PSORIASIS and DIET – Part 1

For many years Dermatologists, General Practitioner’s and many researchers considered that patients who stated that eating certain foods made their psoriasis  worse as being utterly mistaken or delusional. However, over the last several years there has slowly been a change of thought and we are now seeing the results of several recent studies and clinical trials on various nutritional and dietary therapies for psoriasis. And the results have made it clear that diet may influence the health outcome for patients.

A study of some 20,000 eczema and psoriasis patients by the Department of Medical Nutrition, Donau University Krems in Austria, found that the patients showed, besides allergic reactions to foods, an increasing number of pseudo allergic reactions caused by toxic-irritative pollutants (formaldehyde, exhaust particles, food additives, nicotine, wood preservatives, pesticides, heavy metals) which are responsible for the inflammatory process behind the complex symptoms. The Researchers found that 60% of all patients had raised concentrations of circulating immune complexes with food-specific IgE- and IgG responsible for the delayed (Type III) allergic reactions. They found that both in atopic eczema and in psoriasis patients had pseudo allergic  reactions against biogenic amines and had constantly raised serum histamine levels. Previously published results showed significantly reduced DAO activities in  thrombocyte rich plasma of atopic eczema and psoriasis patients explaining their intolerance reactions to histamine, tyramine and octopamine rich foods.1 Diamine oxidase (DAO) is an essential enzyme in the body that breaks down histamine. The body then takes the break-down products (called imidazole compounds) and excretes them through the kidneys into the urine.

Biogenic amines play important role in human body such as: regulation of body and stomach pH, gastric acid secretion, the immune response and cell growth and differentiation. At the same time, amines are important for the growth, renovation and metabolism of every organ in body and are also essential for maintaining the high metabolic activity of the normal functioning and immunological system of the gut. Despite these roles, the consumption of foods with high content of biogenic amines can cause adverse reactions such as nausea, headaches, cardiac palpitation, hot flushes, oral burning, gastric intestinal problems, renal intoxication, rashes and changes in blood pressure. Different biogenic amines can cause different side effects such as: excess tyramine intake could cause hypertension whereas serotonin is a vasoconstrictor. People having deficient natural mechanisms for detoxifying biogenic amines due to genetic defects or due to the intake of antidepressant medicines such as monoamine oxidase inhibitors may experience allergen-type reactions characterized by difficulty in breathing, itching, rash, vomiting, fever and hypertension. 2

Histamine is found in fermented alcoholic beverages, especially wine, champagne and beer,

bacon, salami, luncheon meats and hot dogs,  sour cream, sour milk, buttermilk, sour dough  bread, etc., dried apricots, prunes, dates, figs, raisins, citrus fruits, aged cheese – camembert, brie, blue vein and including goat cheese, walnuts, cashews, and peanuts,  avocados, eggplant, spinach, and tomatoes and smoked fish and certain species of fish: mackerel, tuna, anchovies, sardines.

Psoriasis is considered to be an autoimmune disease and in severe, uncontrollable psoriasis histamine antagonists are of value in reducing disease activity. Histamine formation and release raises the possibility, that histamine is one of the molecules involved in pathogenesis  of autoimmune diseases. 3,5

Tyramine is found in fava beans and tomatoes, broad beans, concentrated yeast extract spreads and bouillons, salamis and mortadella, beer as well as the above foods.

Tyramine, derived from tyrosine, mimics the effects of adrenaline, causing increased heart activity and raising blood pressure. Research has suggested that psychological stress can induce exacerbation of psoriasis. It is further hypothesized that these stress effects on the course and outcome of psoriasis are caused by neuroendocrine modulation of immune functions.4 Excess levels of tyramine releases adrenaline from storage vesicles.4,5 When chronic illness is involved and the body is in a state of chronic stress the adrenal glands begin to work overtime. Over a period of  time the adrenal glands begin to suffer from adrenal fatigue. Impaired adrenal function is associated with the incidence of autoimmune diseases such as skin conditions and arthritis.6

Octopamine is found in green bean, edamame (soybeans), avocados, bananas, pineapple, eggplants, figs, red plums, raspberries, peanuts, Brazil nuts, coconuts, processed meat, yeast as well as the above foods

Octopamine is closely related to the hormone norepinephrine, Researchers studying patients with psoriasis whose psoriasis is associated with increased levels of psychological stress, found that in the psoriasis patients there were significantly increased norepinephrine blood levels compared with non-psoriasis controls. The researchers concluded that there was a positive correlation between the severity of psoriasis and high levels of norepinephrine. 7

There has been a known correlation between Irritable Bowel Diseases such as Crohn’s Disease, Colitis and Irritable Bowel Syndrome (IBS or Leaky Gut), since the 80s. Some researchers have concluded that Psoriasis and IBD are strictly related inflammatory diseases, probably sharing immune-pathogenetic mechanisms. Skin and bowel represent, at the same time, barrier and connection between the inner and the outer sides of the body share similar immune processes which play a key role in maintaining homeostasis and in sustaining pathological processes. 8

 

Solanine is a glyco alkaloid  poison found in species of the nightshade family (solanaceae), e.g. potatoes, tomatoes and eggplant. It can occur naturally in any part of the plant, including the leaves, fruit, and tubers. It is very toxic even in small quantities. Research has shown that the disruption of epithelial barrier integrity is important in the initiation and the cause of inflammatory bowel disease (IBD). Solanine has been found to permeabilize cholesterol-containing membranes, thus leading to the disruption of epithelial barrier integrity. Altered intestinal permeability is believed by some researchers to play a key role in the initiation and propagation of the inflammatory process in conditions other than IBD.9,10  Solanine and related glycoalkaloids are classified as acetylcholinesterase inhibitors leading to increased levels of neurotransmitters which cause prolonged muscle contractions, pain, tenderness, inflammation and stiff body movement. Swollen joints are a clinical manifestation of synovitis and the acute-phase response act as bio marker of pro-inflammatory cytokine production. Solanine may also induce oxidative stress leading to generation of free radicals and alterations in antioxidant and scavengers of oxygen free radicals. 11 There is the potential for solanine to have an adverse effect on psoriatic arthritis. The percentage of arthritic patients who are sensitive to the solanine family of plants might be significantly greater than 10%. A 1982 study published in the Journal of the International Academy of Preventive Medicine demonstrated significant improvements in over 70% of 5,000 (> 3,500) arthiritic patients after having eliminated solanine-containing foods from their diets.12

Also read our blog “PSORIASIS and COMORBIDITIES, PSORIASIS and ALCOHOL and PSORIASIS and WATER INTAKE”.

 

REFERENCES

  1. Ionescu JG, Constantinescu R, Constantinescu AT; Personalized Anti-Inflammatory Nutrition For Atopic Eczema And Psoriasis Patients; EPMA Journal (2011) 2 (Suppl 1):S157–S165 DOI 10.1007/s13167-011-0118-6
  2. Songül Şahin Ercan, Hüseyin Bozkurt and Çiğdem Soysal ; Significance of Biogenic Amines in Foods and Their Reduction Methods; Journal of Food Science and Engineering 3 (2013) 395-410
  3. Nielsen HJ,Hammer JH.; Possible role of histamine in pathogenesis of autoimmune diseases: implications for immunotherapy with histamine-2 receptor antagonists.; Med Hypotheses. 1992 Dec;39(4):349-55.
  4. Schmid-Ott G. et al.; Stress-induced endocrine and immunological changes in psoriasis patients and healthy controls. A preliminary study.; Psychother Psychosom.1998;67(1):37-42.
  5. Maintz and Novak N.; Histamine and histamine intolerance; Am J Clin Nutr 2007;85:1185–96
  6. Physiology of Stress; Chapter 2; http://www.jblearning.com/samples/0763740411/Ch%202_S eaward_Managing%20Stress_5e.pdf
  7. Ionescu G,Kiehl R; Increased plasma norepinephrine in psoriasis.; Acta Derm Venereol. 1991;71(2):169-70.
  8. Skroza et al.; Correlations between Psoriasis and Inflammatory Bowel Diseases; Hindawi Publishing Corporation BioMed Research International Volume 2013, Article ID 983902, 8 pages http://dx.doi.org/10.1155/2013/983902
  9. Patel B. et al.; Potato glycoalkaloids adversely affect intestinal permeability and aggravate inflammatory bowel disease; Volume 8,Issue 5, pages 340–346, September 2002
  10. Shah S. Dietary Factors in the Modulation of Inflammatory Bowel Disease Activity.Medscape General Medicine. 2007;9(1):60.
  11. Ayad S.K.; Effect of Solanine on Arthritis Symptoms in Postmenopausal Female Albino Rats; Arab Journal of Nuclear Science and Applications, 46(3), (279-285) 2013 27
  12. Prousky J. E.; The use of Niacinamide and Solanaceae (Nightshade) Elimination in the Treatment of Osteoarthritis; Journal of Orthomolecular Medicine Vol 30, No 1, 2015

Leave a Reply

Your email address will not be published.
Required fields are marked *