Abstract
The aim of the study was to investigate gastrointestinal comorbidities, identify risk factors and detect the early stages of autoimmune gastrointestinal diseases, such as Crohn's disease, ulcerative colitis and coeliac disease in patients with psoriasis. This was a hospital-based case-control study. Patients with chronic plaque psoriasis were included as cases. The control group consisted of patients with other skin diseases and who complied with the same selection criteria as cases. Two controls were selected per one case. We analysed the following antibodies (ASCA, AEP, p-ANCA, AGC, EMA, ARA, tTG, AGA) and non-specific signs of gastrointestinal diseases. There were significant differences between cases and controls in several parameters. Leucocyte count, CRP, total protein, transglutaminase IgA antibodies and p-ANCA were statistically significant between groups (P < 0.05). In the binary logistic model, leucocyte count and p-ANCA (for all parameters included in the logistic model P ≤ 0.001) were associated with psoriasis. Patients with psoriasis should be regularly screened for coeliac and inflammatory bowel disease. Early diagnosis of gastrointestinal diseases and risk factors may prevent complications and greatly improve the patient's quality of life.
Highlights
IntroductionCoeliac disease is characterized by permanent gluten intolerance
Psoriasis, coeliac disease and inflammatory bowel disease (IBD) are autoimmune diseases whose etiopathogenesis involves individual genetic predisposition as well as environmental factors.Coeliac disease is characterized by permanent gluten intolerance
In the binary logistical model, the following parameters were associated with psoriasis: leucocyte count (Table 3, Fig. 1) and p-ANCA (Table 3, Fig. 2)
Summary
Coeliac disease is characterized by permanent gluten intolerance. It manifests itself in genetically susceptible individuals (association with HLA-DQ2, HLA-DQ8) following a variable period after consuming cereals containing gluten. After the presentation to HLA-DQ2 and HLA-DQ8 positive cells, gliadin peptides induce an inappropriate T-cell mediated immune response in the intestinal mucosa. This simultaneously leads to the production of highly specific autoantibodies (anti - transglutaminase antibodies). The association between coeliac disease and psoriasis is strongly suggested as a gluten-free diet leads to a clear improvement and disappearance of psoriatic skin lesions in some patients[3,4]
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