The Role of the Gut Microbiome in Psoriasis: From Pathogens to Pathology.

Objective: The objective of this article is to bring awareness to the emerging frontier of the correlation of the gut microbiome and its impact on psoriasis.
Methods: A Google Scholar and PubMed literature search was conducted utilizing key words "gut microbiome," "psoriasis," "diet," and "inflammation," yielding several articles for review and classification.
Results: Randomized, controlled trials have revealed that gut microbial imbalances contribute to inflammatory cytokines as well as to the progression and development of psoriasis. Perhaps more importantly, perturbations in the gut microbiome have been correlated to elevated plasma levels of claudin-3, zonulin, and intestinal fatty acid-binding protein, contributing to intestinal barrier dysfunction and permeability. This translocation results in systemic immune activation leading to phenotypic expression of psoriasis in genetically susceptible individuals. Limitations: Numerous limitations were found during the research on this topic, including lack of standardization of diets, coverage of stool testing by insurance, and personalized interactions of microbes on the host. Further studies are needed with longer follow-up and increased number of patients.
Conclusion: A healthy diet positively impacts the gut microbiome, which can dampen inflammatory cytokines and lessen the severity of psoriasis. The use of probiotics can also influence this dynamic.