title: Gluten-free diet in psoriasis patients with antibodies to gliadin results in decreased expression of tissue transglutaminase and fewer Ki67+ cells in the dermis.
abstract: Previous studies have shown that 16% of patients with psoriasis vulgaris have IgA and/or IgG antibodies to gliadin, but few have antibodies to endomysium. The increase in duodenal intraepithelial lymphocytes was mild. Still, highly significant clinical improvement was observed after 3 months on a gluten-free diet. This study surveys certain immunohistological aspects of involved and non-involved skin in 28 AGA-positive psoriasis patients before and after 3 months of a gluten-free diet. Staining was performed for CD4+ T lymphocytes, Langerhans' cells, endothelium, proliferating (Ki67) cells and tissue transglutaminase. In the entire group of patients, as well as in those on a gluten-free diet as the only treatment, Ki67 + cells in involved dermis were highly significantly decreased after the diet. There was a significant decrease in Ki67 + cells even in patients without increased intraepithelial lymphocytes. Tissue transglutaminase was highly overexpressed in involved skin in the papillary endothelium, and decreased by 50% after gluten-free diet. The possible role of tissue transglutaminase in the pathogenesis of psoriasis needs further investigation.
authors.affiliation: Department of Medical Sciences/Dermatology and Venereology, University Hospital, Uppsala, Sweden. gerd.michaelsson@medsci.uu.se
authors.forename: Gerd
authors.initials: G
authors.lastname: Michaëlsson
authors.forename: Stina
authors.initials: S
authors.lastname: Ahs
authors.forename: Ingrid
authors.initials: I
authors.lastname: Hammarström
authors.forename: Inger Pihl
authors.initials: IP
authors.lastname: Lundin
authors.forename: Eva
authors.initials: E
authors.lastname: Hagforsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis / Q000276:immunology*; D001707:Biopsy, Needle; D016022:Case-Control Studies; D002478:Cells, Cultured; D000078404:Epidermal Cells; D004817:Epidermis / Q000502:physiology; D005260:Female; D005903:Gliadin / Q000276:immunology* / Q000378:metabolism; D005983:Glutens; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis / Q000276:immunology; D007074:Immunoglobulin G / Q000032:analysis / Q000276:immunology; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011336:Probability; D011565:Psoriasis / Q000178:diet therapy* / Q000276:immunology / Q000473:pathology*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011503:Transglutaminases / Q000032:analysis / Q000378:metabolism*
chemical_list: D000888:Antibodies, Anti-Idiotypic; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D019394:Ki-67 Antigen; D005983:Glutens; D005903:Gliadin; D011503:Transglutaminases