Assessment of Tumor Necrosis Factor Alpha, Homocysteine and Pro-Collagen type III Peptide as Markers in Patients with Moderate to Severe Psoriasis

Background psoriasis is chronic and recurrent autoimmune inflammatory disease cause morbidity and mortality. TNF is a Pro-inflammatory cytokine and has a key role in the pathogenesis of psoriasis. Homocysteine level in psoriasis and cause hyperhomocystienaemia that paly role in atherosclerosis and. Procollagen type III peptide is fibro genesis marker methotrexate is widely used in treatment of moderate to severe psoriasis and this lead to develop liver fibrosis, hence measurement of procollagen type III peptide may reduce liver biopsy. Objective 1- measured the level of (TNF), Homocystiene and procollagen type III in patient with moderate and sever psoriasis. and compered the result with healthy control.2- the level of (TNF), Homocystiene and PIIIP in patients before methotrexate and after 4week treatment and Subjects, materials and methods This observational case control study involved thirty patients with moderate to severe psoriasis and thirty healthy contral with matched gender and age with patient groups, used ELISA technique for measured of (TNF and, PIIIP). The Homocystiene is measured by used HPLC technique through de-deproteinization the serum and then mixed with POA reagent for analysis. Results Mean serum Homocystiene was significantly higher in patient group than in control group, 106.42 54.68 versus 50.07 24.16 (Pless than0.01), and it underwent no significant change after treatment with methotraxate to a level of 99.11 6.26 (P=0.435). Mean serum Procollagen was significantly higher in patient group than in control group, 31.85 13.84 versus 19.42 2.11 (Pless than0.001), and it underwent significant reduction after treatment with methotraxate to a level of 25.60 8.34 (P=0.002). Mean serum TNF was significantly higher in patient group than in control group, 16.13 2.09 versus 10.25 1.04 (Pless than0.001), but it showed insignificant change after treatment with methotraxate to become 16.18 4.38 (P=0.949). Significant positive correlation between Homocystein before and after MTX treatment and Pro-collagen III before and after treatment with MTX in patient group, were obtained. . Conclusion Homocystein is raised in psoriasis and hyperhomocysteinaemia predispose to atherosclerosis, Pro-collagen III peptide is elevated in psoriasis and not affected by short term treatment with MTX, the TNF is raise in psoriasis and stay higher after MTX treatment. Methotrexate in low dose is safe in patients with moderate to severe psoriasis, however monitoring of renal and liver function tests and hematologic parameters is necessary.