Glucose Trnsporter and PEDF in Psoriasis

Study Overview
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Brief Summary
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Psoriasis is a chronic relapsing cutaneous immune mediated inflammatory disease(IMID). In which there are skin lesions characterized by erythema, thickness and scale formation with different size from a pinhead to 20 cm in diameter. Prevalence of psoriasis is 2% to 4% worldwide. Psoriasis occurs at any age with two peaks: between 15-20 years and between 55-60 years. Women are presented with psoriasis at younger age than men ,but with less severity. lesions usually present on knee, elbow, scalp and sacral region this may be attributed to higher traumatic incident . Psoriasis vulgaris is the most common type, and accounts 90% of cases. Patients with psoriasis vulgaris present with pain, itching and bleeding from skin lesions. There are many theories for psoriasis pathogenesis: angiogenesis, decrease in apoptosis of keratinocyte, hyperproliferation , alteration of cell to cell adhesion and immune-mediated inflammation. Patients with immune mediated inflammatory disease (IMID) are susceptible to develop diabetes mellitus, metabolic syndrome, hyperlipidemia, and hypertension.A previous study found that psoriatic patients are more susceptible to type 2 diabetes compared to control. Glucose transporter type 1(GLUT1) is upregulated in psoriatic patient attributed to angiogenesis and execessive cell proliferation in those patients .Also expression of GLUT 1 is found high with hyperglycemia . A study reported that GLUT 1 density in placenta of women with gestational diabetes was found to be two folds higher than control. Pigment epithelium derived factor (PEDF) has antiangiogenic effect. Topical application of PEDF on mouse model of psoriatic disease helps in reduction of skin proliferation and angiogenesis. GLUT 1 overexpression was found to be associated with decrease in PEDF expression in diabetic retinopathy. In view of that we will compare the level of GLUT 1 gene in psoriatic patients and psoriatic patients with diabetes, as well as healthy control, and detect the effect of PEDF on GLUT 1 expression in vitro using human keratinocytes cell line .

Official Title
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Role of Glucose Transporter (GLUT) Genes Expression in Patients With Psoriasis

Conditions
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Psoriasis Vulgaris

Intervention / Treatment
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* Diagnostic Test: GLUT 1 gene expression


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with psoriasis vulgaris Patients with psoriasis vulgaris and type 2 diabetes Exclusion Criteria: Factors affect GLUT 1 expression As: tumors either benign or malignant cause increase GLUT 1 expression
Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients with psoriasis vulgaris only<br> | Diagnostic Test: GLUT 1 gene expression<br>* GLUT 1 gene expression will done on blood samples taken from three groups using real time PCR. Pigment epithelium derived factor will used on keratinocytes cell line and compare GLUT 1 gene expression before and after treatment.<br>|
| patients with psoriasis vulgaris and type 2 diabetes mellitus<br> | Diagnostic Test: GLUT 1 gene expression<br>* GLUT 1 gene expression will done on blood samples taken from three groups using real time PCR. Pigment epithelium derived factor will used on keratinocytes cell line and compare GLUT 1 gene expression before and after treatment.<br>|
| healthy control<br> | Diagnostic Test: GLUT 1 gene expression<br>* GLUT 1 gene expression will done on blood samples taken from three groups using real time PCR. Pigment epithelium derived factor will used on keratinocytes cell line and compare GLUT 1 gene expression before and after treatment.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| GLUT1 expression in psoriatic patients with or without type 2 diabetes. | assessing fold changes of GLUT1 expression in blood samples using real time PCR. | through study completion, an average of 2 year | 
| GLUT1 expression in keratinocyte before and after treatment with pigment epithelium derived factor (PEDF) |  | through study completion, an average of 2 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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GLUT 1, PEDF, Psoriasis Vulgaris