS: The genotype distributions of IL-1A (-889) polymorphism were as expected under Hardy-Weinberg equilibrium. T allele was predominant in the patients, while C allele predominated in the control subjects (P value < .001). The frequency of TT genotype in patients was significantly higher than in the control subjects (P value < .001). CT genotype was significantly more frequent in the control subjects compared to patients (P value < .001). Among the 47 patients who reported diet as a risk factor for triggering or exacerbating their lesions, 62.5% had TT genotype (P value = .038). CONCLUSION: IL-1A (-889) gene polymorphism has a role in the pathogenesis of acne vulgaris. We suggest that the triggering or exacerbating effect of diet on acne may be related to IL-1A (-889) gene polymorphism.

Serum irisin: A prognostic marker for severe acne vulgaris.

BACKGROUND: Acne vulgaris is a common chronic inflammatory skin disease involving pilosebaceous units. Adipokines are secreted by adipose tissue and function as signaling networks communicating it with different organs. They may have role in pathogenesis of acne vulgaris and the associated insulin resistance. Irisin, a hormone like myokine, is one of adipokines with anti-inflammatory, anti-oxidant, and anti-diabetic effects. AIMS: We aimed at evaluation of serum irisin level in patients with acne vulgaris to assess its correlation with disease pathogenesis. PATIENTS AND METHODS: Serum irisin level was measured by an ELISA technique in 60 acne vulgaris patients and 60 apparently healthy controls. Insulin resistance was calculated by Homeostasis Model Assessment of Insulin Resistance index. RESULTS: Serum irisin level was significantly lower in acne vulgaris patients than control group (P < 0.001). It showed a significant negative correlation with insulin resistance among patients (P 0.012). Moreover, it was decreasing significantly with the increase in disease severity (P 0.004). CONCLUSIONS: Our results revealed that lower serum irisin not only to be a biomarker of disease pathogenesis but also to be a potential prognostic predictor for severity in acne vulgaris.

Sex hormones, erectile dysfunction, and psoriasis; a bad friendship!

BACKGROUND: Sex hormones may play a major role in psoriasis pathogenesis due to their biological and immunological effects on skin. Psoriasis also has a significant impact on patients' sexual function and thus their quality of life. AIM: In the present study, we investigated serum sex hormones and erectile function in male psoriasis patients compared with healthy controls and correlated these findings with various disease parameters. METHODS: Serum total testosterone and estradiol were measured by an ELISA technique in 50 male patients with psoriasis and 30 healthy controls. The erectile function of all subjects was assessed by the international index of erectile function version-5. RESULTS: Patients with psoriasis showed a significant lower serum level of total testosterone, higher level of estradiol, and impaired erectile function relative to healthy controls. CONCLUSION: The detected hormonal disturbance in male psoriasis patients may be a cause of the associated erectile dysfunction beside the known effect of chronic systemic disease on patients' erectile function.

Predictive value of serum markers for postacne scarring.

BACKGROUND: Postacne scarring is the main concern of many acne patients. Predicting the liability to scarring can alter the management protocols and help in preventing such disfigurement. METHODS: Sixty patients with moderate to severe acne vulgaris (according to Global Acne Grading system) were included, only 35 of them had postacne scars. A quantitative latex agglutination commercial kit was used to assess serum C-reactive protein (CRP) concentration by turbidimetry, while serum hepcidin concentration was assessed by a commercially available double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: Patients with postacne scarring had significantly lower serum levels of hepcidin (P-value < .001) and significantly higher serum levels of CRP (P-value < .05). CONCLUSION: Serum levels of hepcidin and CRP are promising markers, which may be considered as objective tools to predict the possibility of postacne scarring.