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Psoriasis and Psoriatic Arthritis

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The Microbiome in Rheumatic Diseases and Infection

Abstract

In complex inflammatory diseases such as psoriasis vulgaris (PsV) and psoriatic arthritis (PsA), interplay between genetic and environmental factors is considered important in the pathogenesis of disease. Among the non-genetic risk factors, there is evidence for the influence of microbial elements in the pathogenesis of PsV and PsA. In both conditions, there is the potential for breach of barriers at sites of host-environment interfaces, such as the skin and mucosal surfaces of the gastrointestinal tract, due to the presence of inflammatory lesions (psoriatic plaques and gut mucosal inflammation). Such a breach could contribute to increased interaction with exogenous antigens including the microbiota and, on the background of increased susceptibility to a dysregulated immune reaction due to genetic predisposition, could result in the onset and maintenance of disease pathology. There is increasing evidence of bacterial dysbiosis in psoriatic plaques. In addition, dysbiosis similar to that observed in inflammatory bowel disease (IBD) has been reported in studies of the gut microbiota from PsV and PsA individuals. Further studies into the microbial composition and their interaction with both the host genotype and immunophenotype should help dissect the links between the skin-gut-joint axis and provide novel therapeutic targets for disease prevention and control.

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Abbreviations

AMP:

Antimicrobial peptide

AS:

Ankylosing spondylitis

EA:

Enteropathic arthritis

hBD:

Human beta-defensin

HIV:

Human immunodeficiency virus

HLA:

Human leukocyte antigen

IBD:

Inflammatory bowel disease

IL:

Interleukin

PsA:

Psoriatic arthritis

PsV:

Psoriasis vulgaris

RA:

Rheumatoid arthritis

ReA:

Reactive arthritis

SpA:

Spondyloarthritis

TLR:

Toll-like receptor

uSpA:

Undifferentiated spondyloarthritis

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Authors and Affiliations

  1. Department of Rheumatology, NIHR Manchester Musculoskeletal Biomedical Research Unit, The University of Manchester, Manchester, UK

    Madhura Castelino

  2. Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, UK

    Steve Eyre & Anne Barton

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  1. Madhura Castelino
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  2. Steve Eyre
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Correspondence to Madhura Castelino .

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Editors and Affiliations

  1. Faculty of Medicine, Cairo University, Cairo, Egypt

    Gaafar Ragab

  2. University of Alabama, Birmingham, Alabama, USA

    T. Prescott Atkinson

  3. University of Alabama, Birmingham, Alabama, USA

    Matthew L. Stoll

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Castelino, M., Eyre, S., Barton, A. (2018). Psoriasis and Psoriatic Arthritis. In: Ragab, G., Atkinson, T., Stoll, M. (eds) The Microbiome in Rheumatic Diseases and Infection. Springer, Cham. https://doi.org/10.1007/978-3-319-79026-8_18

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