astaxanthin and psoriasis

Supplementation with orange and blackcurrant juice, but not vitamin E, improves inflammatory markers in patients with peripheral arterial disease. Micronutrients are essential elements which are found in very small quantities in the human body and include vitamins, minerals and trace elements. A narrative literature review on epigallocatechin gallate and its biophysical properties for topical use in dermatology. The results regarding the parenteral application of n-3 FAs are more encouraging compared to the mostly negative results of oral supplementation, probably because of the swift and sustainable increase in plasma levels of n-3 PUFASs leading to enhanced immune responses [223,224,225].

krill Jeong E.A., Jeon B.T., Shin H.J., Kim N., Lee D.H., Kim H.J., Kang S.S., Cho G.J., Choi W.S., Roh G.S. showed that intramuscular administration of vitamin B12 for 3 weeks offered no benefit to psoriatic patients [210]. Gal J., Lakos G., Szodoray P., Kiss J., Horvth I., Horkay E., Nagy G., Szegedi A. Immunological and clinical effects of alphacalcidol in patients with psoriatic arthropathy: Results of an open, follow- up pilot study. Caputo V., Strafella C., Termine A., Dattola A., Mazzilli S., Lanna C., Cosio T., Campione E., Novelli G., Giardina E., et al. In an RCT by Grimminger et al., 20 patients were hospitalized for acute guttate psoriasis (BSA > 10%) and randomly received either an n-3 lipid emulsion (2.1 g EPA, 2.1 g DHA) or a conventional n-6 lipid emulsion for 10 days. Other studies have evaluated the impact of intramuscular administration of Vitamin B12 on the treatment of psoriasis with inconsistent results. Deng Y.H., Alex D., Huang H.Q., Wang N., Yu N., Wang Y.T., Leung G.P., Lee S.M. The association between psoriasis and obesity: A systematic review and meta-analysis of observational studies.

Psoriasis is an immune-mediated disease where chronic inflammation plays a key role, a fact which has been consolidated through its established association with obesity, which negatively affects disease incidence, severity and response to treatment. In the more recent HUNT study with 33.734 patients, Snekvik et al. Collier et al. Pischon T., Hankinson S.E., Hotamisligil G.S., Rifai N., Willett W.C., Rimm E.B. OBrien K.D., Brehm B.J., Seeley R.J., Bean J., Wener M.H., Daniels S., DAlessio D.A. Improved vascular endothelial function after oral B vitamins: An effect mediated through reduced concentrations of free plasma homocysteine. Li Y., Yao J., Han C., Yang J., Chaudhry M.T., Wang S., Liu H., Yin Y. Quercetin, Inflammation and Immunity. Snekvik I., Smith C.H., Nilsen T.I.L., Langan S.M., Modalsli E.H., Romundstad P.R., Saunes M. Obesity, Waist Circumference, Weight Change, and Risk of Incident Psoriasis: Prospective Data from the HUNT Study. Stroher D.J., Escobar Piccoli Jda C., Gullich A.A., Pilar B.C., Coelho R.P., Bruno J.B., Faoro D., Manfredini V. 14 Days of supplementation with blueberry extract shows anti-atherogenic properties and improves oxidative parameters in hypercholesterolemic rats model. Based on this evidence, the Medical Board of the National Psoriasis Foundation recommends a trial of a three-month gluten-free diet in adults with psoriasis and positive serum markers for gluten sensitivity as an add-on strategy to the standard therapies [167]. Carnevale R., Nocella C., Cammisotto V., Bartimoccia S., Monticolo R., DAmico A., Stefanini L., Pagano F., Pastori D., Cangemi R., et al. Apart from the effects on oxidative stress, selenoproteins protect skin from harmful environmental factors such as ultraviolet (UV) rays, preventing keratinocytes apoptosis and increasing the cells ability to breakdown peroxides [229]. Mayer K., Seeger W., Grimminger F. Clinical use of lipids to control inflammatory disease. Edrisi F., Salehi M., Ahmadi A., Fararoei M., Rusta F., Mahmoodianfard S. Effects of supplementation with rice husk powder and rice bran on inflammatory factors in overweight and obese adults following an energyrestricted diet: A randomized controlled trial. Zhou Y.E., Buchowski M.S., Liu J., Schlundt D.G., Ukoli F., Blot W.J., Hargreaves M.K. Inhibition of TNF- -mediated endothelial cell-monocyte cell adhesion and adhesion molecules expression by the resveratrol derivative, trans-3,5,41-trimethoxystilbene. The application of calcitriol ointment for eight weeks resulted in improvement of psoriatic lesions in approximately 34% of patients, compared with 12% to 22.5% of controls [197]. Plasma lycopene is associated with pizza and pasta consumption in middle-aged and older african american and white adults in the southeastern USA in a cross-sectional study. Effects of virgin olive oils differing in their bioactive compound contents on metabolic syndrome and endothelial functional risk biomarkers in healthy adults: A randomized double-bling controlled trial. These results are in accordance with another RCT by Naldi et al., where a 20-week hypocaloric diet in combination with exercise resulted in a median PASI reduction of 48.0% (95% CI, 33.3%58.3%) in the intervention group vs. 25.5% (95% confidence intervals-CI, 18.2%33.3%) in controls. In a similar manner, in a 6-week ad libitum high animal compared with high plant protein (30% energy) diet in overweight or obese individuals with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM), no differences in IL-6 or monocyte chemoattractant protein 1 (MCP-1) was observed, while decreases in IL-18 and TNF- were observed only in the high animal and in the plant protein group, respectively, suggesting that not only the amount, but also the source of protein intake is important in the inflammation process [16]. Mahil S.K., McSweeney S.M., Kloczko E., McGowan B., Barker J.N., Smith C.H. Omega-3 FAs anti-inflammatory effects are mainly attributed to the interaction with the G-protein coupled receptor 120 (GPR120), expressed on macrophages, which leads to decreased TLR4-dependent and LPS-mediated cyclooxygenase-2 (COX-2) activation and subsequent prostaglandin release [39], while another action on macrophages includes the inhibition of the NOD-like receptor protein 3 (NLRP3) inflammasome activation [40]. Kyriakou A., Patsatsi A., Sotiriadis D., Goulis D.G. Engelman C.D., Meyers K.J., Iyengar S.K., Liu Z., Karki C.K., Igo R.P., Jr., Truitt B., Robinson J., Sarto G.E., Wallace R., et al. Its etiology is considered multifactorial, and it is characterized by the dysregulation of the innate and adaptive immune systems, with the activation of T helper (Th)-1 and Th-17 T cells leading to an increased production of inflammatory cytokines such as interleukins (IL) IL-1, IL-6, IL-23, IL-22, IL-17, and IL-33, tumor necrosis factor alpha (TNF-), and interferon-gamma (IFN-) [6,7]. In 80 patients with chronic, stable psoriasis, 34 of whom also had psoriatic arthritis, supplementation with high doses of EPA and DHA for 8 weeks led to decreases in PASI score and a subjective improvement in joint pain [213]. [49], where the low-GL diet reduced CRP compared to the high-GL diet in 80 participants, despite the fact that the diets were isocaloric. A similar anti-inflammatory effect was shown in a study where 105 individuals were assigned to one of the three energy-restricted diet groups receiving rice bran, rice husk powder and control (low-calorie only) diet for 12 weeks, with the intervention groups demonstrating decreases in hsCRP and IL-6 compared to controls [51]. According to a recent review form Upala et al., including 12 studies, the results regarding the efficacy of n-3 PUFAs supplementation in the severity of psoriasis are still uncertain [221]. As a result, a recommendation for selenium supplementation in patients with psoriasis cannot be established. 1Rheumatology and Clinical Immunology Unit, Fourth Department of Internal Medicine, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; moc.liamg@staklep, 2Second Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; moc.liamtoh@ht-roknam (E.K. ); rg.aou.dem@sitparta (A.R. After 4 weeks, a significant reduction in PASI score >80% along with the resolution of psoriatic arthralgia were observed [187]. Another prospective study showed that a weight loss >5% is significantly associated with the achievement of minimal disease activity as a response to anti-TNF treatment in obese patients with psoriatic arthritis [158]. Zhu K.J., Zhang C., Li M., Zhu C.Y., Shi G., Fan Y.M. In humans, vitamin E supplementation has been shown to reduce pro-inflammatory cytokines IL-1, IL-6 and TNF- by stimulating the production of cyclic adenosine monophosphate (cAMP) [106]. Vitamin D: A millennium perspective. Rajkumar H., Mahmood N., Kumar M., Varikuti S.R., Challa H.R., Myakala S.P. The phenolic compounds in EVOO are capable of diminishing LDL oxidization and possess potent antioxidant properties, with oleuropein also having anti-proliferative properties [7].

Increased consumption of virgin olive oil, nuts, legumes, whole grains, and fish promotes HDL functions in humans. Despite being best renowned for its role in calcium homeostasis, vitamin D also has immunomodulatory effects, with calcitriol being necessary for T-cells function [108]. No difference between the interventional and control group in psoriasis severity was revealed, implying that Vitamin D3 supplementation is not effective as a treatment for moderate to severe psoriasis [200]. Lassus A., Dahlgren A.L., Halpern M.J., Santalahti J., Happonen H.P. [33], the supplementation of flaxseed flour, a source of omega-3 fatty acids, to morbidly obese subjects, led to decreased CRP and serum amyloid A (SAA) concentrations. Katsarou A.I., Kaliora A.C., Chiou A., Kalogeropoulos N., Papalois A., Agrogiannis G., Andrikopoulos N.K. Central obesity is associated with increased visceral fat, where activated macrophages stimulate adipocytes to produce pro-inflammatory molecules such as TNF-, IL-1, IL-6 and IL-8 [140]. Muscogiuri G., Barrea L., Laudisio D., Pugliese G., Salzano C., Savastano S., Colao A. Confusion in the nomenclature of ketogenic diets blurs evidence. However, according to an older study in 69 patients, selenium and Vitamin E supplementation for 12 weeks did not reduce psoriasis severity [233]. Obesity is a major risk factor for psoriasis, which leads to worse clinical outcomes. In patients with peripheral artery disease, supplementation with orange and blackcurrant juice for 4 weeks led to a reduction in CRP and plasma fibrinogen [92]; similarly, MDA and 8,12-isoprostane F2a-VI levels were inversely associated with concentrations of individual carotenoids [93]. This results in a metabolism switch to fat consumption as a main source of energy. Hsu S., Dickinson D., Borke J., Walsh D.S., Wood J., Qin H., Winger J., Pearl H., Schuster G., Bollag W.B. In a retrospective observational study including 110 patients on anti-TNF- agents, Di Lernia et al. Prevalence of antigliadin IgA antibodies in psoriasis vulgaris and response of seropositive patients to a gluten-free diet. The role of fish oil in psoriasis. Mobarhan S., Bowen P., Andersen B., Evans M., Stacewicz-Sapuntzakis M., Sugerman S., Simms P., Lucchesi D., Friedman H. Effects of beta-carotene repletion on beta-carotene absorption, lipid peroxidation, and neutrophil superoxide formation in young men. Oh D.Y., Talukdar S., Bae E.J., Imamura T., Morinaga H., Fan W., Li P., Lu W.J., Watkins S.M., Olefsky J.M. Gisondi P., Del Giglio M., Di Francesco V., Zamboni M., Girolomoni G. Weight loss improves the response of obese patients with moderate-to-severe chronic plaque psoriasis to low-dose cyclosporine therapy: A randomized, controlled, investigator-blinded clinical trial.

PUFAs are comprised of two different categories, omega-3 (n-3) and omega-6 (n-6) fatty acids. showed that obesity is associated with a two-fold increased risk of psoriasis compared to individuals with normal body weight. Effect of dietary supplementation with very-long-chain n-3 fatty acids in patients with psoriasis.

Syland E., Funk J., Rajka G., Sandberg M., Thune P., Rustad L., Helland S., Middelfart K., Odu S., Falk E.S. Overall, available studies suggest that gluten-free diet results in clinical improvement of psoriasis in patients with positive serum markers, with or without celiac disease; however, large randomized controlled trials have not yet been conducted. reported that the cumulative consumption of 0.9 g/d EPA/DHA in 17 patients with psoriasis for 4 months led to moderate-excellent improvement in 10 of them; in a similar study, the supplementation at the dose of 1.9 g/d showed a significant decrease in PASI score after 4 and 8 weeks. The Omega-3 fatty acid based lipid infusion in patients with chronic plaque psoriasis: Results of a double-blind, randomized, placebo-controlled, multicenter trial. Consumption of extra virgin olive oil improves body composition and blood pressure in women with excess body fat: A randomized, double-blinded, placebo-controlled clinical trial. Aune D., Snekvik I., Schlesinger S., Norat T., Riboli E., Vatten L.J. The prevalence and incidence of psoriasis is higher among patients with obesity, while obesity is an important predisposing factor for psoriasis onset, progression and severity. These actions have a favorable effect on psoriatic lesions. and V.L., structuring of the review, writing, and literature review; I.I., E.T., D.V., E.P., A.R., assistance with writing. Higher amounts of sun exposure have been associated with a lower risk of vitamin D deficiency; on the other hand, excessive sun exposure is the primary risk factor for skin cancer and generally seems to have a detrimental effect on many cutaneous diseases such as psoriasis [111,112]. showed that one year of gluten-free diet improves PASI score in 56% of patients with very high levels of IgA-AGA and in 36% of patients with high levels of IgA-AGA [165]. Licensee MDPI, Basel, Switzerland. After 14-weeks of low-calorie diet, the patients in intervention group did not manage to maintain a statistically significant remission rate, possibly because weight regain was progressively observed in the intervention group after week 24; however, there was a trend towards a slower rebound of psoriasis compared to control group [156]. Yang F., Suo Y., Chen D., Tong L. Protection against vascular endothelial dysfunction by polyphenols in sea buckthorn berries in rats with hyperlipidemia. According to recent studies, the ketogenic diet has been considered as an alternative therapeutic strategy with beneficial results for many diseases such as obesity, type 2 diabetes, cardiovascular disease, neurological diseases and polycystic ovary syndrome [179,180,181,182,183]. Based on this data, ketogenic diet is a promising prospect in psoriasis management, but large studies are needed for safe conclusions. The Nurses Health study was the first large-scale, prospective study which pointed out that increased BMI (Body Mass Index) and weight gain are strongly associated with psoriasis, with a relative risk of 1.63 (95% CI, 1.582.61) for BMI 35.0 compared to controls [130]. Ingram M.A., Jones M.B., Stonehouse W., Jarrett P., Scragg R., Mugridge O., von Hurst P.R. Kien C.L., Bunn J.Y., Fukagawa N.K., Anathy V., Matthews D.E., Crain K.I., Ebenstein D.B., Tarleton E.K., Pratley R.E., Poynter M.E. Omega-3 FAs include -linolenic acid (ALA) which is mainly found in plants, and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found mainly in fish and seafood sources. Resveratrol inhibits foam cell formation via NADPH oxidase 1- mediated reactive oxygen species and monocyte chemotactic protein-1. Lopez-Legarrea P., de la Iglesia R., Abete I., Navas-Carretero S., Martinez J.A., Zulet M.A. FOIA [117] showed that supplementation with 5 mg/d of folic acid and 1 mg/d of B12 (typical daily intake: about 500 mcg/day and 3.4 mcg/day, respectively) for eight weeks significantly improved endothelial dilatation, and a similar result was also demonstrated in a 7-year RCT where this combination along with high doses of B6 was provided [118]. Functional characterization of human receptors for short chain fatty acids and their role in polymorphonuclear cell activation. Similarly, a more recent study by Kolchak et al. Moreover, plasma EPA levels increased in patients with oily fish intake [211]. A >75% reduction in the clinical score was noticed in 45% in the intervention group compared to 15% in controls, and the mean duration to 50% reduction was 5.1 and 7.6 weeks, respectively [228]. In a randomized controlled trial (RCT) in healthy adults, a 4-month supplementation of n-3 fatty acids of 2.5 g/d and 1.25 g/d versus placebo resulted in a significant decrease in IL-6 levels by 10% and 12% in the low and high dose n-3 FAs groups, respectively, compared to a 36% increase in the placebo group [31]. Dalamaga M., Christodoulatos G.S. A randomized, double-blind, placebo-controlled study to evaluate the effect of fish oil and topical corticosteroid therapy in psoriasis. Effect of omega-three polyunsaturated fatty acids on inflammation, oxidative stress, and recurrence of atrial fibrillation. Diet and psoriasis. Esposito K., Giugliano D. Mediterranean diet for primary prevention of cardiovascular disease. Miller I.M., Ellervik C., Yazdanyar S., Jemec G.B. SFAs activate dendritic cells, which results in the endocytosis of Toll-like receptor (TLR)-4 and the secretion of pro-inflammatory cytokines such as IL-1 and reactive oxygen species (ROS) [27]. Clemmensen O.J., Siggaard-Andersen J., Worm A.M., Stahl D., Frost F., Bloch I. Psoriatic arthritis treated with oral zinc sulphate. Adiponectin, another adipocytokine which is produced by white adipose tissue (WAT), exerts an anti-inflammatory action by blocking the secretion of TNF-, IL-6, IL-17 and IL-1, enhancing the secretion of IL-10 and downregulating VCAM-1 and ICAM-1 [145,146]. On the other hand, positive associations between lycopene and F2-isoprostane or MDA levels have been shown in large-scale human studies, which were attributed to the fact that lycopene intake came mainly from pasta sauce, ketchup and fast-food consumption and not from tomatoes, its main natural source [96,97]. Liu S., Manson J.E., Buring J.E., Stampfer M.J., Willett W.C., Ridker P.M. Segal R., Baumoehl Y., Elkayam O., Levartovsky D., Litinsky I., Paran D., Wigler I., Habot B., Leibovitz A., Sela B.A., et al. reported that selenium and Vitamin E supplementation for 8 weeks resulted in the increase of glutathione peroxidase in patients with psoriasis [232]. Jarrett P., Camargo C.A., Jr., Coomarasamy C., Scragg R. A randomized, double-blind, placebo-controlled trial of the effect of monthly vitamin D supplementation in mild psoriasis. Christen W.G., Cook N.R., Van Denburgh M., Zaharris E., Albert C.M., Manson J.E. The consumption of EPA (180 mg/d) and DHA (120 mg/d) for six weeks was associated with a reduction in CRP in overweight patients [34], and a similar anti-inflammatory pattern was observed in a study with patients with T2DM, where the supplementation of high doses of n-3 PUFAs led to lower concentrations of IL-2 and TNF- [35].

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astaxanthin and psoriasis