Mild-to-moderate psoriasis is associated with subclinical inflammation in the duodenum and a tendency of disturbed intestinal barrier

Patrik Lundquist; Eva Hagforsen; Michael Wagner; Mohammad Alimohammadi; Fabio Rabelo Melo; Gunnar Pejler; Per Artursson; Marie Carlson; Ola Rollman; Maria Lampinen

doi:10.1016/j.bbadis.2024.167634

Mild-to-moderate psoriasis is associated with subclinical inflammation in the duodenum and a tendency of disturbed intestinal barrier

Biochim Biophys Acta Mol Basis Dis. 2024 Dec 19;1871(3):167634. doi: 10.1016/j.bbadis.2024.167634. Online ahead of print.

Authors

Affiliations

¹ Department of Pharmacy, Uppsala University, Box 580, SE-751 23 Uppsala, Sweden.
² Dermatology and Venereology, Department of Medical Sciences, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
³ Gastroenterology Research Group, Department of Medical Sciences, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
⁴ Department of Medical Biochemistry and Microbiology, Uppsala University, Box 582, SE-751 23 Uppsala, Sweden.
⁵ Department of Pharmacy, Uppsala University, Box 580, SE-751 23 Uppsala, Sweden; Gastroenterology Research Group, Department of Medical Sciences, Uppsala University Hospital, SE-751 85 Uppsala, Sweden. Electronic address: maria.lampinen@farmaci.uu.se.

PMID: 39706352
DOI: 10.1016/j.bbadis.2024.167634

Abstract

Psoriasis is a chronic skin disease occasionally associated with abdominal symptoms and IBD. We aimed to characterize intestinal immune cells and the integrity of the intestinal barrier in psoriasis. Biopsies from the duodenum and colon were analyzed by flow cytometry and immunohistochemistry for the presence and activation status of different immune cell populations. Intestinal permeability was measured using Ussing chambers. Proinflammatory markers were analyzed in fecal and blood samples using ELISA. The intestinal level of inflammatory mediators was assessed using a multiplex proximity extension assay. We found an increased density of intestinal eosinophils, mast cells, macrophages, and CD8⁺ T-cells in psoriasis; eosinophils, macrophages, and CD8+ T-cells expressed activation markers. Half of the psoriasis patients showed increased permeability across the duodenum, correlating with increased mucosal IL-17A, IL-13, IL-2, and IL-20, and with gastrointestinal symptoms. Our findings reveal that psoriasis is associated with low-grade intestinal inflammation, which may contribute to abdominal symptoms in these patients and possibly set the stage for the development of intestinal disease.

Keywords: Comorbidity; IBD; Inflammation; Intestinal permeability; Psoriasis.