Psoriasis is associated with elevated gut IL-1α and intestinal microbiome alterations: results of a cross-sectional study from Central Asia

Objective: Psoriasis is a chronic inflammatory condition that predominantly affects the skin and is associated with extracutaneous disorders, such as inflammatory bowel disease and arthritis. Changes in gut immunology and microbiota are important drivers of proinflammatory disorders and could play a role in the pathogenesis of psoriasis. Therefore, we explored whether psoriasis in a Central Asian cohort is associated with alterations in select immunological markers and/or microbiota of the gut. Setting: We assessed correlates of psoriasis in a community from Kazakhstan. Participants: Outpatients, aged 30-45 years, of a dermatology clinic presenting with plaque, guttate or palmoplantar psoriasis (n=20), and age-sex matched subjects without psoriasis (n=20). Design: We undertook a cross-sectional study of stool samples. Stool supernatant was subjected to multiplex ELISA to assess the concentration of 47 cytokines and immunoglobulins and to 16S rRNA gene sequencing to characterize microbial diversity in both psoriasis+ participants and controls. Results: The psoriasis+ group tended to have higher concentrations of most analytes in stool (29/47=61.7%) and gut IL-1α was significantly elevated (4.19-fold, p=0.007) compared to controls. Psoriasis was associated with alterations in gut Firmicutes, including elevated Faecalibacterium and decreased Oscillibacter and Roseburia abundance, but no association was observed between gut microbial diversity or Firmicutes/Bacteroidetes ratios and disease status. Conclusions: Psoriasis may be associated with gut inflammation and dysbiosis. Studies are warranted to explore the use of gut microbiome-focused therapies in the management of psoriasis in this under-studied population.