Signs of systemic inflammation (as detected by PET/CT imaging, transcription analysis, and neutrophil activation) in a moderately obese psoriasis patient are partially reversed by 6 weeks of dietary intervention with a healthy diet

Summary: Skin, joint, and organ inflammation has been demonstrated in psoriasis (PsO) patients using older positron emission tomography (PET) devices. A diet containing high amounts of saturated fat and sugars - also known as Western diet (WD)- potentially increases the risk of inflammatory disease. We hypothesized that short term intervention with a healthy diet low in saturated fat and sugars can reduce PET-measurable skin and systemic signs of inflammation in PsO patients who consume a WD. The first subject underwent a dynamic FDG-PET/CT scan using an ultra-high resolution (3mm) PET /CT device. The patient’s blood and non-lesional forearm skin samples were obtained at the time of the initial scan and then 6 weeks later at the PET/CT repeat scan following dietary intervention with healthy meals (3 meals/day) supplied by a research kitchen. The subject had PsO under good control with topical agents only. CT imaging showed increased liver density after intervention, indicating likely reduced liver fat content. FDG uptake was reduced in the gastroesophageal junction and right colon, potentially indicating amelioration of inflammation. Total bilirubin and some liver enzymes and lipid levels, which were elevated before intervention, were also reduced after the intervention. MRNA expression in non-lesional skin of TNF, IL6 and CCL20 was elevated at the first scan and reduced by ~70% at the final scan, whereas IL17A/F was not detected at either time point. At the end of the study, blood neutrophil inflammasome activation in response to <i>ex vivo</i> stimulation with TNFa was reduced by 2.6- fold. These preliminary results, including those obtained by PET/CT imaging, suggest that systemic inflammation may be measurably improved following even relatively short-term healthy diet intervention in a PsO patient. F Steinberg², A Chaudhari³, S Wyatt², Y Abdelhafez³, Y Matsushima¹, S Nasim¹, Xuesong Wu¹, R Badawi³, Scott Simon¹, Sam Hwang¹ 1. Dermatology, UC Davis Health, Sacramento, CA, United States. 2. Nutrition, University of California Davis, Davis, CA, United States. 3. Radiology, UC Davis Health, Sacramento, CA, United States. Clinical Research: Interventional Research