Psoriasis Vulgaris Clinical Trial
Official title:
Serum Granulysin as a Possible Key Marker to Detect the Severity of Psoriasis
Psoriasis is a chronic inflammatory and proliferative papulosquamous skin disease of unknown
cause,overexpression of Anti Microbial Peptides is characteristic of psoriasis.
Granulysin is a cytolytic and proinflammatory peptide that belongs to a family of
saposin-like, lipid binding antimicrobial peptides, and localized in the granular
compartments of cytotoxic T lymphocytes and natural killer cells,Patients with psoriasis had
high tissue granulysin expression, which increased with increased clinical severity of the
disease.
The aim of the study is to measure serum granulysin level and correlate with severity of
psoriasis and tissue level of granulysin.
The pathogenesis of psoriasis involves dynamic interactions between multiple cell types and
numerous cytokines in response to triggers in genetically predisposed individuals leading to
activation of T cells and their migration into skin, in addition to dysregulation of
immunological cell function, keratinocyte proliferation takes place.
Psoriatic lesions are densely infiltrated by T cells and dendritic cells , the majority of T
cells in the dermis are T-helper cells, while T cytotoxic cells predominate in the epidermis.
T helper1 secrets cytokines, such as interferon gamma, tumor necrosis factor-alpha and
interleukin 12. Recently discovered population of T helper cells called T helper17 cells
which secrets interleukin 17 and interleukin 22 which stimulates epidermal proliferation,
while interleukin 17 is responsible for the release of proinflammatory cytokines,
antimicrobial peptides and chemokines.
A significant upregulation of perforin-expressing lymphocytes, especially cytotoxic T cells
and natural killer cells, has been observed in psoriatic patients at the systemic and local
levels. Perforin is a prototype granular cytotoxic mediator that ensures the quick access of
pro-apoptotic molecules, such as granzymes and granulysin, into the target cells to induce
apoptosis .
Granulysin is well associated with diverse activities of natural killer cells and cytotoxic T
cells in physiological and pathological settings and could be a useful serum marker for
monitoring host cell mediated immune cytotoxic responses.
Granulysin contributes toward the defense mechanisms against mycobacterial and viral
infections as it can kill microbial pathogens through disruption of their membrane integrity,
this can explain why infections is extremely rare in psoriatic lesions as psoriasis had high
tissue granulysin expression, which increased with increased clinical severity of the
disease.
Granulysin was found in the sera of healthy individuals at minimal concentrations.
No previous studies performed to detect the level of serum granulysin in patients with
psoriasis vulgaris.
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