There is 30 years of contradictory research on the association of the disease with the bacteria Klebsiella pneumoniae. So far, it has come to nothing.
This is a strain of bacteria that can also cause rheumatic fever, which has an autoimmune component; it's capable of molecular mimicry, which causes the body to develop antibodies against itself. So the thinking goes that many strep bacteria can linger in the body and cause autoimmunity.
The idea behind the streptococcal hypothesis is that you have a sub-clinical infection. There's a lot of uncertainty about whether strep bacteria merely act as a trigger — confusing the immune system into developing autoimmunity, but then disappearing — or whether bacteria remain in the body, hiding in places like the tonsils and in biofilms and periodically coming out to reinfect the host.
About molecular mimicry, Helgi Valdimarsson and his colleagues at the university of Reykjavik has written several papers [1] [2]. The same team has also experimented with whether a tonsillectomy can improve psoriasis, something we actually have a lot of evidence for [3]. The biofilm hypothesis has some clinical evidence (e.g. [4]).
Regarding things your mom can do that's actually supported by studies:
* A recent study on the probiotic Streptococcus salivarius K12 against S. pyogenes saw incredible (many too incredible) results [5].
* We have some support for other probiotics [6].
* There's decent evidence that large doses (10K–30K IU daily) of vitamin D2 and D3 may help psoriasis [7]. Psoriatics are, pretty consistently, vitamin D-deficient. It's very hard to achieve hypervitaminosis, but it's a good idea to monitor your serum levels while doing this. It's important to take vitamin K2 to increase bioavailability and avoid bone loss.
* Psoriasis severity is linked to being overweight, to alcohol consumption, and to smoking.
* There's anecdotal evidence that a radical diet change can significantly improve psoriasis; for example, going vegetarian. I don't have any proof, however.
[1] https://pubmed.ncbi.nlm.nih.gov/19781993/
[2] https://pubmed.ncbi.nlm.nih.gov/15373909/
[3] https://pubmed.ncbi.nlm.nih.gov/22491250/
[4] https://www.walshmedicalmedia.com/open-access/psoriasis-a-se...
[5] https://www.researchgate.net/publication/359856583_Improveme...
[6] https://www.medicaljournals.se/acta/content/html/10.2340/000...
Big grain of salt, of course. Thankfully even if we can't pinpoint its exact etiology we still have a million proven drugs to throw at this thing.
The specialists can’t concur with their own conclusions, let alone the conclusions of others. Diagnosis changes every few years. It’s a confusing situation for the patient and their family.
One treatment that is used for a specific condition might have harmful - even carcinogenic -side effects. It’s difficult
I mainly mention this because I was terrified of starting Humira when I got diagnosed with AS years ago—those black box warnings are legit scary. But I had to weigh the risk of maybe developing a rare side effect versus the guarantee of my spine permanently fusing and my immune system burning everything else to the ground out of spite, and ultimately went for the Humira. And I'm glad I did, because my quality of life has improved massively.
Which is all to say that I hope your sibling's doing okay and found a treatment that works for them. It's scary out here, but there's hope, I promise.
For what it's worth, though, many people don't develop resistance, or at least not for a loooong time. My gastro told me one patient of his has been on Remicade for 15+ years and it's put them in happy remission the whole time.
Not everyone's a success story, but the success stories are very very good.
Yes, but I have also seen people who used biologics for 10 years without issue, and out of the blue they started to have severe side effects that made them move drop off (or move to another one). You just never know.
I read somewhere that a startup was working on controlling Immune system response via some brain waves. I have never rooted so strong for any startup as I am rooting for them.