[Role of bile acids and endotoxins in the pathogenesis and therapy of psoriasis]

Abstract

The authors demonstrated significant curative effect of bile acids (Suprachol; Acidum dehydrocholicum) in 551 psoriatic patients. The clinical efficiancy was evaluated by means of PASI-score (Psoriasis Area Severity Index). During this treatment (1-8 weeks) 434 patients (78.8 per cent) became asymptomatic. However, the traditional therapy resulted in 62 patients (24.9 per cent) of 249 sick persons a recovery (p < 0.05). In acute form of psoriasis (184 patients) this curative effect of bile acids was elevated (95.1 per cent). Two years later 319 patients (57.9 per cent) of bile treated 551 people were asymptomatic in contrast with 15 people (6.0 per cent) of 249 traditional treated patients (p < 0.05). In same time among the patients which were treated in acute form of psoriasis 10 (7.2 per cent) of 139 controls and 147 (79.9 per cent) of 184 bile-treated individuals were asymptomatic (p < 0.01). On the basis of their clinical observations (digestive disorders, ultrasonical confirmed gallbladder complaints, etc.) authors supposed that the deficiency of bile acids and the consecutive endotoxin translocation might play a role in the pathogenesis of psoriasis. In normal conditions the bile acids as detergent (physico-chemical defense) can protect the body against enteral endotoxins while split them to atoxic fragments and so preventing consecutive cytokin liberation.