Abstract
Psoriasis is an inflammatory disease of the epidermis based on an immunological mechanism involving Langerhans cells and T lymphocytes that produce pro-inflammatory cytokines. Genetic factors, environmental factors, and improper nutrition are considered triggers of the disease. Numerous studies have reported that in a high number of patients, psoriasis is associated with obesity. Excess adipose tissue, typical of obesity, causes a systemic inflammatory status coming from the inflammatory active adipose tissue; therefore, weight reduction is a strategy to fight this pro-inflammatory state. This study aimed to evaluate how a nutritional regimen based on a ketogenic diet influenced the clinical parameters, metabolic profile, and inflammatory state of psoriasis patients. To this end, 30 psoriasis patients were subjected to a ketogenic nutritional regimen and monitored for 4 weeks by evaluating the clinical data, biochemical and clinical parameters, NMR metabolomic profile, and IL-2, IL-1β, TNF-α, IFN-γ, and IL-4 concentrations before and after the nutritional regimen. Our data show that a low-calorie ketogenic diet can be considered a successful strategy and therapeutic option to gain an improvement in psoriasis-related dysmetabolism, with significant correction of the full metabolic and inflammatory status.
Highlights
Psoriasis is a chronic inflammatory and multifaceted disease
enzyme-linked immunosorbent assay (ELISA) performed on serum samples to evaluate the levels of IL-2, IL-1β, TNF-α, IFN-γ, and IL-4 showed that there were significant differences in the levels of the cytokines IL-2 (P = 0.04) and IL-1β in patients between T0 and T1 (P = 0.006) (Figure 8)
Thirty psoriasis patients were subjected to a ketogenic nutritional regimen and monitored by evaluating (i) the clinical symptoms, (ii) the blood biochemical parameters, including IL-2, IL-1β, TNF-α, IFN-γ, and IL-4, and (iii) the metabolomic profile, as derived from 1H Nuclear magnetic resonance (NMR) analysis
Summary
Psoriasis is a chronic inflammatory and multifaceted disease. This condition affects approximately 2−3% of the world’s population[1] and is less common in children than in adults. Psoriasis is associated with morbidity and mortality.[2] Generally, significant differences among individuals from various ethnic groups and geographical location have been recorded, with an increased incidence in individuals living at high latitudes.[3] From a sex viewpoint, some studies reported differences between males and females.[4,5] Patients with psoriasis have a decreased quality of life,[6] with anxiety and depression. Psoriasis is a disorder of multifactorial etiology with both genetic and trigging factors. Numerous studies have reported the identification of genetic loci, in particular, 10 loci as susceptibility regions. The factors identified as triggers for the development of psoriasis are trauma, obesity, infections, medications, sunlight, stress, alcohol, smoking, and endocrine factors.[7]
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