Psoriasis: new therapies keep obesity and inflammation under control

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28105403_mThere are important news on psoriasis and its relative way of treatment.

Recently, we have reported some thoughts around a possible relationship between psoriasis and inflammation, and in particular we highlighted a study recently published, which brings the development of insulin resistance in close relation with such condition.

Such relationship can be explained only in part by the use of cortisone-based drugs, while instead it can find some sort of justification from the eating behaviour of the sufferer.

Today we know that food-related inflammation is strongly linked to our eating habits; all the treatments we implement in our practice to fight psoriasis do actually work both on the skin, through a gentle process, which is neither suppressive nor aggressive, and on the metabolic and nutritional features of the person who suffers from it.

The nutritional side is of particular importance both in regard to inflammatory cytokines production, to the development of insulin resistance but also to some emotional aspects that stimulate us to think about what the psoriasis patient is not able to “digest”, as mentioned a few years ago in an article by Dr. Cavagna.

To understand the importance of inflammation in psoriasis we should go back to what was said in 1800s by Koebner, who described the presence of a “hyper-reactive” skin condition, which nowadays we may define, using a more scientific language, as an activated and inflamed state caused by peculiar inflammatory cytokines.

Dr. Roberto Cavagna, who recently re-joined our medical staff, described such peculiar inflammatory condition by referring to the most recent research studies, which represent solid points of reference for the treatment of psoriasis at Eurosalus.

A treatment can be defined as effective if it pays respect to the whole patient’s health and if it also aims to tackle the gastro-enteric disorders affecting his/her “second brain”.

Compared to how psoriasis was considered only a few years ago, today we know with certainty that this is a skin condition with immunological grounds, actually the manifestation of a systemic inflammation, whose metabolic correlation is indeed known today.

For this reason, a group of researchers at the Department of Dermatology, “La Sapienza” University in Rome, published in the Italian Journal of Dermatology and Venereology the detailed description of a nutritional supplementation based on CoEnzyme Q10, Omega-3, Lipoic Acid, Vitamin E, Selenium and Resveratrol, defining their action on the correlated metabolic syndrome (Skroza N et al, G Ital Dermatol Venereol. 2013 Dec, 148 (6):661-5).

Therefore, the integration of certain nutraceuticals can effectively work on the metabolic changes present in psoriasis.

In the same way, a paper published in Acta Dermato-Venereologica by a group of Danish researchers confirmed that a dietary intervention, aimed at helping the overweight psoriatic patient reducing his/her body weight, changes numerous metabolic parameters associated with disease initiation (P Jensen et al, Acta Derm Venereol. February 20 2014. doi: 10.2340/00015555-1824. [Epub ahead of print ]).

Indeed, for years we have been treating psoriatic patients at SMA with methods similar to those we usually employ as part of therapeutic programs suitable for people needing to lose weight.

At the bottom of this we may find the possible interference of cytokines such as TNF-alpha or BAFF (two very similar molecules; BAFF is strongly activated by food-related inflammation) in psoriasis induction. A personalized dietary approach towards all the possible types of food-related reactivity helps reducing the levels of inflammatory substances present.

A few days ago, a group of Spanish researchers published in PLoS Biology the results of a study, which confirms, once more, the role of TNF-alpha (and its analogues, such as BAFF) in the induction of psoriasis (Candel S. et al, PLoS Biol. 2014 May 6, 12(5):e1001855. doi:10.1371/journal.pbio.1001855. eCollection 2014).

The researchers were able to demonstrate that the modulation of TNF cannot be entrusted only to products such as etanercept (a genetically engineered monoclonal antibody, described as “organic”, which irreversibly blocks TNF while producing, along with a few positive results, some important and often severe side effects). TNF modulation should be conveyed one in a mellower and more integrated way, while respecting the whole person.

For this reason, in accordance with the procedures used by Dr. Cavagna, we always start treating psoriasis with a nutritional investigation and a personalized diet that leads to a “gentle” regulation of the cytokines involved. All this has the vision of the possible integration of therapies in perspective of more specific effects.

In addition, we know that even simple moves such as sugar intake control, carefully by matching it always (in every meal) with a portion of proteins, fat and fibres, lower the glycaemic impact and result in an effective and cost-effective anti-diabetes preventive effect, as well as being an effective tool to control the systemic inflammation linked to psoriasis.

All the news related to a new knowledge of psoriasis-related cytokines, along with simple measures such as nutritional re-education, represent the winning strategy to generate a new form of treatment, both of high scientific impact and, at the same time, human