Psoriatic Disease and the Human Microbiome
The skin and gut microbiomes have an intricate role in the body’s immune responses. The development and progression of chronic inflammatory diseases, including psoriasis and psoriatic arthritis, have been linked to changes in these microbiomes.
A recent review examined the crucial role that the human microbiome plays in psoriatic disease and identified potential aspects of the relationship between the microbiome functions and disease processes that may be targeted by future therapies.
To learn more about the associations between the human microbiome and psoriatic disease, Consultant360 reached out to lead study author, Valentina Celoria, MD. Dr Celoria is part of the Dermatologic Clinic in the Department of Medical Sciences at the University of Turin (Turin, Italy).
Consultant360: What prompted this review?
Valentina Celoria: My goal was to facilitate future studies on the skin microbiome to identify potential novel therapies for patients with psoriatic disease. The aim of my study was to highlight the relationship between skin and gut microbiome functions and their role in inflammatory systemic processes such as psoriasis.
C360: Could you briefly discuss some of the most important aspects of the relationship between the skin microbiome and psoriasis, psoriatic arthritis, and other inflammatory conditions that were highlighted in your review?
VC: In analysing the microbiome of skin with psoriatic lesions, uninvolved skin, and skin from healthy people, we saw that the microbial population covering the lesions was more abundant and varied than the healthy skin samples, which were found to be relatively homogeneous.
The skin and gut are complex immune and neuroendocrine organs that play a crucial role in maintaining overall homeostasis. In addition to the epithelial barrier, the gut microbiome also impacts the immune-regulatory properties of the gut. However, the specific microbes responsible for these mechanisms in psoriasis are not yet well understood.
C360: How can health care practitioners for patients with psoriatic disease and other inflammatory skin disorders utilize a multidisciplinary approach to management?
VC: Increasing the population’s understanding in psoriatic disease as a systematic disease can improve the multidisciplinary approach. With the establishment of multispecialty cardiovascular, gastroenterological, and rheumatological outpatient clinics one could improve the clinical approach to the patient. Personalized therapy could greatly improve the quality of life of these patients.
C360: What are the next steps for research on the relationship between the skin microbiome and psoriasis and psoriatic arthritis?
VC: Recently there has been a significant increase in metagenomic data due to advances in sequencing technology, particularly in the field of skin microbiome research. The use of next-generation 16S rRNA sequencing has revolutionized our understanding of the skin microbiome. This is a major expansion of our understanding compared with what was previously possible with traditional culture techniques, which identified only about 1% of the skin microbiome.
Clinical trials with larger sample sizes and greater power are necessary to establish the safety and efficacy of probiotic interventions, including identifying optimal species combinations, doses, and treatment durations. Additionally, exploring combination therapy with phages or antibiotics may provide promising results for microbiome replacement strategies. Overall, research in this field may lead to the development of new diagnostic and therapeutic opportunities for a range of diseases.
Reference:
Celoria V, Rosset F, Pala V, et al. The skin microbiome and its role in psoriasis: a review. Psoriasis (Auckl). 2023;13;71-78. doi:100.2147/PTT.S328439.