Probiotics Supplementation Improves Quality of Life, Clinical Symptoms, and Inflammatory Status in Patients With Psoriasis

June 2022 | Volume 21 | Issue 6 | 637 | Copyright © June 2022


Published online May 25, 2022

doi:10.36849/JDD.6237

Jalal Moludi PhDa, b, Pourya Fathollahi BScc, Hamed Khedmatgozar MScd, Fatemeh Pourteymour Fard Tabrizi PhDe, Armaghan Ghareaghaj Zare MDf, Hamidreza Razmi MScc, Mahdi Amirpour MScc

aSchool of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
bClinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
cStudent Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
dCenter for Biotechnology and Genomics, Texas Tech University, Lubbock, TX
eNutrition Research Center, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
fDermatology Department, Tabriz University of Medical Sciences, Tabriz, Iran

Abstract
Background: Studies have proposed a link between psoriasis and imbalanced gut microbiome. Therefore, the modulation of the gut microbiota with probiotics may improve clinical outcomes, chronic inflammation, and cardiovascular risk factors in patients with psoriasis. Methods: In a randomized double-blind placebo-controlled clinical trial, forty-six patients with psoriasis randomly assigned into probiotic capsules contains multi-strain at least 1.6× 109 CFU/g bacteria or placebo for two months. Psoriasis Area and Severity Index (PASI), blood pressure, quality of life (QOL) pro-inflammatory cytokines (hs-CRP and IL1-β), and lipopolysaccharides (LPS) were measured.
Results: Improvements in QOL was significant in patients taking probiotics supplementation comparing to the placebo group and PASI (-5.06±2.10 vs 0.30±1.80, P=0.049) as well. After the intervention, a considerable reduction in serum LPS levels (-7.21±10.33 vs -2.74±0.97 mmol/L, P=0.010), hs-CRP levels (-1.67±0.95 vs -0.70+ 0.38 mg/L, P=0.013), and IL1- β levels (-1.64±1.10 vs 0.17+ -0.20 mg/L, P=0.043) in the probiotics group.
Conclusion: This study shows that probiotics significantly improved the quality of life and seriousness in psoriatic patients. Moreover, it enhances cardiovascular risk factors and inflammatory/oxidative stress markers.
Trial registration: This trial also was recorded in the Iranian registry of clinical trials (https://www.irct.ir) (code: IRCT20191124045483N1).

J Drugs Dermatol. 2022;21(6):637-644. doi:10.36849/JDD.6237

INTRODUCTION

Recent studies revealed the importance of gut microbiota in body health conditions.1 Understanding the gut microbiome started a new field of study that emphasizes the potential biochemical mechanisms of the healthy gut to local and distant organ diseases2 and study how the gut affects the skin is a new area of research.1 The gut and skin are both complex immune and neuroendocrine organs with a specific community of microbes that regulates the atmosphere of that part,3 and they have some effects on each other, especially the microbiome and its metabolites.1 A modification in the gut microbiota (dysbiosis) is related to type 2 diabetes, obesity, atopy, and cardiovascular disease.

Moreover, it has been shown that there is a possible relationship in the role of dysbiosis in the pathogenesis of skin conditions, including psoriasis, rosacea, and acne; however, we still need to do more clinical trials to have a better understanding of these disorders.4 Also, some gastrointestinal disorders accompany with dermatological skin abnormality. For instance, Celiac disease links to skin manifestations, such as erythema and oral lesions,5 and compared with healthy people, those who have Crohn’s disease present more possibility of having psoriasis.6

The positive effects of gut bacteria on skin health and appearance are determined in previous animal and human studies.1,4 As far as we know, no previous research has investigated the effect of probiotics supplementation in patients with psoriasis.

Psoriasis has long been observed as an immune-mediated chronic inflammatory disease with impairment in psychologic and emotional daily physical functioning and decreased quality of life (QOL).7 Regardless of the extensive use of several drugs,
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