Psoriasis is a chronic inflammatory skin disease with autoimmune pathogenic characteristics and is caused by chronic inflammation, which results in uncontrolled keratinocyte growth and defective differentiation. The link between the gut microbiota and immune system regulation opened a novel angle to understand the pathogenesis of many chronic multifactorial diseases, including psoriasis. Current evidence suggests that modulation of the gut microbiota, both through dietary approaches and through supplementation with probiotics and prebiotics, could represent a novel therapeutic approach. The present work aims to highlight the latest scientific evidence regarding the microbiome alterations of psoriatic patients, as well as state of the art insights in terms of microbiome-targeted therapies as promising preventive and therapeutic tools for psoriasis.

Psoriasis is a chronic inflammatory skin disease with autoimmune pathological characteristics. Recent research has found a link between psoriasis, inflammation, and gut microbiota dysbiosis, and that probiotics and prebiotics provide benefits to patients. This 12-week open-label, single-center clinical trial evaluated the efficacy of probiotics (Bacillus indicus (HU36), Bacillus subtilis (HU58), Bacillus coagulans (SC208), Bacillus licheniformis (SL307), and Bacillus clausii (SC109)) and precision prebiotics (fructooligosaccharides, xylooligosaccharides, and galactooligosaccharides) in patients with psoriasis receiving topical therapy, with an emphasis on potential metabolic, immunological, and gut microbiota changes. In total, 63 patients were evaluated, with the first 42 enrolled patients assigned to the intervention group and the next 21 assigned to the control group (2:1 ratio; non-randomized). There were between-group differences in several patient characteristics at baseline, including age, psoriasis severity (the incidence of severe psoriasis was greater in the intervention group than in the control group), the presence of nail psoriasis, and psoriatic arthritis, though it is not clear whether or how these differences may have affected the study findings. Patients with psoriasis receiving anti-psoriatic local therapy and probiotic and prebiotic supplementation performed better in measures of disease activity, including Psoriasis Area and Severity Index, Dermatology Life Quality Index, inflammatory markers, and skin thickness compared with those not receiving supplementation. Furthermore, in the 15/42 patients in the intervention group who received gut microbiota analysis, the gut microbiota changed favorably following 12 weeks of probiotic and prebiotic supplementation, with a shift towards an anti-inflammatory profile.

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Background/Aim: Berberine, an isoquinoline alkaloid widely used in traditional medicine, has attracted considerable interest for its capacity to modulate the gut microbiota and improve cardiometabolic outcomes. Although preclinical evidence is promising, no systematic review has previously synthesised evidence from randomised controlled trials (RCTs) in humans. This review aimed to evaluate the effects of berberine supplementation on gut microbiota and to explore associated cardiometabolic, inflammatory, and immunological changes. Methods: Prospectively registered in PROSPERO (CRD42024524143) and conducted in accordance with PRISMA guidelines, this review searched PubMed, Web of Science, Scopus, and Embase from inception to 10 January 2026. Eligible studies were RCTs in adults reporting gut microbiota outcomes following berberine supplementation. Methodological quality was assessed using the Cochrane Risk of Bias tool. Microbiota assessment methods, including sequencing platforms and bioinformatic pipelines, were systematically characterised across the included studies. Results: Seven RCTs enrolling 34 to 446 participants per intervention arm were included across diverse clinical populations—type two diabetes mellitus (T2DM), hyperlipidaemia, colorectal adenoma, psychiatric disorders, and Parkinson’s disease. Six of seven studies reported significant compositional shifts; the most extensively characterised changes—observed predominantly in T2DM populations—included enrichment of γ-Proteobacteria and depletion of butyrate-producing taxa, with specific taxa and the breadth of compositional changes varying considerably across clinical populations and sequencing methodologies. These shifts co-occurred with improvements in fasting glucose, lipid profiles, and inflammatory markers; however, causal inference cannot be established. Conclusions: Berberine consistently modulated gut microbial composition across heterogeneous clinical populations, with concurrent cardiometabolic and anti-inflammatory improvements. Compositional shifts were not uniformly favourable, and findings should be interpreted as hypothesis-generating. Geographically diverse, mechanistically focused RCTs are required to establish causality.

Psoriasis is a chronic, inflammatory skin disease which highly impacts the quality of life of psoriatic patients. Although the pathogenesis of psoriasis is multifactorial, recent evidence suggest that alterations in the intestinal microbiome play an important role suggesting a clear status of dysbiosis associated with the disease. This study aimed to assess the frequency of probiotic and prebiotic food consumption in psoriasis patients in Romania (n = 122), with an emphasis on potential dietary risk or protective factors linked with psoriasis. The results showed that consuming fermented and probiotic foods, such as fermented dairy products, kombucha, whole grains, fruits, and vegetables, may have an essential role in limiting or alleviating psoriasis symptoms. Future research should also investigate this relationship, considering other food groups, such as fish, meat, and fats, using a national validated food frequency questionnaire.

Background/Objectives: The gut microbiota has been increasingly studied in the context of gastrointestinal, neuropsychiatric, and immune-mediated disorders. However, comparative data across these conditions within the same population remain limited. This observational study aimed to perform a comparative analysis of gut microbiota composition across individuals with irritable bowel syndrome (IBS), anxiety disorders (AG), and autoimmune diseases (AI) and healthy controls (HC) from a Romanian cohort, aiming to identify population-specific microbial patterns. Methods: This study included 59 Romanian adults categorized into IBS (n = 27), AG (n = 13), AI (n = 11), and HC (n = 8) groups. Gut microbiota profiles were analyzed using 16S rRNA gene sequencing (NGS), and fecal short-chain fatty acids were quantified by headspace gas chromatography–mass spectrometry. Results: At the phylum level, Actinobacteria showed significantly higher relative abundance in HC compared to both the AI (adjusted p = 0.028) and the AG (adjusted p = 0.023) groups, with the AG–HC difference confirmed by LinDA analysis (FDR-adjusted p = 0.049). At the genus level, Bifidobacterium spp. was significantly lower in the AG compared to HC (adjusted p = 0.036), while Bacteroides spp. showed higher abundance in the AG compared to AI (adjusted p = 0.013), a finding supported by Kruskal–Wallis analysis. Lactate production was significantly lower in both the AI (p = 0.014) and AG (p = 0.038) compared to HC. The Simpson index revealed significantly lower microbial evenness in the AG compared to IBS and AI (FDR-adjusted p = 0.042). Beta diversity analysis identified significant differences in community composition between groups (PERMANOVA: Pseudo-F = 2.395, R² = 0.116, p = 0.039), with the most distinct separation between AI and AG (FDR-adjusted p = 0.048). Spearman correlation analysis revealed strong positive associations between Bifidobacterium and lactate, Bacteroides and the acetate/propionate ratio, and Actinobacteria and lactate (all FDR-adjusted p < 0.001). Conclusions: The present study provides exploratory evidence of disease-associated microbial and functional patterns in a Romanian cohort, with reduced Actinobacteria in the anxiety group as the most robust observation, suggesting a potential role of the gut microbiota in gut–brain–immune interactions and contributing preliminary population-specific data from an underrepresented Eastern European population.