Owczarczyk-Saczonek Agnieszka, Purzycka-Bohdan Dorota, Nedoszytko Bogusław, Reich Adam, Szczerkowska-Dobosz Aneta, Bartosiñska Joanna, Batycka-Baran Aleksandra, Czajkowski Rafał, Dobrucki Iwona T, Dobrucki Lawrence W, Górecka-Sokołowska Magdalena, Janaszak-Jasiecka Anna, Kalinowski Leszek, Krasowska Dorota, Radulska Adrianna, Reszka Edyta, Samotij Dominik, Słominski Andrzej, Słominski Radomir, Sobalska-Kwapis Marta, Stawczyk-Macieja Marta, Strapagiel Dominik, Szczêch Justyna, Żmijewski Michał, Nowicki Roman J
Chair and Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland.
Chair and Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland.
Postepy Dermatol Alergol. 2020 Aug;37(4):452-467. doi: 10.5114/ada.2020.98284. Epub 2020 Sep 2.
Psoriasis is a systemic disease that is strictly connected with metabolic disorders (insulin resistance, atherogenic dyslipidemia, arterial hypertension, and cardiovascular diseases). It occurs more often in patients with a more severe course of the disease. Obesity is specially an independent risk factor and it is associated with a worse treatment outcome because of the high inflammatory activity of visceral fatty tissue and the production of inflammatory mediators involved in the development of both psoriasis and metabolic disorders. However, in psoriasis the activation of the Th17/IL-17 and the abnormalities in the Th17/Treg balance axis are observed, but this pathomechanism does not fully explain the frequent occurrence of metabolic disorders. Therefore, there is a need to look for better biomarkers in the diagnosis, prognosis and monitoring of concomitant disorders and therapeutic effects in psoriasis. In addition, the education on the use of a proper diet as a prophylaxis for the development of the above disorders is an important element of holistic care for a patient with psoriasis. Diet may affect gene expression due to epigenetic modification which encompasses interactions of environment, nutrition and diseases. Patients with psoriasis should be advised to adopt proper diet and dietician support.
银屑病是一种与代谢紊乱（胰岛素抵抗、致动脉粥样硬化性血脂异常、动脉高血压和心血管疾病）密切相关的全身性疾病。它在病情较重的患者中更常发生。肥胖尤其是一个独立的危险因素，并且由于内脏脂肪组织的高炎症活性以及参与银屑病和代谢紊乱发展的炎症介质的产生，它与较差的治疗结果相关。然而，在银屑病中观察到Th17/IL-17的激活以及Th17/Treg平衡轴的异常，但这种发病机制并不能完全解释代谢紊乱的频繁发生。因此，有必要在银屑病合并症的诊断、预后和监测以及治疗效果方面寻找更好的生物标志物。此外，关于采用适当饮食预防上述疾病发生的教育是银屑病患者整体护理的重要组成部分。饮食可能由于表观遗传修饰而影响基因表达，表观遗传修饰包括环境、营养和疾病之间的相互作用。应建议银屑病患者采用适当饮食并获得营养师的支持。
