Estimation of Anti-Mullerian Hormone and Other Biochemical Parameters Levels in Iraqi Women with Psoriasis Patients Treated with Etanercept as A Biological Drug

Abstract

     Psoriasis is a complex, chronic disease frequently accompanied by significant comorbidities. It adversely impacts individual physical health, social functioning, and sexual well-being. Particular exclusive concerns regarding the impact of this disease on women. The study aims to evaluate the immune state and ovarian backup in women with psoriasis disease within different age groups by evaluating the tumor necrosis factor and Anti-mullerian hormone levels, respectively. Forty-eight female patients with severe to moderate psoriasis and a control group of 50 healthy females were studied. Both groups aged between 20 and 67 years were evaluated from December 2020 to October 2021. The patients were categorized into two sub-groups (24 patients for each group), the first before treatment group and the second after treatment group (with etanercept as a biological drug). The patients that previously shown inadequate responses to other medical treatments were excluded from this study.  The Anti-Mullerian Hormone, Interleukins 2&7(IL-2, IL-17) and TNF-α were evaluated in this study. The study included that the age of both groups was divided into three ranges (20-35, 36-51 and 52-67years). In patients, most psoriasis cases are 20-35 years compared to the other age ranges (36-51 and 52-67 years). TNF-α levels were increased (P<0.01) in psoriasis before care and therapy, measuring 189.5±26.0 ng/mL compared to 93.5±2.4 ng/mL in control. A notable increase (P<0.05) in TNF-α concentration in psoriatic patients after biological treatment in comparison to its level before treatment was noted, with a mean of 189.50±26.00 ng/mL and 223.60±41.10 ng/mL, respectively. Similarly, serum IL-2 concentration was notably increased (P<0.05) in psoriatic subjects before treatment with a mean of 97.50±6.60 ng/mL compared to 77.90±3.10 ng/mL in the control group, as well as differences were noted in serum IL-2 levels among psoriatic patients before and after treatment, with a mean of 97.50±6.60 ng/mL and 92.90±5.00 ng/mL, respectively. The data revealed a significant increase (P<0.05) of IL-17 cytokine level in psoriatic patients before treatment (93.80 ± 3.40 ng/ml) compared to control group (65.80 ± 2.70 ng/ml), and its level was decreased significantly (P<0.05) after treatment with a mean of 72.70 ± 4.40 ng/mL in comparison with psoriatic patients before treatment. Finally, the serum AMH level reduced statistically (P<0.05) in psoriatic patients previous to treatment assessment, where the level mean was 0.42±0.17 ng/ml, while in healthy control group was 2.5±0.16 ng/mL, and it is found a statistical increase of serum AMH concentration (P<0.05) in psoriatic patients after treatment with a mean of 2.8±0.23 ng/mL in comparison to its mean before treatment. Autoimmune syndromes may disturb ovarian backup regardless of immunosuppressive treatment. So, the follow-ups concerning reproductive role might be essential in women with psoriasis, especially those in reproductive periods.