Psoriasis and Microbiota: A Systematic Review.

Farida Benhadou, Dillon Mintoff, Benjamin Schnebert, Hok Bing Thio

Journal: Diseases (Basel, Switzerland) 2018;6(2):47

PMID: 29865237

Plain Language Summary

Psoriasis is an autoimmune inflammatory skin disease that causes red, itchy, flaky and scaly skin. Skin integrity and function are critically dependent on the microbial population on it. Based on this systematic review, the immune system's interaction with microbes on the skin was examined and its relationship to psoriasis. T-cell mediated inflammation is characteristic of psoriasis where interaction between type IV collagen and α1β1 integrin, a collagen receptor, occurs. In psoriatic skin lesions, Firmicutes were predominant, while Actinobacteria were less prevalent. Psoriasis exacerbations are also associated with an exacerbated number of fungi, Malassezia species, in skin lesions. As therapeutic strategies for psoriasis, this systematic review suggests adhering to a gluten-free diet and incorporating prebiotics and probiotics such as Lactobacillus. However, further research is needed to develop specific therapeutic and skin modulation strategies. Health care professionals can benefit from this systematic review by understanding the pathophysiology behind psoriasis and possible therapeutic strategies to consider.

Abstract

BACKGROUND

Recent advances have highlighted the crucial role of microbiota in the pathophysiology of chronic inflammatory diseases as well as its impact on the efficacy of therapeutic agents. Psoriasis is a chronic, multifactorial inflammatory skin disorder, which has a microbiota distinct from healthy, unaffected skin.

AIM

Through an extensive review of the literature, we aim to discuss the skin and gut microbiota and redefine their role in the pathogenesis of psoriasis.

CONCLUSIONS

Unfortunately, the direct link between the skin microbiota and the pathogenesis of psoriasis remains to be clearly established. Apart from improving the course of psoriasis, selective modulation of the microbiota may increase the efficacy of medical treatments as well as attenuate their side effects.

Address: Dermatology Department, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, Anderlecht, 1070 Brussels, Belgium. [email protected].; Dermatology Department, Sir Paul Boffa Hospital, 1491 Floriana, Malta. [email protected].; Medecine Faculty, Université Libre de Bruxelles, 1070 Brussels, Belgium. [email protected].; Dermatology Department, Erasmus Medical Center, 3000 Rotterdam, The Netherlands. [email protected].

DOI: 10.3390/diseases6020047