Levels of proelafin peptides in the sera of the patients with generalized pustular psoriasis and pustulosis palmoplantaris

The levels of proelafin peptides in the sera of patients with pustulosis pa lmoplantaris, a unique type of localized pustular psoriasis, and generalize d pustular psoriasis were determined by competitive enzyme-linked immunosor bent assays using antibodies against synthetic proelafin polypeptides corre sponding to the elastase inhibitor (elafin) and transglutaminase substrate domains, The sera of patients with pustulosis palmoplantaris (9 cases) exhi bited a normal range of proelafin peptide levels, The sera of patients with generalized pustular psoriasis (3 cases) showed high titres of proelafin p eptide, There were no large! differences in the titres between the 2 antibo dies, The antibodies for 2 different domains of proelafin showed a similar immunoreactivity for the non-pustular region of the epidermis in all pustul osis palmoplantaris tested, The results indicate that serum proelafin pepti des in pustular psoriasis may depend on the extent of the involved area, an d that proelafin peptide level in pustulosis palmoplantaris remains normal despite enhanced local expression in the lesional skin, Since the skin lesi ons of patients with pustulosis palmoplantaris are limited to the palms and soles, enhanced expression of proelafin in the lesional skin may not lead to elevation of proelafin peptides in the serum.