Serum level of IL22 and IL17 in recalcitrant common warts

Background: Recalcitrant warts are defined as warts persistent for longer than two years in spite of proper use of appropriate treatment. The interleukin-17 (IL-17) family cytokines have an essential protective role in host immune response to infection. IL-22 production is upregulated by NK and CD4 + T cells secondary to different types of viral infections throughout which IL-22 causes an essential role in the antiviral defense mechanism. Objectives: The aim of this study was to measure the level of IL-22 and Il-17 in recalcitrant common warts and healthy controls in an attempt to explain their role in wart pathogenesis. Methodology: This was a case control study conducted on 50 patients with recalcitrant warts, and 40 healthy controls. All cases were subjected to history taking, physical examination and laboratory investigations comprising serum IL22 and IL 17 levels. Results: Cases showed significantly lower IL-17 and IL22 levels in comparison with the control group. (p<0.001). Moderate accuracy was found for IL22 and IL17 to discriminate between cases and control groups. In addition, both IL-17 and IL-22 could be used for prediction of recalcitrant warts susceptibility (p<0.001). Conclusion: Cases with recalcitrant warts were associated with significant decreases in serum IL-22 level, and this low level may have a potential function in improving the cell-mediated immune response towards HPV infections. Patients with recalcitrant warts were associated with significant reductions in serum IL-17 value; IL-17 deficiency plays a main role in recalcitrant wart pathogenesis via disturbance of the balance of the immune system and deficiency of immune cells. As a result, IL-17 may have an essential role in the antiviral immune response to HPV infection.