Clinical Implications of Intestinal Barrier Damage in Psoriasis

Sikora, Mariusz; Stec, Albert; Chrabąszcz, Magdalena; Giebułtowicz, Joanna; Samborowska, Emilia; Jaźwiec, Radosław; Dadlez, Michał; Olszewska, Małgorzata; Rudnicka, Lidia

doi:10.2147/jir.s292544

Cited by 16 publications

(12 citation statements)

References 37 publications

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“…However, the association between HS and increased circulating TMAO levels was still unexplored. In line with our findings, Sikora et al [74] very recently reported that in psoriasis, another chronic, immune-mediated disease of the skin associated with multiple systemic effects, increased circulating TMAO levels were associated with an altered gut barrier, gastrointestinal symptoms, and a systemic inflammatory profile. Of interest, TMAO has been demonstrated to activate pro-inflammatory signaling pathways [3].…”

Section: Discussionsupporting

confidence: 93%

Association of Trimethylamine N-Oxide (TMAO) with the Clinical Severity of Hidradenitis Suppurativa (Acne Inversa)

Barrea

Muscogiuri²,

Pugliese³

et al. 2021

Nutrients

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In this case-control, cross-sectional, observational study, we evaluated circulating trimethylamine n-oxide (TMAO) levels, a gut-derived metabolite associated with inflammation and cardiometabolic risk, in patients with hidradenitis suppurativa (HS), a highly disabling inflammatory skin disease associated with an elevated prevalence of comorbidities, especially cardiovascular and metabolic diseases. In this study, we enrolled 35 naive-treatment patients with HS and 35 controls, matched for sex, age, and body mass index (BMI). HS Sartorius score was 49.0 (33.0–75.0), while according to the Harley system 12 and 23 patients presented grade 1 and grade 2 severity, respectively. HS patients had a lower adherence to the Mediterranean diet (MD) (p = 0.002), lower phase angle (PhA) (p < 0.001), and higher circulating TMAO levels (p < 0.001) than the control group. HS patients with grade 2 rather than grade 1 of Harley grade severity showed a higher BMI (p = 0.007), waist circumference (p = 0.016), total energy intake (p = 0.005), and lower PhA (p < 0.001) and adherence to the MD (p = 0.003). Of interest, patients with Hurley grade 2 of severity exhibited higher circulating TMAO levels (p < 0.001) compared to grade 1. Circulating TMAO levels showed a positive correlation with HS Sartorius score even after adjustment for confounding covariates, including BMI, waist circumference, adherence to the MD, total energy intake, and PhA (r = 0.570, p = 0.001). Using a linear regression model, circulating TMAO levels and PhA were the main predictors of the clinical severity of HS.

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Section: Discussionsupporting

confidence: 93%

Association of Trimethylamine N-Oxide (TMAO) with the Clinical Severity of Hidradenitis Suppurativa (Acne Inversa)

Barrea

Muscogiuri²,

Pugliese³

et al. 2021

Nutrients

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“…The present study preliminarily demonstrated the relevance of gut microbiota in the course of psoriasis from several aspects. We first found that multiple gastrointestinal symptoms were significantly more frequent in patients with psoriasis than healthy controls, which may result from compromised intestinal barrier and/or disordered gut microbes ( 32 ). Except for gastric acid reflux, other gastrointestinal symptoms involved in this study were not found to be related to gender.…”

Section: Discussionmentioning

confidence: 99%

Involvement of Gut Microbiota in the Development of Psoriasis Vulgaris

et al. 2021

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Objectives: Psoriasis is a common chronic recurrent dermatitis. Accumulating observations show gut microbiota dysbiosis in psoriasis. We intend to further investigate the relationship between intestinal microbiota and psoriasis development.Design: We first performed an epidemiological investigation on differences of gastrointestinal discomfort symptoms between patients with psoriasis and general population. Then variation of gut microbiota in patients with psoriasis (un)treated with acitretin plus narrow-band ultraviolet B (NB-UVB) was analyzed by 16S rRNA sequencing. We last compared recovery status and vital cytokines (lesion and intestine) of mouse psoriasiform models, which were transplanted with fecal microbiota from patients with psoriasis or healthy controls.Results: (1) About 85.5% of patients with psoriasis vs. 58.1% of healthy controls presented with at least one gastrointestinal symptom. The prevalence of investigated symptoms (e.g., abdominal distension and constipation) were significantly higher in patients, compared with controls (p < 0.05). Passing flatus and constipation were significantly correlated with psoriasis (p < 0.05 in both cases). (2) The abundance of Ruminococcaceae family, Coprococcus_1 genus, and Blautia genus were decreased with psoriasis improvement (p < 0.05, respectively), which had been demonstrated significantly increased in psoriasis. (3) Mice receiving psoriatic microbes transplantation showed delayed recovery of psoriasiform dermatitis and less reduction of interleukin (IL)-17A than those receiving healthy microbiota or blank control (p < 0.05 and p < 0.01, respectively).Conclusion: Multiple evidence we provided here preliminarily demonstrates the involvement of gut microbiota in the different degree of psoriasis activity. The strategy based on overall microbial communities is expected to be a promising supplementary for long-term management of psoriasis.

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“…Some researchers unveiled that SCFAs could maintain gut barrier integrity and reduce intestinal permeability so that microbial dysbiosis related to the deregulation of SCFA may associate with “leaky gut” [ 70 , 71 ], and thus lead to the onset of numerous diseases including but not limited to psoriasis. Furthermore, a number of studies showed that an altered intestinal barrier was linked with psoriasis activity and severity through quantifying intestinal barrier integrity markers (such as claudin-3 and intestinal fatty acid binding protein, I-FABP) or the serum concentrations of gut microbiota-associated metabolite trimethylamine N-oxide (TMAO) [ 73 , 74 , 75 , 76 , 77 ]. The enrichment of L-arginine-related pathways and urea cycle intermediates (e.g., citrulline, ornithine, proline) also coincided with previous serum metabolomic studies on psoriasis patients [ 78 ].…”

Section: Discussionmentioning

confidence: 99%

A Novel E3 Probiotics Formula Restored Gut Dysbiosis and Remodelled Gut Microbial Network and Microbiome Dysbiosis Index (MDI) in Southern Chinese Adult Psoriasis Patients

Choy¹,

Chan²,

Siu³

et al. 2023

IJMS

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Psoriasis is a common chronic immune-mediated inflammatory skin disease with the association of various comorbidities. Despite the introduction of highly effective biologic therapies over the past few decades, the exact trigger for an immune reaction in psoriasis is unclear. With the majority of immune cells residing in the gut, the effect of gut microbiome dysbiosis goes beyond the gastrointestinal site and may exacerbate inflammation and regulate the immune system elsewhere, including but not limited to the skin via the gut-skin axis. In order to delineate the role of the gut microbiome in Southern Chinese psoriasis patients, we performed targeted 16S rRNA sequencing and comprehensive bioinformatic analysis to compare the gut microbiome profile of 58 psoriasis patients against 49 healthy local subjects presumably with similar lifestyles. Blautia wexlerae and Parabacteroides distasonis were found to be enriched in psoriasis patients and in some of the healthy subjects, respectively. Metabolic functional pathways were predicted to be differentially abundant, with a clear shift toward SCFA synthesis in healthy subjects. The alteration of the co-occurrence network was also evident in the psoriasis group. In addition, we also profiled the gut microbiome in 52 of the 58 recruited psoriasis patients after taking 8 weeks of an orally administrated novel E3 probiotics formula (with prebiotics, probiotics and postbiotics). The Dermatological Life Quality Index (p = 0.009) and Psoriasis Area and Severity Index (p < 0.001) were significantly improved after taking 8 weeks of probiotics with no adverse effect observed. We showed that probiotics could at least partly restore gut dysbiosis via the modulation of the gut microbiome. Here, we also report the potential application of a machine learning-derived gut dysbiosis index based on a quantitative PCR panel (AUC = 0.88) to monitor gut dysbiosis in psoriasis patients. To sum up, our study suggests the gut microbial landscape differed in psoriasis patients at the genera, species, functional and network levels. Additionally, the dysbiosis index could be a cost-effective and rapid tool to monitor probiotics use in psoriasis patients.

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Clinical Implications of Intestinal Barrier Damage in Psoriasis

Cited by 16 publications

References 37 publications

Association of Trimethylamine N-Oxide (TMAO) with the Clinical Severity of Hidradenitis Suppurativa (Acne Inversa)

Association of Trimethylamine N-Oxide (TMAO) with the Clinical Severity of Hidradenitis Suppurativa (Acne Inversa)

Involvement of Gut Microbiota in the Development of Psoriasis Vulgaris

A Novel E3 Probiotics Formula Restored Gut Dysbiosis and Remodelled Gut Microbial Network and Microbiome Dysbiosis Index (MDI) in Southern Chinese Adult Psoriasis Patients

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