People with psoriasis, a skin disease, often have invisible inflammation in the small intestine with an increased propensity for “leaky gut”, according to new research from Uppsala University. These changes in the intestine could explain why psoriasis sufferers often have gastrointestinal problems and are more likely to develop Crohn’s disease. The study is published in Biochimica et Biophysica Acta (BBA) – Molecular basis of disease.
Psoriasis is a chronic, inherited skin condition that can also cause inflammation of the joints. In Sweden, almost 300,000 people live with some form of this disease. Chronic inflammatory bowel diseases (IBD), especially Crohn’s disease, are more common in patients with psoriasis than in the rest of the population.
“Previous research has also shown that people with psoriasis have more gastrointestinal problems than the general population. However, we didn’t know much about why this is so. With our study, we can now show that people with psoriasis often have inflammation invisible in the small intestine, with a higher risk of what is called leaky gut,” says Maria Lampinen, a researcher at Uppsala University.
Proinflammatory activity in the intestine.
18 patients with psoriasis and 15 healthy controls participated in the study as subjects. None of the participants had been diagnosed with gastrointestinal diseases. Samples were taken from both the small and large intestines. The researchers then studied different types of immune cells in the mucous membrane.
“It turned out that psoriasis patients had higher numbers of certain types of immune cells in their small intestine, and the cells showed signs of pro-inflammatory activity. Interestingly, we found the same type of immune cells in the skin flares of psoriasis patients. , suggesting that skin inflammation may have an impact on the gut, or vice versa.
Increased propensity for leaky gut
Normally, the intestinal mucosa acts as a protective barrier that also allows the passage of nutrients and water. In some autoimmune diseases, the intestinal barrier can malfunction. This is called leaky gut and causes bacteria and harmful substances to leak through the intestinal barrier and cause inflammation. This can also cause more widespread inflammation when these substances spread through the bloodstream.
Half of the psoriasis patients in the study had increased intestinal barrier permeability or leaky gut. These same patients also reported more gastrointestinal symptoms, such as abdominal pain and bloating, than patients with a normal intestinal barrier. They also had elevated levels of inflammatory substances in their intestines.
“Since the psoriasis patients in our study had relatively mild skin disease and did not show visible intestinal inflammation on gastroscopy, they had strikingly clear changes in their small intestine compared to healthy controls. These changes could explain why the Patients with psoriasis often have gastrointestinal problems and an increased risk of developing Crohn’s disease.
Important research for these patients.
He Psoriasis disease (the member journal of the Swedish Psoriasis Association) published an article about this study. After its publication, Maria Lampinen received numerous emails from people who recognized this phenomenon.
“They wanted to know more about the link between the gut and the skin because they recognized that gut and skin symptoms were often linked. Therefore, it seems that this research is necessary and is important for the patients themselves. Greater understanding of the Gastrointestinal system problems in psoriasis patients may help the healthcare system pay more attention to the relationship between the gut and the skin of psoriasis patients and, in the long term, could also lead to better treatment of these problems.
The study was funded by funds administered by the Psoriasis Association and Hudfonden (The Skin Foundation), among others.