Recent evidence suggests that a group of psoriasis patients have silent gluten intolerance and may experience improvement of their psoriasis by going on a gluten-free diet. Although there is still controversy as to the prevalence of this subset of psoriasis patients, screening patients with moderate to severe psoriasis for antigliadin antibodies may be helpful in identifying this group. Evidence illustrates that patients with positive antigliadin antibodies who undertake a gluten-free diet experience significant improvement of their psoriasis compared with prediet measurements. To make definitive clinical recommendations, a large randomized, controlled trial is needed. Even though the evidence is limited, it may be beneficial to screen psoriasis patients for silent gluten intolerance to identify those who could benefit from a gluten-free diet.
MichaëlssonG., GerdenB., HagforsenE.Psoriasis patients with antibodies to gliadin can be improved by a gluten-free diet. Br J Dermatol.2000; 132: 44–51.
4.
SchuppanD.Current concepts of celiac disease pathogenesis. Gastroenterology.2000; 119: 234–42.
5.
Damasiewicz-BodzekA., WielkoszyńskiT.Serologic markers of celiac disease in psoriatic patients. J Eur Dermatol Venereol.2008; 22: 1055–61.
6.
FleckensteinB., QiaoS.W., LarsenM.R., JungG., RoepstorffP., SollidL.M.Molecular characterization of covalent complexes between tissue transglutaminase and gliadin peptides. J Bio Chem.2004; 279: 17607–16.
7.
BizzaroN., TozzoliR., VillaltaD., FabrisM., TonuttiE.Cutting-edge issues in celiac disease and gluten intolerance. Clin Rev Allergy Immunol.2010; [E pub ahead of print].
LewisN.R., ScottB.B.Systematic review: the use of serology to exclude or diagnose celiac disease (a comparison of the endomysial and tissue transglutaminase antibody tests). Aliment Pharmacol Ther.2006; 24(1): 47–54.
10.
AddoloratoG., ParenteA., de LorenziG.Rapid regression of psoriasis in a coeliac patient after gluten-free diet. A case report and review of the literature. Digestion.2003; 68: 9–12.
11.
Van der WindtD.A., JellemaP., MulderC.J., KneepkensC.M., van der HorstH.E.Diagnostic testing for celiac disease among patients with abdominal symptoms: a systemic review. JAMA.2010; 303(17): 1738–46.
12.
MichaëlssonG., GerdenB., OttossonM.Patients with psoriasis often have increased serum levels of IgA antibodies to gliadin. Br J Dermatol.1993; 129(6): 667–73.
13.
OjettiV., Aguilar SanchesJ., GuerrieroC., FossatiB., Capizzir De SimoneC.High prevalence of celiac disease in psoriasis. Am J Gastroenterol.2003; 98: 2574–5.
14.
OjettiV., De SimoneC., SanchezJ.A.Malabsoprtion in psoriatic patients. Scand J Gastroenterol.2006; 41: 1267–71.
15.
KiaK.F., NairR.P., IkeR.W., HiremagaloreR., ElderJ.T., EllisC.N.Prevalence of antigliadin antibodies in patients with psoriasis is not elevated compared with controls. Am J Clin Dermatol.2007; 8(5): 301–5.
LindqvistU., RudsanderA., BoströmA., NilssonB., MichaëlssonG.IgA antibodies to gliadin and coeliac disease in psoriatic arthritis. Rheumatology.2002; 41: 31–7.
18.
MichaëlssonG., KristjánssonG., Pihl LundinI., HagforsenE.Palmoplantarpustulosis and gluten sensitivity: a study of serum antibodies against gliadin and tissue transglutaminase, the duodenal mucosa and effects of gluten-free diet. Br J Dermatol.2007; 156: 659–66.
19.
AntonioliD.A.Celiac disease: a progress report. Mod Pathol.2003; 16(4): 342–6.
20.
KakarS., NehraV., MurrayJ.A., DayharshG.A., BurgartL.J.Significance of intraepithelial lymphocytosis in small bowel biopsy samples with normal mucosal architecture. Am J Gastroenterol.2003; 98(9): 2027–33.
21.
MichaëlssonG., KraazW., HagforsenE., Pihl-LundinI., LööfL.Psoriasis patients have highly increased numbers of tryptase-positive mast cells in the duodenal stroma. Br J Dermatol.1997; 136: 866–70.
22.
MichaëlssonG., KraazW., GerdénB.Patients with psoriasis have elevated levels of serum eosinophil cationic protein and increased numbers of EG2 positive eosinophils in the duodenal stroma. Br J Dermatol.1996; 135(5): 371–8.
23.
MichaëlssonG., KraazW., GerdénB.Increased lymphocyte infiltration in duodenal mucosa from patients with psoriasis and serum IgA antibodies to gliadin. Br J Dermatol.1995; 133(6): 896–904.
24.
MichaëlssonG., AhsS., HammarströmI., LundinI.P., HagforsenE.Gluten-free diet in psoriasis patients with antibodies to gliadin results in decreased expression of tissue transglutaminase and fewer Ki67+cells in the dermis. Acta Derm Venereol.2003; 83: 425–9.
25.
HolickM.F.Vitamin D: a millennium perspective. J Cell Biochem.2003; 88: 296–307.
