"Celiac and psoriasis? Definitely maybe. Celebrities with psoriasis Taken from the "National Psoriasis Foundation: connection between psoriasis and celiac disease Have you ever wondered if something in your diet that can worsen the psoriasis?. Many people have done. There are almost as many theories about diet and psoriasis as people with psoriasis. But scientists have never been convincingly demonstrated the effect of any particular diet on the disease. However, a growing body of research establishing that for a very small percentage of patients may be a connection between what is therefore important mouthed and what happens to your skin.
This connection may have to do with the pasta dish last night, with cereal this morning, with the donut noon in the office and the sandwich lunch. All of these foods contain gluten, which is insoluble component of grains of wheat, barley and rye. Some researchers believe that a very small subgroup of people with psoriasis may be celiac disease (gluten intolerance). Celiacs have the backing of the small intestine so badly damaged they can cause chronic diarrhea, nutritional problems and absorption of food and vitamin deficiencies. Celiac patients may experience abdominal cramping and pain, bone pain and joint pain, bloating, flatulence and fatigue among other symptoms.
No more pasta? Researchers who have studied psoriasis and intolerance to gluten believe that people with both diseases could significantly improve their psoriasis using the only available treatment for celiac disease: a strict diet called GFD (Gluten-Free Diet). The diet requires a total and prolonged absence at the time of gluten leading to a radical change in eating habits. Avoid
gluten meal means giving as common as grains, beer, barley, anything made with wheat flour and pasta. A well Deita implies a change in lifestyle and the results may appear only after weeks or months of close monitoring. Gerald Krueger, MD Professor of Dermatology at the University of Utah, confirmed that no one should deceived by the GFD. "It's a very strict diet. People with a severe problem of celiac disease can tell you how hard it is." Research
psoriasis and gluten
In 1993 a study by Swedish scientists led by Gerd Michaelsson, MD, Ph.D., professor emeritus at the University of Uppsala in Sweden, found that 16% of patients with psoriasis had increased their antibodies to gliadin (gluten protein to which some people have a reaction). Elevated levels of these antibodies, called AGA, are an indicator of celiac disease.
The same researchers conducted another study, published in the British Journal of Dermatology in 2000, which evaluated the effect of a gluten-free diet in 33 people with psoriasis who had antibodies AGA (AGA +) compared to 5 people with psoriasis without (AGA-). Patients sugieron the GFD for 3 months, followed by 3 months of their ordinary diet. 30 of the 33 AGA + improved with the GFD, while none of the 6 patients AGA-noted improvements. When patients AGA returned to their eating habits ordinary psoriasis worsened for 18 of the 30 had improved.
According to Dr. Krueger, it is clear from these small experiments that many of the patients with psoriasis who are AGA + improved with the GFD. "There seems to increase in the frequency of celiac disease among people with psoriasis, "says Dr. Krueger." I firmly believe I have something here, given that both psoriasis and celiac disease appear to be autoimmune diseases Th-1 type. It believe that both diseases are caused by overactive T cells, or activated inappropriately in the skin in the case of psoriasis, and the gut in the case of celiac disease. This is an intriguing connection that has scientists estuciando both diseases in finding common links in the origin and treatment.
connection still in doubt.
However, the most basic math would dictate that surprising if there were no people with both diseases. "In fact," says Dr. Krueger, "a small percentage of normal people with celiac disease, and a small percentage of normal people with psoriasis, so do not be surprised to find a significant number of people who have both. The challenge is to determine if the connection is real. The difficulty in determining it is a problem of numbers: number of patients and number of dollars. It can be very difficult for researchers to gather enough patients to study a small subrgrupo of patients with a disease that affects only 2% of the general population. And it's very, very expensive "Meanwhile, it is very important to talk to your doctor about celiac disease and the GFD before changing your diet or treatment. Symptoms may or may not be present in people com both diseases. Dr. Michaelsson believes that, in fact, many people with psoriasis who are AGA + and are potentially benefit from the GFD may have no symptoms celiac disease, but instead could have what she calls "silent celiac disease"
"If you think Intolerance to gluten can affect you, particularmene if you have moderate to severe psoriasis or uncontrolled pustolosis palmoplantar, Dr. Krueger recommends that you discuss the situation thoroughly with your doctor. Talk about whether a monitoring on Celiac disease markers could be useful. These markers are present in the blood of a person with celiac disease has been exposed to gluten, but the markers disappear when gluten is removed from the diet.
is important to consult your doctor and make appropriate tests before starting a GFD, because following a GFD before having made the appropriate blood tests may jeopardize the accuracy of the tests. Many doctors want to perform blood tests and intestinal biopsy to confirm celiac disease. For patients with psoriasis with celiac disease, Dr. Krueger agrees with Dr. Michaelsson to recommend the GFD.
Psoriasis and gluten intolerance.
An interview with Dr. Gerd Michaelsson
What are the key pieces of evidence that celiac disease (or gluten intolerance) and psoriasis?
First, the majority of patients with psoriasis are not gluten intolerant. However, there is a subgroup with silent celiac disease is important to identify these patients, since there is a chance to improve their skin lesions trave's a gluten-free diet (GFD). Some patients may have a total or near total recovery from the diet. When gluten is reintroduced there is a worsening of psoriasis. The effect of diet also appears to be very positive for palmoplantar pustular psoriasis (PPP), again with worsening when gluten is reintroduced. Moreover, the main focus in the PPP is in the snuff, and that 95% of PPP patients are smokers at the onset of his illness. As for patients with psoriatic arthritis and intolerance to gluten, there is an improvement in the skin lesions and as for arthritis. But the effect on arthritis is less noticeable than on the skin, indicating that there may be other contributing factors associated with arthritis.
In your opinion, what percentage of people with psoriasis and / or psoriatic arthritis have this connection?
About 16% of patients with psoriasis vulgaris have antibodies against gliadin, which is a fraction of the gluten. It is interesting to note that we have not found patients with psoriasis vulgaris, without arthritis, which had been previously diagnosed with celiac disease. Probably celiac disease patients who follow a strict diet GFD do not develop psoriasis or it goes away with diet and these patients need not go to a dermatologist. Not all psoriasis patients with antibodies to gliadin have the disease Classic celiac, which is characterized by damage to the villi of the intestinal mucosa and pronounced inflammation. Some patients have only slight changes in the intestine with very discrete inflammatory bowel disease. They can still improve with GFD. However, the most dramatic improvement in psoriasis occurs in those with more pronounced changes in the intestinal mucosa. Some of these patients also have antibodies against the enzyme transglutanimasa. Among patients with arthritis the percentage of antibodies to gliadin is the same as in those with psoriasis vulgaris, but also found that 4% had been previously diagnosed with celiac disease which again indicates that the arthritis does not respond the same way to the skin GFD. The highest percentage of anticerpos to gliadin (20%) were found in patients with PPP. Preliminary data indicate a very good response to GFD in these patients.
What do you think may be the most likely explanation for the connection between the two diseases? Is it genetic or caused by other factors (such as T-cell activation, immune system, etc.)?
psoriasis patients who have gluten intolerance may belong to a genetic subgroup with an increased risk for psoriasis, celiac disease and illness thyroid (the latter association is particularly common in women with PPP). Possibly there may be one or more autoantigens that are relevant to inflammation in psoriasis. One of these possible autoantigens may be the enzyme transglutaminase is also related to the processing of gluten. The expression of this enzyme is increased in blood vessels of psoriatic lesions and this expression is reduced when patients adhere to the GFD.
you recommend to patients with psoriasis or psoriatic arthritis to seek any particular symptoms or taking any concrete action?
In patients who had not been previously diagnosed with gluten intolerance enconramos that none of them had a history of gastrointestinal complaints increased compared to those without gluten intolerance. We recommend that patients with severe psoriasis or palmoplantar pustulosis analyzing the presence of antibodies against gliadin and transglutaminase and IgA serum levels. Other indicators of celiac disease are low levels of iron, zinc and folic acid, but in patients with mild intestinal changes these parameters are usually normal. The test costs are low while the results can be very rewarding. So our first patients treated with psoriasis and silent celiac disease have 25 years clean!
More about:
Celiac Disease:
psoriasis and celiac disease: