Serologic markers of CD in psoriatic patients

Medical University of Silesia, Department of Chemistry, Zabrze, Jordana, Poland.
Journal of the European Academy of Dermatology and Venereology (Impact Factor: 2.83). 05/2008; 22(9):1055-61. DOI: 10.1111/j.1468-3083.2008.02713.x
Source: PubMed


Aetiopathogenesis of psoriasis is complex and not yet well known. In recent years, it has been observed that psoriasis can coexist with clinically asymptomatic celiac disease and a gluten-free diet helps to obtain remission, even in patients with very chronic lesions.
The aim of our work was to investigate how often the positive titres of antibodies characteristic for celiac disease occur in psoriatics' serum in exacerbation in comparison with controls.
Serum samples from 67 patients with intensified psoriatic lesions were investigated. Serum from healthy people at a comparable age and with no familial predisposition to psoriasis and celiac disease was the control material. Antibodies against human tissue transglutaminase (recombinant antigen), against tissue transglutaminase isolated from guinea pig's liver and against gliadin were determined by enzyme-linked immunosorbent assay technique. Anti-endomysial antibodies were determined by indirect immunofluorescence method.
Patients with psoriasis have significantly higher mean concentrations of antibodies against tissue transglutaminase (human recombinant and guinea pig-derived antigen) and against gliadin for IgA. IgA antibodies against tissue transglutaminase (both antigens) and gliadin positively correlate with psoriasis activity. No anti-endomysial antibodies for IgA were found in any serum.
Our results seem to imply an association between psoriasis and asymptomatic celiac disease/gluten intolerance. High percentage of positive results to guinea pig-derived tTG could be due to cellular activity of tissue transglutaminase in psoriasis.

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Available from: Tomasz Wielkoszyński, May 21, 2015
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    • "In recent studies, the incidence of psoriasis in patients with CD has been reported to be increased, and genetic and common immune mechanisms and CD-associated enteropathy and/or intestinal barrier dysfunction occurring in undiagnosed or untreated CD patients may have a role in producing the skin lesions of psoriasis patients22-24. Furthermore, antibodies that are typical for CD such as antigliadin IgA, IgG, anti-endomysium IgA and anti-tTG IgA show an increase in psoriatic patients10,14-16,22,25-28. In a study by Woo et al.15, AGA-IgA was found to be 8.8%, IgG 3.8% and TGA 7.7% in psoriatic patients. "
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    ABSTRACT: The possible relationship between psoriasis and coeliac disease (CD) has been attributed to the common pathogenic mechanisms of the two diseases and the presence of antigliadin antibodies in patients has been reported to increase the incidence of CD. The aim of this report was to study CD-associated antibodies serum antigliadin antibody immunoglobulin (Ig)A, IgG, anti-endomysial antibody IgA and anti-transglutaminase antibody IgA and to demonstrate whether there is an increase in the frequency of those markers of CD in patients with psoriasis. Serum antigliadin antibody IgG and IgA, antiendomysial antibody IgA and anti-transglutaminase antibody IgA were studied in 37 (19 males) patients with psoriasis and 50 (23 males) healthy controls. Upper gastrointestinal endoscopy and duodenal biopsies were performed in patients with at least one positive marker. Antigliadin IgA was statistically higher in the psoriasis group than in the controls (p<0.05). Serological markers were found positive in 6 patients with psoriasis and 1 person from the control group. Upper gastrointestinal endoscopy was performed in all these persons, with biopsies collected from the duodenum. The diagnosis of CD was reported in only one patient with psoriasis following the pathological examination of the biopsies. Whereas one person of the control group was found to be positive for antigliadin antibody IgA, pathological examination of the duodenal biopsies obtain from this patient were found to be normal. Antigliadin IgA prominently increases in patients diagnosed with psoriasis. Patients with psoriasis should be investigated for latent CD and should be followed up.
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    • "Moreover, there are hypotheses implicating the pathogen in triggering psoriasis [3]. There are also data concerning concurrent presentation of psoriasis and gastritis, duodenitis, celiac disease or inflammatory bowel disease [4] [5] [6]. A few authors have related psoriasis and disturbances of the incretory and excretory pancreatic functions and even acute pancreatitis [7-9]. "
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    ABSTRACT: The literature published in the last decade has variously assessed the possible association between coeliac disease (CD) and other chronic inflammatory autoimmune diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and psoriasis (Ps). This study included a total of 93 patients (15 with RA, 27 with PsA and 51 with Ps). None from the group with RA and PsA were positive to the test, while 3 of the patients belonging to the group with Ps tested positive. All three underwent intestinal biopsy, which confirmed the presence of CD. Our data revealed a higher prevalence of CD in patients with Ps compared to the general population: 3:51 patients (5.88%) vs. 1:184 resident (0.54%). It can be affirmed that screening for CD is not routinely recommended for patients suffering from RA and PsA. KeywordsCoeliac disease-Epidemiology-Prevalence-Psoriasis-Psoriatic arthritis-Rheumatoid arthritis
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