The association of anti‐gliadin and anti‐transglutaminase antibodies and chronic plaque psoriasis in Indian patients: Preliminary results of a descriptive cross‐sectional study

Abstract

Background: Gluten sensitivity among psoriasis patients and its association with gender, age, disease duration and severity of psoriasis are under studied in Indians. Objective: To examine association among serum levels of anti-tTG and anti-gliadin antibodies and clinical features including gender, age, duration and severity of psoriasis. Methods: Serum levels of anti-transglutaminase and anti-gliadin antibodies were measured quantitatively in 80 (M:F 57:23) psoriasis patients aged 15 to 83 years and matched healthy subjects. Results: Forty-five (56.3%) patients were aged ≥41years, duration of disease was >5years in 43 (53.8%) patients, and 22 (27.5%) patients had moderate-to-severe psoriasis. Two (2.5%) patients had arthritis and elevated serum anti-gliadin antibody. Significantly more patients than controls had elevated serum anti-gliadin antibody (67.5% vs. 2.5%) and anti-transglutaminase antibody levels (62.5% vs. 0%). Two patients, each with mild and moderate-tosevere psoriasis, had highly elevated serum antigliadin antibody and symptoms akin to coeliac disease. Except for a longer duration of psoriasis in patients with elevated anti-gliadin antibodies, there was no statistically significant difference in gender, age, and severity of psoriasis when compared with patients having normal levels. Conclusion: Significant elevation of serum antitransglutaminase and anti-gliadin antibodies levels is noted in psoriasis patients reflecting a possible link. However, results need careful interpretation for any significance of gluten sensitivity in pathogenesis of psoriasis/arthritis or as a stand-alone risk factor for chronicity/severity of psoriasis or whether gluten-free diet will be ameliorating. Small number of subjects, cross-sectional study design, lack of pathological/endoscopic diagnosis and follow-up are study limitations.

Screening of antigliadin and antitissue transglutaminase antibodies in patients with chronic plaque psoriasis: a case-control study

“…Still, they found that celiac disease patients had the highest AGA-IgA levels, followed by psoriasis patients with moderate levels and healthy controls with only weak positive AGA-IgA levels [ 27 ]. Likewise, another study from India found no relationship between age, sex, the severity of psoriasis, and celiac antibody levels [ 28 ]. Moreover, there are studies suggesting that a gluten-free diet may be beneficial in celiac antibody-positive psoriasis patients, but additional, better-designed studies are needed to confirm this [ 29 – 34 ].…”

Psoriasis in the pediatric population: comorbidities with psoriasis

“…A UK study found that patients with psoriasis have a higher prevalence of the disease. Studies in Italy, the Czech Republic, and India confirmed an increased prevalence of coeliac disease in psoriasis [127][128][129][130][131][132][133][134][135][136][137][138][139][140][141]. There are also isolated reports that do not confirm the association of psoriasis with coeliac disease or the presence of elevated celiac-specific antibodies, suggesting the need for further follow-up of patients [142,143].…”

Defining the optimum strategy for identifying adults and children with coeliac disease: systematic review and economic modelling

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