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Gut Microbiota in Psoriasis

The skin acts as a physical and immunological barrier against external stimuli, including pathogens and physical damage. Changes in the composition of the skin microbiome can trigger inflammatory processes leading to inflammatory skin diseases in susceptible individuals.

Psoriasis is a chronic (long-lasting) disease in which the immune system becomes overactive, causing skin cells to multiply too quickly. Patches of skin become scaly and inflamed, most often on the scalp, elbows, or knees, but other parts of the body can be affected as well. Psoriasis is a chronic inflammatory skin disease with autoimmune pathogenic characteristics and is caused by chronic inflammation, which results in uncontrolled keratinocyte growth and defective differentiation. 

Many factors can influence intestinal microbiota composition and functions, including dietary patterns, antibiotics, as well as the mode of delivery at birth having an essential role in the bacterial diversity

What can trigger psoriasis?
• Stress.
• Skin injury, such as a cut or bad sunburn.
• Infection, such as strep throat.
• Some medications, including lithium, prednisone, and hydroxychloroquine.
• Weather, especially cold, dry weather.
• Tobacco.
• Alcohol (heavy drinking)

Diet and External Factors on the Composition of the Gut Microbiota

Diet is appreciated as the most potent modulator of both microbiota composition and function. Intestinal microbiota dysbiosis in psoriasis patients depends on the severity and status of the disease
Western diet consisting of energy-dense, processed foods, high in fat and sugar, and low in fiber, decreased the diversity of the cecal microbiota, shifted its composition toward a pro-inflammatory profile by enhancing the Desulfovibrionaceae and Proteobacteria’s relative abundance, and altered the cecal metabolome. Moreover, maltodextrin, a polysaccharide, causes endoplasmic reticulum stress in intestinal cells, decreasing mucus secretion and increasing the level of inflammation in mice models
Current evidence suggests that modulation of the gut microbiota, both through dietary approaches and through supplementation with probiotics and prebiotics, could represent a new therapeutic target in autoimmune pathologies, for instance multiple sclerosis , celiac disease and psoriasis . In the following, we will discuss if the gut microbiota-targeted therapies, including dietary approaches and supplementation with bioactive dietary components, probiotics and prebiotics, could present health benefits in psoriasis patients.

Mediterranean Diet,Gluten-Free and Low-FODMAP Diet

The Mediterranean diet encourages a high consumption of plant-based foods, such as fruits, vegetables, nuts, legumes, grains and olive oil, while reducing the intake of red meat, dairy products, and processed products. Recent evidence shows that psoriasis corelates with celiac disease and that patients with psoriasis present a higher risk of developing this autoimmune disease . Thus, psoriasis patients must benefit from screening for celiac disease for a more precise and effective nutritional therapy regarding gastrointestinal and inflammatory symptoms.


Probiotics enclose a wide range of microorganisms. Bacteria from the Lactobacillaceae and Bifidobacteriaceae families are the most frequent, but other bacteria, as well as yeasts, can be administered as probiotics. nondigestible dietary components, such as fructooligosaccharides (FOS), inulins, or galactooligosaccharides, promote the development of beneficial bacteria in the intestinal microbiota, and they are named prebiotics . When ingested together from the same mixture or dietary supplement, they are called synbiotics.

My thoughts:

As a diet clinician expert, I know that treating chronic health issues requires a thorough approach and sticking to treatment plans. Quick fixes won’t solve problems that have developed over time. Following a specialist’s guidance is crucial to effectively managing and possibly reversing complex clinical conditions. With dedication and professional support, positive outcomes can be achieved through persistent effort.


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