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Abstract AD is a common, complex and chronic inflammatory skin disorder characterized by eczema, pruritus and cutaneous hyper-reactivity to allergic, irritant or microbial triggers, and affected individuals suffer significant morbidity. The pathogenesis of AD is a product of complex interactions among susceptibility genes, the host’s environments, defect in barrier function and systemic and local immunological response. IL-33/ST2 signaling has been studied in a wide range of inflammatory skin conditions for its crucial role in immune response and tissue homeostasis and it was found that IL-33 level increased in the skin and serum of patients with AD. In the present study, the possible role of IL-33 in the pathogenesis of AD was evaluated by measuring its level in both serum and tissue of AD patients and comparing it with IL-33 level in normal healthy subjects (controls). This case control study included 30 patients diagnosed as having AD according to Hanifin and Rajka criteria. Further, 10 age and sex matched healthy controls were recruited. All patients were selected from the dermatology outpatient clinic of Ain-Shams University Hospitals in the period from April 2017 till February 2018. The control individuals were selected from the working staff of Ain-Shams University hospitals. All patients were subjected to full history taking, general examination and dermatological examination. Patients were divided into 3 groups based on clinical severity according to EASI score. Group1: included 17 patients with mild AD (score<10). Group2: included 7 patients with moderate AD (score 10-20). Group3: included 6 patients with severe AD (score>20). Blood samples were taken from all patients with AD, also blood samples were taken from the controls. Three mm punch biopsies were taken from patientsʼ lesional skin (from thigh in 15 patients, from forearm in 5 patients and form the leg in 10 patients) and from thigh of the controls and homogenized for detecting IL-33 level by ELISA. Our study found a high statistically significant difference between cases and controls regarding tissue IL-33 level with higher tissue IL-33 level among cases as compared to controls. There was a high statistically significant difference between cases of AD and controls regarding serum IL-33 level with higher serum IL-33 level among cases as compared to controls. A statistically significant positive correlation was found between serum and tissue IL-33 level and EASI score which means that serum and tissue IL-33 level increases as EASI score increases. Also in our study there was positive correlation between serum and tissue IL-33 level with age of patients of AD which means that serum and tissue IL-33 level increases as age of patients increases. Also in our study there was positive correlation between serum and tissue IL-33 level with duration of AD which means that serum and tissue IL-33 level increases as duration of AD increases. No statistically significant difference was found regarding IL-33 level according to sex, personal history of atopy or family history of atopy. Concluding that IL-33 has an important role in AD pathogenesis regardless of sex, personal or family history of atopy. Also the current study concluded that Alteration of IL-33 levels may play an important role in the pathogenesis of AD. In addition, it concluded that IL-33 level can be used as an indicator of severity of AD. In view of the small number of studied cases, future studies are recommended on larger number of patients with AD to assess the effect of different treatment options on IL-33 in patients with AD and investigate the role of anti-IL-33 as a possible therapeutic option in AD. |