Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India.
Department of, Biochemistry, Dr. R. P. Govt. Medical College, Kangra, India.
Australas J Dermatol. 2020 Nov;61(4):e378-e382. doi: 10.1111/ajd.13308. Epub 2020 May 12.
Gluten sensitivity among psoriasis patients and its association with gender, age, disease duration and severity of psoriasis are under studied in Indians.
To examine association among serum levels of anti-tTG and anti-gliadin antibodies and clinical features including gender, age, duration and severity of psoriasis.
Serum levels of anti-transglutaminase and anti-gliadin antibodies were measured quantitatively in 80 (M:F 57:23) psoriasis patients aged 15 to 83 years and matched healthy subjects.
Forty-five (56.3%) patients were aged ≥41years, duration of disease was >5years in 43(53.8%) patients, and 22 (27.5%) patients had moderate-to-severe psoriasis. Two (2.5%) patients had arthritis and elevated serum anti-gliadin antibody. Significantly more patients than controls had elevated serum anti-gliadin antibody (67.5% vs. 2.5%) and anti-transglutaminase antibody levels (62.5% vs. 0%). Two patients, each with mild and moderate-to-severe psoriasis, had highly elevated serum anti-gliadin antibody and symptoms akin to coeliac disease. Except for a longer duration of psoriasis in patients with elevated anti-gliadin antibodies, there was no statistically significant difference in gender, age, and severity of psoriasis when compared with patients having normal levels.
Significant elevation of serum anti-transglutaminase and anti-gliadin antibodies levels is noted in psoriasis patients reflecting a possible link. However, results need careful interpretation for any significance of gluten sensitivity in pathogenesis of psoriasis/arthritis or as a stand-alone risk factor for chronicity/severity of psoriasis or whether gluten-free diet will be ameliorating. Small number of subjects, cross-sectional study design, lack of pathological/endoscopic diagnosis and follow-up are study limitations.
在印度人中，关于银屑病患者的麸质敏感性及其与性别、年龄、疾病持续时间和严重程度的关系，研究较少。
研究血清抗转谷氨酰胺酶和抗麦胶蛋白抗体水平与包括性别、年龄、银屑病病程和严重程度在内的临床特征之间的关系。
检测了 80 例（男女比例为 57:23，年龄 15-83 岁）银屑病患者和匹配的健康对照者的血清抗转谷氨酰胺酶和抗麦胶蛋白抗体水平。
45 例（56.3%）患者年龄≥41 岁，43 例（53.8%）患者病程>5 年，22 例（27.5%）患者为中重度银屑病。2 例（2.5%）患者有银屑病关节炎和血清抗麦胶蛋白抗体升高。与对照组相比，显著更多的患者有升高的血清抗麦胶蛋白抗体（67.5%比 2.5%）和抗转谷氨酰胺酶抗体水平（62.5%比 0%）。2 例分别为轻度和中重度银屑病患者，有高度升高的血清抗麦胶蛋白抗体和类似乳糜泻的症状。除了血清抗麦胶蛋白抗体升高的患者银屑病病程较长外，与血清抗体正常的患者相比，在性别、年龄和银屑病严重程度方面无统计学差异。
银屑病患者血清抗转谷氨酰胺酶和抗麦胶蛋白抗体水平显著升高，提示两者之间可能存在关联。然而，鉴于乳糜泻样麸质敏感性在银屑病/关节炎发病机制中的意义、作为慢性/严重程度的独立危险因素，或无麸质饮食是否会改善病情等方面，结果需要谨慎解释。研究的局限性在于研究对象数量少、横断面研究设计、缺乏病理/内镜诊断和随访。
