Biotics: The Food Ingredients Supporting the Intestinal Microbiota and Immune System in Psoriasis

Psoriasis is a chronic immune-mediated inflammatory skin disease affecting 4 million new individuals worldwide each year. Although the etiology of psoriasis is not fully understood, genetic factors play a key role in conjunction with systemic inflammation and gut microbiota dysbiosis. Current methods of psoriasis treatment, while effective, may cause adverse reactions. Biotics (pre-, pro-, syn-, and postbiotics) are generally recognized as safe, have a good reputation, and have confirmed beneficial health effects. Considering the growing awareness of the impact of diet and lifestyle on health among individuals with psoriasis, the recognition of biotics as a potential source of health benefits with minimal constraints even during therapy has become more relevant. In this review, we highlight the therapeutic potential and beneficial effects of biotics in inflammatory skin diseases involving dysbiosis and screen the scientific data concerning recent randomized controlled trials that specifically assessed the use of biotics in psoriasis to understand the progress achieved to date. Most studies matching our screening criteria used lactic acid bacteria along with oligosaccharides as prebiotics. Probiotics have shown promising results in suppressing inflammatory pathways and alleviating the symptoms of psoriasis by modulating the gut microbiota. After several weeks of intervention, patients showed microbiome changes along with reduced levels of inflammatory biomarkers and psoriasis severity. Overall, biotics appear to be good candidates for improving the quality of life in patients with psoriasis; however, more randomized controlled trials with more rigid protocols and rigorously reported results are needed to properly assess their potential.