Psoriasis, Gluten Intolerance and Celiac Disease

Affecting an estimated 1 percent of the Western population, celiac disease is an autoimmune disease caused by a permanent intolerance to gluten found in foods like wheat, barley and rye. Some studies, including a large case-control study that involved 12,502 people with psoriasis and 24,285 healthy controls matched for age and sex, suggest that there is an elevated incidence of celiac disease among people with psoriasis; however, this association remains controversial due to a lack of consistent data.

But what is perhaps even more interesting is that many psoriatic patients who have tested negative for celiac disease have reported improvements in their symptoms after adopting a gluten-free diet. This phenomenon was also observed by a group of Swedish researchers who found a link between adherence to a gluten-free diet and improvement in psoriasis symptoms in patients with antibodies to gliadin. However, in psoriatic patients who had no antibodies to gliadin, a gluten-free diet did not reduce symptoms. Gliadins are a component of gluten, and high levels of antibodies to gliadin may be indicative of gluten intolerance or sensitivity. However, there is substantial controversy over whether measuring the level of antibodies to gliadin is a sensible way of detecting a gluten intolerance.

It has been proposed that the link between the relatively high incidence of celiac disease among psoriatic patients could perhaps be explained by the fact that both conditions are related to T helper 1 cytokines. Also a number of other theories have sought to explain the mechanism by which gluten-free diets might help relieve psoriasis symptoms in people with celiac disease or gluten intolerance. Some of the mechanisms that have been proposed are altered intestinal permeability, immune mechanisms and vitamin D deficiency. However, much more research is still needed to be carried out both to prove (or disprove) that psoriasis is linked to gluten intolerance in some people and to investigate the possible mechanisms by which gluten may trigger psoriasis symptoms such as scaling and itching in susceptible individuals.

References
1. M. Araujo et al (2012). Food, Nutrition and Diet Therapy in Psoriasis. InTechOpen.
2. S. Birkenfeld et al (2009). Coeliac disease associated with psoriasis. British Journal of Dermatology, 161(6):1331-4.
3. G. Michaelsson et al (2000). Psoriasis patients with antibodies to gliadin can be improved by a gluten-free diet. British Journal of Dermatology, Vol.142, pp.44-51.
4. W. K. Woo et al (2004). Coeliac disease – associated antibodies correlate with psoriasis activity. British Journal of Dermatology, Vol.151, pp.891-4.
5. V. Ojetti et al (2003). High prevalence of celiac disease in psoriasis. The American Journal of Clinical Nutrition, Vol.98, pp.2574-5.
6. G. Michaelsson et al (2003). 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 Dermato-Venearologica, Vol.83, pp.425-9.
7. L. Abenavoli (2006). Cutaneous manifestations in celiac disease. World Journal of Gastroenterology, Vol.12, pp.843-52.

Useful Resources

Offline
Dr. John Pagano has gained international fame with his ground-breaking book, Healing Psoriasis, which has been translated into numerous languages. In this compelling book, Dr. Pagano presents an all-natural regimen designed to alleviate and heal psoriasis without steroid creams, tar baths, injections, or ultraviolet treatments. Packed with invaluable diet and lifestyle tips, recipes, case studies, and before-and-after photos, Healing Psoriasis is a great resource for anyone interested in a drug-free treatment for psoriasis. Available from Amazon.com and Amazon.co.uk.

Online FREE
Make it a habit to visit HealWithFood.org's online Guide to Healing Psoriasis on a regular basis. Updated once a week, the sidebar on the home page of the guide contains tons of links to interesting nutrition-related articles hand-picked for psoriasis sufferers. It also contains a weekly smoothie recipe featuring ingredients with psoriasis-fighting potential, as well as a book tip.