091: Psoriasis & Bacterial DNA: An Interesting Connection (RESEARCH)

As you probably know, psoriasis is so much more than JUST a skin rash condition. That’s why looking at the psoriasis gut connection is crucial!

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn

In this episode:

  • Study discussion looking at bacterial DNA found in blood of patients with psoriasis
  • What form of psoriasis did this impact the most
  • Bacterial DNA can trigger cytokines and other inflammatory markers
  • Types of bacterial DNA found
  • Where researchers suspect the bacterial DNA came from

Quotes:

Out of the 45 total participants, 35.5% with plaque psoriasis were found to have bacterial DNA fragments in their blood samples.

In those with plaque psoriasis who had bacterial DNA fragments in their blood, inflammatory mediators (cytokines) were also significantly increased including Interferon Gamma, Tumor Necrosis Factor (TNF), Interleukin-1ß, Interleukin-6, and Interleukin-12.

Woman researching DNA

Psoriasis & Bacterial DNA: An Interesting Connection (RESEARCH) (FULL TRANSCRIPT)

Welcome to Episode #91 of the Healthy Skin Show!

In today's episode, I wanted to talk about a potential root cause trigger of psoriasis.

Could a potential psoriasis trigger that increases inflammatory factors come from bacterial DNA fragments floating around in your blood?

That is the exact question being asked by a group of researchers. There was a really cool research letter published in JAMA dermatology back in June, 2015 called “Identification of Bacterial DNA in the Peripheral Blood of Patients with Active Psoriasis.”

Researchers got the idea to study this because it's not uncommon for bacterial DNA fragments to end up floating around in the blood of other inflammatory conditions like Crohn's disease.

I figured this would be a really awesome article to share with you because of the article published by Dr. P. Haines Ely that I discussed in episode #69. He asked a very similar question — is psoriasis a problem stemming from the gut?

He makes connections between his psoriatic patients and dysbiosis (or microbiome imbalance) of the gut. And notes the incidence of outright gut infections that appear to exacerbate his patient's symptoms (like crazy itchiness).

As you know, I'm a big fan of always looking in the gut to see what the heck is going on. I’ve definitely found it to impact inflammatory markers in my clinical practice.

Plus, gut dysbiosis can impact your body’s ability to absorb nutrition.

So either way, psoriasis must be looked at from a deeper, more complete picture than JUST at your skin in my opinion and experience as a clinical nutritionist.

Tubes of blood in blood test

Bacterial DNA Fragments in Blood As Trigger For Psoriasis

The study results are pretty interesting!

Researchers divided up psoriasis patients into different groups based on the type of psoriasis that they had.

Those groups were plaque psoriasis, guttate psoriasis, and inverse psoriasis.

Out of the 45 total participants, 35.5% with with plaque psoriasis were found to have bacterial DNA fragments in their blood samples.

Everyone else in the study including those with guttate psoriasis, inverse psoriasis, and the control group did not have bacterial DNA found in their blood.

They also went a step further and identified where the bacterial DNA had come from.

The bacteria found include “Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, Proteus mirabilis, Streptococcus pyrogenes and Shigella fresneli.”

It’s also worthwhile to note is that out of all of those, E. coli was the most prevalent found.

In those with plaque psoriasis who had bacterial DNA fragments in their blood, inflammatory mediators (cytokines) were also significantly increased. The following markers that increased include Interferon Gamma, Tumor Necrosis Factor (TNF), Interleukin-1ß, Interleukin-6, and Interleukin-12.

And the researchers wrapped up their thoughts by sharing that “the bacterial DNA fragments detected in our patients with psoriasis may have their origin in the intestinal lumen. Supporting this hypothesis is the fact that intestinal permeability has already been reported to be increased in patients with psoriasis. Taken together, these data suggest a role for bacterial DNA fragment translocation in active plaque psoriasis.”

Researcher studying DNA through microscope

Breaking Down The Plaque Psoriasis Gut Connection

Because I just shared a lot of science-y, research jargon with you, allow me to break it down so it's a bit easier to understand.

Basically, researchers looked at a group of psoriasis patients who were not currently taking medications to control their condition. They broke them into different groups based on the type of psoriasis that they had. One group didn't have psoriasis at all — this was the control group.

Those with plaque psoriasis ended up having a higher percentage of bacterial fragment DNA floating around in their blood.

Somehow bacterial DNA ended up in their blood and the question is where did it come from?

Their hypothesis or guess is that because gut permeability (AKA. leaky gut) in psoriatic patients is possible, gut bacteria can sneak in between the cells that line the gut wall and enter your body.

The presence of bacterial DNA fragments in your blood likely triggers all cytokines which are inflammatory. Cytokines are signals from your immune system saying, “Hey, there is a problem.” They help to alert and communicate your immune system.

While this is incredibly interesting, I'm not implying nor claiming that this is exactly what's going on. I'd argue that while I do believe that it adds to the data supporting connections between skin and gut, it's not the “final nail in the coffin” (as they say).

The reason is that this study was small. It included a total of only 54 people who had psoriasis.

That means that a lot more research needs to be done on this particular concept.

I have other papers that I'd like to share with you on psoriasis with the goal in mind of giving you more potential answers and avenues to investigate.

This way, we all can build awareness that a lot of these chronic skin rash conditions, including psoriasis, are a heck of a lot more than just a skin problem.

If you've got any questions or comments, leave your thoughts below so we can keep the conversation going!

I'm excited to continue digging into research like this and sharing it with you, but here's the thing, you've got to share it with others.

This is the most critical part of our community — we share what we find with others who are suffering and feel really lost.

If you know someone with plaque psoriasis that is super frustrated, this is a great episode to share to help them see that this is way more than a skin issue. There's a lot of other things going on underneath the surface that we can absolutely investigate.

I wish you a wonderful rest of your day and I'll see you in the next episode!

Reference books on library shelf

REFERENCES:

https://jamanetwork.com/journals/jamadermatology/fullarticle/2174889

https://www.sciencedirect.com/science/article/pii/S0738081X18300476#!

https://www.nature.com/articles/s41598-018-22125-y

Out of the 45 total participants, 35.5% with with plaque psoriasis were found to have bacterial DNA fragments in their blood samples.