Increased intestinal barrier permeability in patients with moderate to severe plaque‐type psoriasis

Richetta, Antonio Giovanni; Grassi, Sara; Moliterni, Elisa; Chello, Camilla; Calvieri, Camilla; Carnevale, Roberto; Peruzzi, Mariangela; Violi, Francesco; Calvieri, Stefano

doi:10.1111/1346-8138.15361

Cited by 11 publications

(14 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies previously revealed increased intestinal permeability in patients with psoriasis. 12 , 14 However, the clinical significance of this phenomenon still remains unclear. To our knowledge, it is the first study that evaluates disease activity, self-reported gastrointestinal symptoms and TMAO concentration in patients with psoriasis according to the presence of a normal or altered gut barrier.…”

Section: Discussionmentioning

confidence: 99%

“…The increased blood concentration of lipopolysaccharide, an endotoxin derived from Gram-negative bacterial cell walls and a strong proinflammatory molecule, was confirmed in psoriatic patients. 12 , 15 Cell-free bacterial DNA was also identified in the blood of patients with psoriasis. 16 , 17 Nucleotide sequencing indicates that the detected DNA fragments correspond to the microbiota commonly found in the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

“…Gut microbiota profiling in psoriasis confirmed significant alterations in its biodiversity and composition. 8 Several studies assessed the intestinal barrier in psoriasis by measuring the plasma concentrations of intestinal fatty acid-binding protein (a marker of enterocyte damage), 9 , 10 zonulin (a protein that specifically and reversibly regulates intestinal permeability), 11 , 12 claudin-3 (a component of tight junctions), 13 , 14 lipopolysaccharide (a bacterial endotoxin) 12 , 15 and bacterial DNA. 16 , 17 However, the results were heterogeneous, with some patients presenting significantly affected intestinal integrity, and others showing a properly functioning gut barrier.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Implications of Intestinal Barrier Damage in Psoriasis

Sikora¹,

Stec²,

Chrabąszcz³

et al. 2021

JIR

View full text Add to dashboard Cite

Background An increasing amount of evidence suggests an association between increased intestinal permeability and the pathogenesis of chronic inflammatory diseases. However, the clinical significance of gut barrier dysfunction in psoriasis remains to be established. Objective To evaluate whether there are differences in disease activity, the severity of gastrointestinal symptoms and the blood concentration of bacterial metabolites in psoriatic patients with a normal and altered intestinal barrier. Patients and Methods Gut barrier integrity was assessed with the serum concentrations of claudin-3, a modulator of intestinal tight junctions and an intestinal fatty acid-binding protein, a marker of enterocyte damage. Gastrointestinal symptoms were evaluated with a validated questionnaire. The concentration of trimethylamine N-oxide (TMAO), a gut microbiota-associated metabolite, was measured with high-performance liquid chromatography. Results One hundred and fourteen patients with psoriasis were finally enrolled in the study – 68 with an altered gut barrier and 46 with a properly functioning intestinal barrier. Patients with an altered gut barrier showed a significantly higher score in the Gastrointestinal Symptom Rating Scale (3.20 vs 1.46, p<0.001). Moreover, patients with psoriasis and a disrupted intestinal barrier demonstrated a higher disease activity (PASI: 19.7 vs 10.3, p<0.001) and systemic inflammatory parameters (neutrophil-to-lymphocyte ratio: 2.86 vs 1.71, p<0.001; C-reactive protein 3.76 vs 1.92; p<0.05). The marker of bacterial translocation was significantly higher in psoriatic patients with damaged gut integrity (TMAO: 375.7±51.9 vs 119.4±27.5 ng/mL; p<0.05). Conclusion The altered gut barrier in psoriasis is associated with gastrointestinal symptoms, systemic inflammatory profile and the increased blood concentration of gut microbiota-derived metabolite – TMAO. Intestinal barrier modulation represents a new promising therapeutic approach.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Implications of Intestinal Barrier Damage in Psoriasis

Sikora¹,

Stec²,

Chrabąszcz³

et al. 2021

JIR

View full text Add to dashboard Cite

show abstract

“…In addition, they also found a linear correlation between LPS and zonulin. Based on these data, they concluded that intestinal barrier permeability is increased in psoriasis and that the uncontrolled passage of antigens across the intestinal barrier may be a factor that initiates inflammation in the skin 13 …”

Section: Discussionmentioning

confidence: 99%

“…initiates inflammation in the skin. 13 In our study, we compared plasma zonulin levels of vitiligo patients and healthy controls to investigate whether there is an increased intestinal permeability due to elevated zonulin expression in vitiligo disease. Plasma zonulin level in the patient group (2.02 ± 0.93 ng/ml) was higher than the zonulin level in the control group (1.61 ± 0.47 ng/ ml).…”

Section: Re Sultsmentioning

confidence: 99%

Evaluation of plasma zonulin level and its relationship with inflammatory cytokines in patients with vitiligo

Arslan

Altunışık

Türkmen

et al. 2022

J of Cosmetic Dermatology

View full text Add to dashboard Cite

Background It has been proven that there is an increase in intestinal permeability in some autoimmune diseases. In our study, we purposed to assess intestinal permeability in vitiligo disease by looking at zonulin levels. At the same time, we aimed to examine the correlation of inflammatory cytokines and lipopolysaccharide (LPS) levels with zonulin. Methods Forty‐one patients and 41 healthy participants were involved in our study. Blood samples were taken from all patients and controls, and the levels of zonulin, tumor necrosis factor (TNF)‐α, interleukin (IL)‐6 and LPS were examined. Results The mean of zonulin in the patient group was found to be statistically higher than the control group (p < 0.05). A positive correlation was found between zonulin level and IL‐6, TNF‐α, and LPS levels (p < 0.05). TNF‐α and LPS levels in the vitiligo group were significantly higher than in the control group, but there was no such significance in terms of IL‐6 levels. Conclusion We think that serum zonulin level increases and intestinal permeability increases in vitiligo disease.

show abstract

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

Zákostelská

Reiss

Tlaskalová‐Hogenová

et al. 2023

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

Psoriasis is a chronic, immune-mediated, inflammatory disease primarily affecting the skin. It is currently coming to light that patients with psoriasis have disrupted intestinal barrier and often suffer from comorbidities associated with the gastrointestinal tract. Moreover, there is growing evidence of both cutaneous and intestinal paradoxical reactions during biologic treatment in patients with psoriasis. This review focuses on barrier defects and changes in immune responses in patients with psoriasis, which play an important role in the development of the disease but are also influenced by modern biological treatments targeting IL-17 and TNFα cytokines. Here, we highlight the relationship between the gut–skin axis, microbiota, psoriasis treatment, and the incidence of paradoxical reactions, such as inflammatory bowel disease in patients with psoriasis. A better understanding of the interconnection of these mechanisms could lead to a more personalized therapy and lower the incidence of treatment side effects, thereby improving the quality of life of the affected patients.

show abstract

Increased intestinal barrier permeability in patients with moderate to severe plaque‐type psoriasis

Cited by 11 publications

References 7 publications

Clinical Implications of Intestinal Barrier Damage in Psoriasis

Clinical Implications of Intestinal Barrier Damage in Psoriasis

Evaluation of plasma zonulin level and its relationship with inflammatory cytokines in patients with vitiligo

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

Contact Info

Product

Resources

About