Background: Early recognition is crucial because the natural course of psoriasis (Ps) may result in vision loss. Psoriatic arthritis (PsA) patients with ophthalmological manifestations of psoriasis (Ps) account for 30% of cases. Assessment of visual functions and correlation with blood levels of tumour necrosis factor-alpha (TNF-α) and pigmented epithelium derived factor (PEDF) were the study's main goals in Ps and PsA patients. Objectives: to assess visual functions in Ps and PsA patients and correlate them with serum levels of tumour necrosis factor-alpha (TNF-α) and Pigmented Epithelium Derived Factor (PEDF). Subjects &Methods: This case-control study involved 60 Ps patients, 30 of whom had Ps without arthritis and 30 of whom had PsA, 30 age and sex-matched healthy individuals were included, representing the control group. Serum levels of both TNF-α and PEDF were measured by enzyme-linked immune sorbent assay and complete ophthalmological examination of the anterior and posterior segment by slit-lamp Biomicroscopy, best corrected visual acuity, intraocular pressure, and visual field using automated perimetry. Results: Visual affection in PsA patients was affected more than psoriatic patients with positive correlation with serum TNF-α level and negative correlation with PDF. High statistically significant increase in serum TNF-α level with the severity of both Ps and PsA P= 0.000. Also, high statistically significant increase in mean deviation (MD) and increase the negativity of PSD. High statistically significant increase in TNF and decrease in PEDF levels were found between patients and control (p = 0.001) with a higher significant difference (p =0.000) in PsA patients Conclusion: To prevent vision impairment, patients with Ps and PsA should receive routine ophthalmological tests to evaluate their visual functions and spot potential ocular involvement.

DiscussionThe immune system has evolved a number of mechanisms to maintain the peripheral immune tolerance and to CD4 + CD25 high FoxP3 Expression in SLE and RA Abd El-Aziz et al. 59

BackgroundToll-like receptors (TLRs) have been found to be important pattern recognition receptors that are involved in recognizing components of microbial pathogens and initiating and instructing cutaneous immune responses. Human keratinocytes express a large repertoire of TLRs and functional TLR2, 3, and 4. Objective To evaluate the expression of TLR2 in psoriasis. Patients and methodsThe study was carried out on 20 patients with psoriasis vulgaris and 20 healthy controls. One 4-mm punch skin biopsy specimen was taken from every patient and control. Immunohistochemical staining for TLR2 expression was carried out for all the specimens. Results TLR2 expression in psoriatic skin was significantly higher in all layers of the epidermis compared with the controls (Po0.01), and their expression in the upper epidermal layers was significantly higher in psoriatic skin compared with that in normal controls (Po0.01). The expression of TLR2 in basal/suprabasal layers was significantly higher in normal skin compared with psoriatic skin (Po0.01). The expression of TLR2 in the dermis of psoriatic skin was significantly higher compared with normal skin (Po0.01). Conclusion TLR2 overexpression in psoriatic skin provides new insights into the role of TLR in the pathogenesis of psoriasis, through inappropriate stimulation by infectious or endogenous ligands. Furthermore, TLR2 targeted by specific pharmacologic TLR2 antagonists may offer new therapeutic modalities and preventive approaches for psoriatic patients.

No abstract