Psoriasis is a chronic inflammatory skin disease that affects millions of people worldwide. What at first glance appears to be a purely dermatological problem turns out, upon closer inspection, to be a complex immune disorder that extends far beyond the skin. Recent research shows that the microbiome — specifically , the bacterial community in our gut—could play a crucial role in the development and regulation of the disease. This means that probiotics , particularly certain strains such as Lactobacillus paracasei LP-33 and GMNL-133, are increasingly becoming the focus of medical innovations.
What is psoriasis?
Psoriasis is an autoimmune skin disease triggered by an overactive immune response . Skin cells are produced in an above-average cycle—the normal process, which usually takes about 28 days, is shortened to just a few. The result is inflamed, scaly skin patches that are often accompanied by itching, pain, and psychosocial distress.
Typical symptoms
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Reddish, sharply defined skin areas with silvery scales
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Itching or burning
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Dry, cracked skin that may bleed
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Thickened, discolored nails
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In severe cases: joint pain (psoriatic arthritis)
Psoriasis most commonly occurs on the elbows, knees, scalp, and lower back. However, theoretically, any part of the body can be affected.
Causes and risk factors
The exact causes of psoriasis are not fully understood, but several factors are known that can increase the risk or trigger flare-ups:
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Genetic predisposition : Those who have first-degree relatives with psoriasis have a significantly increased risk.
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Immunological factors : A misguided immune response leads to an inflammatory reaction in the skin.
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Trigger factors : stress, infections (e.g. streptococci), medications, skin injuries or hormonal changes.
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Lifestyle : Obesity, smoking and alcohol consumption are also associated with more severe courses.
Classical therapy approaches
The treatment of psoriasis is individualized depending on the severity and includes several levels:
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Topical therapies : corticosteroids, vitamin D analogues, tar preparations
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Systemic medications : Methotrexate, ciclosporin, biologics (e.g., adalimumab, secukinumab)
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Phototherapy : UVB or PUVA treatments
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Nutrition and stress management
Although these therapies help many patients, they are often not free of side effects or only lead to temporary relief. Therefore, researchers worldwide are searching for alternative or complementary approaches – one of which is the targeted use of probiotics .
The role of the microbiome in psoriasis
A growing body of scientific studies shows that the gut microbiome —the complex ecosystem of trillions of microorganisms in the digestive tract—plays a central role in chronic inflammatory diseases. There is a bidirectional connection between the gut and skin , often referred to as the "gut-skin axis."
An imbalance in the microbiome (dysbiosis) can activate the immune system, promote systemic inflammation, and exacerbate autoimmune diseases like psoriasis. Conversely, healthy gut bacteria could dampen inflammatory processes, strengthen the skin barrier, and regulate the immune system.
Probiotics as a source of hope in psoriasis therapy
Probiotics are living microorganisms that, when consumed in sufficient quantities, can have a health-promoting effect. Their use in skin diseases such as psoriasis is a relatively new field of research, but it is yielding promising results.
The idea is simple but effective: through the targeted administration of certain bacterial strains, the disturbed microbiome can be modulated and thus the immune system can be influenced – a completely new therapeutic approach.
What does a probiotic do for psoriasis?
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Stabilization of the intestinal flora
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Reduction of inflammatory cytokines such as TNF-α, IL-6 or IL-17
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Strengthening the intestinal barrier , which reduces systemic inflammation
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Induction of regulatory T cells that curb autoimmune reactions
In focus: Lactobacillus paracasei LP-33 and GMNL-133
Two strains that have recently received increased scientific attention are Lactobacillus paracasei LP-33 and GMNL-133 . Both belong to the genus Lactobacillus , which has traditionally been associated with beneficial effects on intestinal health.
Lactobacillus paracasei LP-33
This strain is primarily known for its anti-inflammatory effects and was originally studied in the context of allergies (e.g., hay fever). It was shown that LP-33 can exert immunomodulatory effects—particularly through the inhibition of pro-inflammatory cytokines.
Recent studies suggest that LP-33 may also have positive effects on autoimmune inflammatory diseases such as psoriasis, for example through:
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Reduction of systemic inflammatory markers
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Improvement of skin barrier function
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Reduction of oxidative stress
Lactobacillus paracasei GMNL-133
Another promising strain is GMNL-133, a proprietary isolate from the Taiwanese biotech company GenMont. GMNL-133 demonstrates impressive effects in preclinical models against inflammatory diseases, including:
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Inhibition of the Th17 cell response , which is overactive in psoriasis
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Protection of the intestinal mucosa
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Modulation of Toll-like receptors (TLRs) , which play a role in the development of autoimmune reactions
Some studies suggest that GMNL-133 may reduce the severity of psoriatic skin lesions by modulating the IL-23/IL-17 axis —a central signaling axis in psoriasis pathogenesis.
Clinical studies and scientific evidence
Although many of the mechanisms of action known to date are based on animal models and in vitro experiments, the number of clinical studies is increasing. Initial pilot studies show that certain probiotic strains, in combination with conventional therapies, can contribute to faster remission , a longer symptom-free period , and a better quality of life .
In addition, meta-analyses show that probiotics can have a beneficial effect on inflammatory skin diseases such as acne, atopic dermatitis and psoriasis – especially when several immunomodulatory strains are combined.
Nutrition is key – integrate probiotics naturally
In addition to taking probiotic supplements, fermented foods can also have a positive influence on the microbiome:
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Yogurt with active cultures
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sauerkraut
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Kimchi
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kefir
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Miso
Additionally, a prebiotic diet is recommended, meaning the intake of fiber, which serves as "food" for probiotic bacteria. Particularly suitable are:
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Psyllium husks
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Chicory
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Black salsify
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oatmeal
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linseed
Conclusion: New perspectives for an old disease
Psoriasis remains a challenge for both medical professionals and those affected. However, insights into the microbiome and the gut-skin axis are opening up entirely new therapeutic possibilities. Probiotics such as Lactobacillus paracasei LP-33 and GMNL-133 are more than just a dietary trend—they could become a crucial component in personalized psoriasis treatment.
Even though many questions remain unanswered and further studies are needed, it is worthwhile to take a holistic view of the disease – moving away from purely symptomatic treatment towards a cause-oriented, immunological approach .
For those affected, this means hope for better control, longer symptom-free periods and a better quality of life – perhaps even through taking the right probiotic every day.
