Zusammenfassung
Psoriasis ist eine T-Lymphozyten-vermittelte Entzündung der Haut, die durch Hyperproliferation und verminderte Differenzierung epidermaler Keratinozyten gekennzeichnet ist. In schweren Fällen kommt es zu einer Beeinträchtigung des Ernährungsstatus, zusätzlich forciert durch Medikamenten-Nährstoff-Interaktionen bei systemischer Therapie. Die Art der Ernährung wie auch einzelne Nahrungsinhaltsstoffe werden als ätiologische und pathogenetische Faktoren diskutiert. Positive Effekte zeigten sich durch Fastenperioden, vegetarische Ernährung oder die erhöhte Zufuhr von Omega-3-Fettsäuren aus Fischöl. Die Verbesserung resultiert aus einer verminderten Arachidonsäure- bzw. einer erhöhten Eicosapentaensäurezufuhr. Als Konsequenz verändert sich das Eicosanoidprofil und damit die Konzentration der Entzündungsmediatoren. Allerdings konnte nur in einer von 4 randomisierten, kontrollierten Studien mit Omega-3-Fettsäuren ein Nutzen nachgewiesen werden. Einige Patienten weisen eine Glutensensitivität auf und könnten von einer glutenfreien Diät profitieren. Eine Verbesserung der Symptome lässt sich darüber hinaus durch Vitamin D erzielen, welches antiproliferative und immunregulatorische Effekte besitzt.
Abstract
Psoriasis is a T cell mediated inflammatory skin disease characterized by hyperproliferation and reduced differentiation of epidermal keratinocytes. In severe cases, the disease can result in an insufficient nutritional status which may even be promoted by nutrient-drug interactions. Both the general diet and single food components have been suggested to play a role in etiology and pathogenesis of psoriasis. Fasting periods, vegetarian diets, and diets rich in omega-3 polyunsaturated fatty acids from fish oil have all been associated with improvement in some studies. The most likely explanation is the reduced amounts of arachidonic acid and the increased eicosapentaenoic acid intake resulting in a modulated eicosanoid profile. However, only one of four controlled studies showed a benefit of omega-3 fatty acids compared to placebo. Some psoriasis patients are gluten-sensitive and may benefit from a gluten free diet. The active form of vitamin D exhibits anti-proliferative and immunoregulatory effects and has been shown to be useful in the treatment of psoriasis.
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Wolters, M. Die Bedeutung der Ernährung und begleitender Faktoren für die Psoriasis. Hautarzt 57, 999–1004 (2006). https://doi.org/10.1007/s00105-006-1164-1
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DOI: https://doi.org/10.1007/s00105-006-1164-1