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Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Autoimmune diseases are common in psoriasis. Particularly, celiac disease as well as Crohn’s disease occur with greater frequency in psoriasis than controls.
Is It Leaky Gut or Leaky Gut Syndrome?
- As many as 10% of Crohn’s disease patients suffer from psoriasis as compared to only 2% in healthy control subjects.
- 10% of first degree relatives of patients with psoriasis have Crohn’s as compared to3 % of controls.
- Ulcerative colitis is more common in psoriasis as compared to controls.
- Malabsorption syndrome is more common in psoriasis than controls.
- There are increased levels of with celiac disease associated antibodies associated in psoriasis and disease severity correlates with levels of antibodies.
- Gluten-free diet has beneficial effect in patients with psoriasis who have increased celiac disease associated antibodies.
- Vitamin D deficiency is common in these diseases.
Skin-Gut Axis
Skin as well as gut are characterized by a barrier separating the body from the environment including overlying bacteria on skin or the gut.
- Immune mediated inflammation is one of the factors implicated in the co-occurrence of the skin and GI diseases. Infection has been proposed as one of the triggers.
- The co-existance can be better understood when skin and gut are considered as complex barriers sharing functional as well as immunological features.
- TLR signaling pathways have been implicated in pathogenesis of many such autoimmune disorders wherein immune alterations occur due to interaction with the bacterial or dietary proteins. TLR are recognition receptors present on various cells especially in immune system. They recognize different bacterial proteins. Once such a receptor is activated, it gives rise to an inflammatory cascade. Depending the receptor type etc, different diseases may occur.
Connecting the dots
Psoriaisis which is a disorder of disordered skin barrier and inflammation is linked to gut. Above factors suggest leaky gut is involved in GI disorders like celiac disease, inflammatory bowel disease as well as psoriasis.
Leaky gut allows passage of abnormal proteins from bacteria and/or diet. For example gluten related activation of inflammation may be the cause for inflammation in psoriasis. Similarly dysbiosis in gut would lead to similar immune reaction.
Once these foreign proteins gain access to the body, they provoke immune reaction setting of disease processes. The physical/pathological expression of such abnormal immune cascades varies depending in the protein and the person’s genes.
- Primarily GI disease with some skin changes
- Primarily skin disease with some GI dysfunction like malabsorption
- Generalized skin disease and generalized GI disease
Thus, while one person may just have celiac disease or Crohn’s disease, other may have skin disease like psoriasis or combined Crohn’s and psoriasis.
Skin is a mirror of gut
Dr. FA Jones writing in the journal Geriatrics has described skin as the “mirror of gut”. Thus skin and gut diseases tend to co-exist as part of gut-skin axis.
Effect of probiotics on skin barrier and immune system
Studies by Dr. Benyacoub from Switzerland have shown that the probiotic Lactobacillus paracasei NCC2461 (ST11) reduces skin sensitivity, potentiates skin barrier, and curbs the skin immune system thus restoring the immune balance in the skin. leading to restoration of healthy skin balance.
Is It Leaky Gut or Leaky Gut Syndrome?
Dr. Minocha’s comments
Circumstantial evidence suggests that gut dysfunction plays a key role in skin diseases like psoriasis and skin eczema.
In the absence of evidence to the contrary, it would be prudent for such patients to take measures to aim for and then maintain a healthy gut and nutrition thus removing one critical element of the factors promoting their illness.
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