Nurlinah Amalia, Danar Wicaksono, Elvan Wiyarta, Derren David Christian Homenta Rampengan, Hari Darmawan, Muhammad Reva Aditya, Ariq Fadhil Athallah, Maulana Bagus Adi Cahyono, Aiman Idrus Alatas, Trina Ekawati Tallei, Raymond Rubianto Tjandrawinata, Arun K. Bhunia, Fahrul Nurkolis
Psoriasis, a chronic immune-mediated skin condition, has been intricately linked to gut microbiota dysbiosis through the gut-skin axis. This meta-analysis synthesizes data from 15 randomized controlled trials encompassing 1,423 participants to evaluate the efficacy of gut microbiota interventions—probiotics and synbiotics—in psoriasis management. The findings reveal that probiotics significantly improved the Psoriasis Area and Severity Index (PASI) (Mean Difference [MD]: −4.05, 95 % CI: −6.73 to −1.38; p < 0.0001) and Dermatology Life Quality Index (DLQI) (MD: −5.74, 95 % CI: −11.45 to −0.03; p = 0.0001), outperforming synbiotics and systemic pharmacological therapies such as anti-TNF-α and anti-interleukin agents. Notably, probiotics demonstrated superior systemic anti-inflammatory (TNF-α and IL-17) and immunomodulatory responses, and enhanced gut barrier integrity. This study highlights probiotics as a promising adjunct or alternative therapy, paving the way for integrative treatment strategies that address psoriasis's multifaceted pathophysiology. Future research should focus on long-term efficacy and molecular mechanisms to optimize outcomes. These findings could redefine therapeutic paradigms, offering a cost-effective and accessible solution for millions of psoriasis patients worldwide. © 2025 The Authors
Medical Study Program, Faculty of Medicine, Universitas Brawijaya, East Java, Malang, Indonesia; Master Program of Biomedical Science, Faculty of Medicine, Universitas Brawijaya, East Java, Malang, Indonesia; Medical Research Center of Indonesia, East Java, Surabaya, Indonesia; Alumnus Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; University of Indonesia Hospital, Depok, 16424, Indonesia; Risetku, Jakarta, South Jakarta, 12820, Indonesia; Medical Study Program, Faculty of Medicine, Universitas Sam Ratulangi, North Sulawesi, Manado, Indonesia; Dermatovenerology Department, Faculty of Medicine, Universitas Tarumanagara, Jakarta, Indonesia; Medical Study Program, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia; Program of Clinical Microbiology Residency, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Department of Biology, Faculty of Mathematics and Natural Sciences, Sam Ratulangi University, Manado, 95115, Indonesia; Center for Pharmaceutical and Nutraceutical Research and Policy, Faculty of Biotechnology, Atma Jaya Catholic University of Indonesia, Jakarta, 12930, Indonesia; Molecular Food Microbiology Laboratory, Department of Food Science, Purdue University, West Lafayette, 47907, IN, United States; Purdue Institute of Inflammation, Immunology and Infectious Diseases, Purdue University, West Lafayette, 47907, IN, United States; Department of Comparative Pathobiology, Purdue University, West Lafayette, 47907, IN, United States; Master of Basic Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; State Islamic University of Sunan Kalijaga (UIN Sunan Kalijaga), Yogyakarta, 55281, Indonesia
