Psoriasis patients with antibodies to gliadin can be improved by a gluten-free diet

Abstract

In a previous screening study, 16% of patients with psoriasis had IgA and/or IgG antibodies to gliadin (AGA). The aim of the present study was to evaluate the effect of a gluten-free diet (GFD) in 33 AGA-positive and six AGA-negative psoriasis patients. Of the 33 AGA-positive patients, two had IgA antibodies to endomysium (EmA) and 15 an increased number of lymphocytes in the duodenal epithelium, but in some this increase was slight. Two patients had villous atrophy. A 3-month period on a GFD was followed by 3 months on the patient's ordinary diet. The severity of psoriasis was evaluated with the psoriasis area and severity index (PASI). The examining dermatologists were unaware of the EmA and duodenal biopsy results throughout the study. Thirty of the 33 patients with AGA completed the GFD period, after which they showed a highly significant decrease in mean PASI. This included a significant decrease in the 16 AGA-positive patients with normal routine histology in duodenal biopsy specimens. The AGA-negative patients were not improved. After GFD, the AGA values were lower in 82% of those who improved. There was a highly significant decrease in serum eosinophil cationic protein in patients with elevated AGA. When the ordinary diet was resumed, the psoriasis deteriorated in 18 of the 30 patients with AGA who had completed the GFD period. In conclusion, psoriasis patients with raised AGA might improve on a GFD even if they have no EmA or if the increase in duodenal intraepithelial lymphocytes is slight or seemingly absent.

The role of lipids in psoriasis

“…It seems, however, that gluten-free diet may have a desirable effect on the activity of psoriasis, though it is to be expected mostly in AGA-positive (antigliadin antibodies) patients. After 3 months of GFD, a significant PASI reduction was noted in 73% of the total of 33 AGA-positive patients, and AGA values were decreased in 82% of patients from this group [86,87].…”

“…Wydaje się, że dieta bezglutenowa może korzystnie wpływać na aktywność łuszczycy, jednak raczej u pacjentów AGA-dodatnich (antigliadin antibodies -przeciwciała przeciwko gliadynie). Po 3 miesiącach stosowania GFD u 73% spośród 33 pacjentów AGA-dodatnich stwierdzono istotną redukcję PASI, a u 82% osób z tej grupy zmniejszyły się wartości AGA [86,87].…”

Celiac Disease and Autoimmunity in the Gut and Elsewhere

“…[49] These studies raise interesting questions in terms of the immunological mechanisms connecting gastrointestinal and skin diseases and the opportunity for potential treatments. Multiple mechanisms have been proposed including, increased intestinal permeability, vitamin D deficiency, and gluten-induced T-cell activation.…”

Food, Nutrition and Diet Therapy in Psoriasis

“…This gluten-sensitive enteropathy tends to bemildly symptomatic and even asymptomatic, which may explain the association between latent gluten sensitivity and psoriasis (Wolters, 2005). A number of studies report an association between celiac disease and psoriasis (Michaelsson et al, 2000;Woo et al, 2004). According to some authors, however, this association is controversial due to currently limited data (Addolorato et al, 2003;Collin & Reunal, 2003).…”