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The role of the gut microbiome – skin axis in the pathogenesis of psoriasis (Master thesis)

Λουψάτη, Μαρία/ Loupsati, Maria/ Τρόφιμα, Διατροφή και Μικροβίωμα

Psoriasis constitutes a chronic, immune-mediated inflammatory dermatosis that exerts a profound impact on the quality of life of affected individuals, characterized by a complex and multifactorial pathogenesis. In recent years, the gut-skin axis has emerged as a subject of escalating scientific interest, as it elucidates the bidirectional relationship among the intestinal microbiota, the immune system and the skin – a nexus facilitated via immunological, metabolic and neuroendocrine pathways. Recent literature underscores the critical role of the gut microbiome in modulating immune homeostasis and the inflammatory response, thereby shaping the underlying mechanisms associated with the development and progression of psoriasis. Alterations in the intestinal microbiota composition can induce elevated inflammatory activity, immunological imbalance and compromised instestinal permeability. Consequently, dysbiosis activates cytokine production pathways and modulates immune cell function, triggering systemic inflammation, which represents a hallmark feature of psoriasis. The IL-23/Th17 signaling axis appears to play a pivotal role, contributing to the perpetuation of inflammation and the activation of keratinocytes. Furthermore, microbial metabolites, such as short-chain fatty acids (SCFAs), contribute significantly to maintaining immunological homeostasis and preserving the integrity of the intestinal epithelial barrier. Dietary habits, psychological stress, antibiotic administration and broader lifestyle choices represent catalytic factors capable of altering the architecture of the gut microbiome and inducing destabilization. Dietary interventions, probiotics, prebiotics, along with innovative therapeutic modalities such as fecal microbiota transplantation (FMT), hold the potential to attenuate inflammation and optimize patient clinical outcomes. A more comprehensive investigation into the gut-skin axis may facilitate the development of personalized and targeted therapeutic strategies, offering novel avenues for the future comprehension and management of psoriasis.