Serum Granulysin as a Possible Key Marker of Vitiligo Activity and Severity.

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.

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.

Serum retinol-binding protein: a novel biomarker for recalcitrant cutaneous warts.

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.

Angiotensin-converting enzyme gene insertion/deletion polymorphism and family history in severe acne vulgaris.

BACKGROUND: Acne vulgaris is an inflammatory disorder with a profound heterogenous aetio-pathophysiology. ACE gene I/D polymorphism affects angiotensin-converting enzyme activities that play a role in inflammation. However, there are no molecular genetic studies investigating the contribution of ACE gene insertion/deletion polymorphism in the genetic background of acne vulgaris. AIMS: The aim of this work was to reveal the relation between the ACE gene I/D polymorphism and acne vulgaris development among a sample of patients. PATIENTS AND METHODS: This study included 100 acne vulgaris patients in addition to 120 matched control subjects. The ACE gene I/D polymorphism was analyzed using polymerase chain reaction (PCR). RESULTS: The distribution of DD, ID genotypes, and D allele showed higher frequency in AV patients than in controls (P < 0.001 for all). Moreover, positive family history and ACEI/D gene polymorphism (DD + ID genotypes) were considered as independent predictors for severe acne grades (P ≤ 0.001 and 0.046, respectively) in multivariate analysis. CONCLUSIONS: The current study results suggest that the D allele of the ACE I/D gene polymorphism might confer risk to AV among the studied patients. Moreover, ACE I/D gene polymorphism and positive family history were considered as independent predictors of severe AV.

Structural changes of hair shaft after application of chemical hair straighteners: Clinical and histopathological study.

BACKGROUND: Chemical hair straightening becomes popular for managing frizzy hair. Keratin in hair care products can penetrate the cortex of the hair fiber improving the mechanical properties of damaged fibers and promote a surface coating that prevents or decreases water diffusion through the hair fibers. This may have beneficial effects on the hair structure; however, the side effects and safety of this treatment have not yet been completely evaluated. AIMS: To evaluate the efficacy and safety of chemical hair straightening application on the hair shaft. SUBJECTS AND METHODS: Thirty female subjects older than 15 years with hair curl types III-V were included. They were subjected to full history taking and dermatologic examination of hair and scalp prior to and after application of chemical hair straightener. To detect the presence of transverse fissures, split ends, or possible side effects, the distal 3-5 cm of hair fibers were cut before and after the last step of chemical hair straightener application for light microscopy examination. Three randomly selected samples were examined by transmission electron microscope. RESULTS: Chemical hair straightening led to significant decrease in the degree of hair curl and increased hair smoothness and shine. The treated hair fibers showed significant repair of the broken cuticle (P < 0.001), while no significant improvement was observed regarding transverse fissures or split ends (P 0.60 and 0.74, respectively). CONCLUSION: Although chemical hair straightening application has a beneficial effect on hair shafts, some side effects may occur after. Hence, it is necessary to develop a more safe tool.

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.