Abstract
Objective: Studies have proposed a link between psoriasis and an imbalanced gut microbiome. Therefore, the modulation of the gut microbiota with probiotics may improve clinical outcomes, metabolic endotoxemia, chronic inflammation, and cardiovascular risk factors in patients with psoriasis.Methods: Forty-six patients with psoriasis randomized into two groups, group 1 received a twice a day capsule having freeze-dried powder with 1.6×109 CFU for eight weeks, and group 2 received placebo. For clinical outcomes, we used the Psoriasis Area and Severity Index (PASI), blood pressure, and SF36 to measure the quality of life. And for biochemistry analysis, we measured pro-inflammatory cytokines (hs-CRP and IL1-β), lipopolysaccharides (LPS), and lipid profile. All the data collected at baseline and the end of the study. Results: Forty-six patients (28 [60%] female; mean [SD] age, 42.51 [14.55] years) contributed to the study. Improvements in SF36 score as an indexed for the QOL was significant in patients taking probiotics supplementation comparing to the placebo group and PASI (-5.06±2.10 vs. 0.30±1.80, P=0.049) as well. After the intervention, the treatment group had significant reductions in LDL and TC compared to the placebo group. In addition, we observed a considerable reduction in serum LPS levels (-7.21±10.33 vs. -2.74±0.97 mmol/L, P=0.010), hs-CRP levels (-1.67 ±0.95 vs. -0.70+ 0.38 mg/L, P=0.013), and IL1- β levels (-1.64 ±1.10 vs. 0.17+ -0.20 mg/L, P=0.043) in the probiotics group. Conclusion: This study shows that probiotics significantly improved the quality of life and seriousness in psoriatic patients. Moreover, it enhances cardiovascular risk factors and inflammatory/oxidative stress markers. Trial registration: This trial also was recorded in the Iranian registry of clinical trials (https://www.irct.ir) (code: IRCT20191124045483N1).