MedicalResearch: What is the background for this study? What are the main findings?
Response: Infections have been related with the pathogenesis of guttate psoriasis, however antibiotic treatment does not improve prognosis nor does it affect the evolution of the disease. The association between psoriasis and other infectious diseases has been reported as well, although in these cases there is scarce information on the causative microbial likely involved and the role of these bacteria in the pathogenesis of this skin disease.
MedicalResearch: What are the main findings?
Response: Bacterial DNA may be detected in bloodstream of a significant proportion of patients with active plaque psoriasis. Increased levels of pro-inflammatory cytokines in patients with presence of bacterial DNA but not in patients without presence of bacterial genomic fragments suggest a role of bacterial DNA translocation in inducing an inflammatory response.
MedicalResearch: What should clinicians and patients take away from your report?
Response: Data here reported open the possibility of research on new therapeutic paths.
It remains of great interest to assess if controlling psoriasis may help blockade episodes of bacterial translocation (BT), or if in turn, avoiding BT may help control active plaque psoriasis. We can hypothesize that new therapies might help to decrease the levels of systemic inflammatory markers acting as an adjuvant therapy to the currently known treatment for psoriasis and opening the possibility to improve the clinical situation of patients.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Response: New studies are needed to clarify if BT is related with the pathogenesis of not only active plaque psoriasis but also all phenotypes of psoriasis. Future investigations on these issues as well as on the intestinal permeability and the intestinal microbiota in psoriatic patients seems necessary to ascertain the real role that all these facts play in the pathogenesis of psoriasis and help designing new therapeutic options. We are still in the beginings of this new finding that is the phenomenon of bacterial translocation in the psoriasis, but multidisciplinary medical treatment involving infectologists, geneticists, immunologists and dermatologists could be the near future in the treatment of psoriasis.
Ramírez-Boscá A, Navarro-López V, Martínez-Andrés A, et al. Identification of Bacterial DNA in the Peripheral Blood of Patients With Active Psoriasis. JAMA Dermatol. Published online March 11, 2015. doi:10.1001/jamadermatol.2014.5585.
MedicalResearch.com Interview with: Dr. Ana Ramírez-Boscá, MD Department of Dermatology and Clinical R (2015). Bacterial DNA Detected In Blood Of Patients With Active Psoriasis