Prevalence of Candida species in Psoriasis

Abstract

Background Psoriasis patients are more frequently colonised with Candida species. The correlation between fungal colonisation and clinical severity is unclear, but may exacerbate psoriasis and the impact of antipsoriatic therapies on the prevalence of Candida is unknown. Objectives To examine the prevalence of C species in psoriasis patients compared to an age‐ and sex‐matched control population, we investigated the influence of Candida colonisation on disease severity, immune cell activation and the interplay on psoriatic treatments. Methods The prevalence of C species was examined in 265 psoriasis patients and 200 control subjects by swabs and stool samples for fungal cultures. Peripheral mononuclear blood cells (PBMCs) were collected from 20 fungal colonised and 24 uncolonised patients and stimulated. The expression of interferon (IFN)‐γ, IL‐17A, IL‐22 and tumour necrosis factor (TNF)‐α from stimulated PBMCs was measured by quantitative real‐time polymerase chain reaction (qPCR). Results A significantly higher prevalence for Candida was detected in psoriatic patients (p ≤ .001) compared to the control subjects; most abundant in stool samples, showing Candida albicans. Older participants (≥51 years) were more frequent colonised, and no correlation with gender, disease severity or systemic treatments like IL‐17 inhibitors was found. Conclusions Although Candida colonisation is significantly more common in patients with psoriasis, it does not influence the psoriatic disease or cytokine response. Our study showed that Candida colonisation is particularly more frequent in patients with psoriasis ≥51 years of age. Therefore, especially this group should be screened for symptoms of candidiasis during treatment with IL‐17 inhibitors.

Long-term safety of Ixekizumab in adults with psoriasis, psoriatic arthritis, or axial spondyloarthritis: a post-hoc analysis of final safety data from 25 randomized clinical trials

“…OIs were largely due to Candida species, likely due to the role of IL-17 in host defense against infections of this type [ 41 ]. There is evidence to suggest that patients with PsO have an increased risk of Candida colonization (odds ratio: 2.47; 95% CI: 1.68 – 3.6 [ 42 ]) compared to control individuals, and the rate of oral candidiasis is higher among patients with PsO compared to the general population [ 43 ]. No relevant information on the background rate of Candida infection is available in the general PsA or axSpA populations.…”

Paradoxical Reactions to Anti-TNFα and Anti-IL-17 Treatment in Psoriasis Patients: Are Skin and/or Gut Microbiota Involved?

“…Even though it does not influence the immune response, massive colonization with Candida is common in patients with psoriasis. For this reason, patients should be screened for candidiasis before and after treatment with IL-17 inhibitors [ 172 ].…”

A Next Generation Sequencing (NGS)-based approach to diagnosing Algerian patients with suspected Inborn Errors of Immunity (IEIs)

“…The CARD14 variant c.205C>T, p.(Arg69Trp) has been seen in psoriasis vulgaris (PV) and psoriatic arthritis patients [124]. Though CARD14 is predominantly associated with skin autoinflammation, these phenotypes have been linked to increased risk for Candida infections [125][126][127][128][129]. This variant has been seen in 5% of Tunisian PV cases and 0.5% of Tunisian controls, but rare or absent in other populations [124].…”