In Sweden alone, nearly 300,000 people live with some form of psoriasis, a hereditary condition that can also affect joints. Studies have already shown that psoriasis patients are more likely to develop inflammatory bowel diseases (IBD), particularly Crohn’s disease. However, the underlying reasons for these gastrointestinal problems have remained unclear until now.
According to new research from Uppsala University, people with skin conditions such as psoriasis often suffer from invisible inflammation in their small intestines. It may contribute to gastrointestinal issues and an increased risk of developing conditions like Crohn’s disease.
Published in Biochimica et Biophysica Acta (BBA) – Molecular Basis of Disease, the study sheds light on how psoriasis, a chronic inflammatory skin disorder, is more than just a skin condition.
Researchers discovered psoriasis sufferers often have subtle yet significant inflammation in their small intestine, which can increase the likelihood of a condition known as “leaky gut.” This finding could help explain the gastrointestinal symptoms- such as abdominal pain and bloating- that many psoriasis patients experience. Furthermore, it may clarify why they are more prone to developing Crohn’s disease and other gut-related conditions.
“Previous research has shown that people with psoriasis have more gastrointestinal problems than the general population,” says Dr. Lampinen. “However, we didn’t know much about why this is the case. With our study, we can now show that people with psoriasis often have invisible inflammation in their small intestines, with an increased risk of leaky gut.”
The study involved 18 psoriasis patients and 15 healthy controls. None of the participants had been diagnosed with any gastrointestinal diseases. The researchers collected small and large bowel samples and analyzed immune cells in the mucous membranes.
The results were striking: psoriasis patients showed a higher number of specific immune cells in their small intestines, and these cells exhibited signs of pro-inflammatory activity. Interestingly, the same types of immune cells were found in the skin flare-ups of psoriasis patients, suggesting a potential link between skin inflammation and gut issues.
“This suggests that inflammation in the skin might be influencing the gut, or vice versa,” says Lampinen. “It’s a two-way street we hadn’t fully understood until now.”
The gut’s mucosal lining acts as a protective barrier, allowing nutrients and water to pass through while keeping harmful substances at bay. However, in some autoimmune diseases, this barrier becomes compromised—a condition known as a leaky gut. When the gut becomes “leaky,” bacteria and other harmful substances can leak into the bloodstream, triggering inflammation.
In the study, half of the psoriasis patients exhibited signs of leaky gut, with increased intestinal permeability. These patients also reported more frequent gastrointestinal symptoms, including abdominal pain and bloating. Moreover, they had elevated levels of inflammatory substances in their intestines.
“Even though many of the psoriasis patients in our study had relatively mild skin disease and showed no visible intestinal inflammation in a gastroscopy, they had surprising changes in their small intestine compared to healthy controls,” says Lampinen. “These changes could help explain why psoriasis sufferers often experience gastrointestinal problems and are at greater risk for Crohn’s disease.”
The study could have possible applications in the treatment and management of psoriasis. The connection between the skin and gut could lead to more comprehensive care for patients, addressing skin flare-ups and gastrointestinal health.
Following the study’s publication, Lampinen received numerous emails from psoriasis patients who recognized the symptoms in the findings. Many patients reported that their gut and skin symptoms seemed linked and were eager to learn more about the connection.
“This research is important for the patients themselves,” Lampinen says. “A greater understanding of gastrointestinal issues in psoriasis patients could lead to better treatment and help the healthcare system recognize the link between the gut and the skin. In the long run, this could lead to improved outcomes for these patients.”
The Psoriasis Association and Hudfonden (the Skin Foundation) funded the study, among others.
Journal Reference:
- Patrik Lundquist, Eva Hagforsen et al. Mild-to-moderate psoriasis is associated with subclinical inflammation in the duodenum and a tendency of disturbed intestinal barrier. Biochimica et Biophysica Acta (BBA) – Molecular Basis of Disease. DOI: 10.1016/j.bbadis.2024.167634
Source: Tech Explorist
