Relevance of gastrointestinal manifestations in a large Spanish cohort of patients with systemic lupus erythematosus: what do we know?

Segura, Beatriz Tejera; González, Irene Altabás; Rúa-Figueroa, Íñigo; Veiga, Natalia Pérez; Pérez, Victor Del Campo; Olivé-Marques, Alejandro; Galindo, María; Calvo, J.; Ovalles-Bonilla, J.G.; Fernández‐Nebro, Antonio; Menor‐Almagro, Raúl; Tomero, Eva; Amo, Natividad del Val del; Isacelaya, Esther Uriarte; Martínez‐Taboada, Víctor M.; Andreu, José Luís; Boteanu, Alina; Narváez, Javier; Movasat, A.; Montilla, Carlos; Gallego, José; Hernández‐Cruz, Blanca; Andrés, Mariano; Salgado, Eva; Freire, Mercedes; García, Sergio Machín; Moriano, C.; Expósito, Lorena; Velásquez, Clara Pérez; Velloso-Feijoó, María Luisa; Cacheda, Ana Paula; Lozano-Rivas, Nuria; Bonilla, Gema; Arévalo, M.; Jiménez, Inmaculada; Quevedo-Vila, Víctor; Manero-Ruiz, Francisco J; Lefebvre, Paloma García de la Peña; Vázquez-Rodríguez, Tomás R.; Ibañez-Rua, Jesús; Cobo‐Ibáñez, Tatiana; Pego-Reigosa, José María

doi:10.1093/rheumatology/keab401

Cited by 6 publications

(3 citation statements)

References 32 publications

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“…Regarding GI manifestations associated with SLE and damage accrual, a recent Spanish retrospective cohort study of 3658 SLE patients found that 3.7% developed GI damage. 15 This low prevalence is consistent with the findings of previous cohort studies. 16 , 17 Furthermore, they observed that GI damage is associated with poorer prognosis and clinical involvement of other target organs in SLE, such as vasculitis, renal disease, and serositis.…”

Section: Introductionsupporting

confidence: 92%

Gastrointestinal Manifestations in Patients with Systemic Lupus Erythematosus

Alharbi¹

2022

OARRR

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Systemic lupus erythematosus (SLE) is an autoimmune disorder of unknown etiology. Women of childbearing age are affected approximately nine times more often than men. Its presentation and course are highly variable, ranging from mild to fulminant systemic disease. Any organ can be affected by SLE. Although less common than in other systems, such as the skin, joints, and kidneys, 40%–60% of SLE patients have gastrointestinal (GI) involvement. SLE can affect any part of the GI tract, from the mouth to the anus. GI manifestations can be caused by SLE, medication-related side effects, or non-SLE causes including infection. This article reviews the most common types of GI involvement associated with SLE.

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Section: Introductionsupporting

confidence: 92%

Gastrointestinal Manifestations in Patients with Systemic Lupus Erythematosus

Alharbi¹

2022

OARRR

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“…The gastrointestinal symptoms were reported to occur in >50% of SLE patients, and lupus enteritis was possibly identified as an initial manifestation in SLE ( 37 , 38 ). The histological examination showed that both probiotics restored the colonic histomorphology to a certain extent ( Fig.…”

Section: Resultsmentioning

confidence: 99%

Akkermansia muciniphila and Lactobacillus plantarum ameliorate systemic lupus erythematosus by possibly regulating immune response and remodeling gut microbiota

Guo

Chen

et al. 2023

mSphere

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Systemic lupus erythematosus (SLE), characterized by persistent inflammation, is a complex autoimmune disorder that affects all organs, challenging clinical treatment. Dysbiosis of gut microbiota promotes autoimmune disorders that damage extraintestinal organs. Modulating the gut microbiome is proposed as a promising approach for fine-running parts of the immune system, relieving systematic inflammation in multiple diseases. This study demonstrated that the administration of Akkermansia muciniphila and Lactobacillus plantarum contributed to an anti-inflammatory environment by decreasing IL-6 and IL-17 and increasing IL-10 levels in the circulation. The treatment of A. muciniphila and L. plantarum restored the intestinal barrier integrity to a different extent. In addition, both strains reduced the deposit of IgG in the kidney and improved renal function significantly. Further studies revealed distinct remodeling roles of A. muciniphila and L. plantarum administration on the gut microbiome. This work demonstrated essential mechanisms of how A. muciniphila and L. plantarum remodel gut microbiota and regulate the immune responses in the SLE mice model. IMPORTANCE Several pieces of research have demonstrated that certain probiotic strains contribute to regulating excessive inflammation and restoring tolerances in the SLE animal model. More animal trials combined with clinical studies are urgently needed to further elucidate the mechanisms for the effect of specific probiotic bacteria in preventing SLE symptoms and developing novel therapeutic targets. In this study, we explored the role of A. muciniphila and L . plantarum in ameliorating the SLE disease activity. Both A. muciniphila and L. plantarum treatment relieved the systemic inflammation and improved renal function in the SLE mouse model. We demonstrated that A. muciniphila and L. plantarum contributed to an anti-inflammatory environment by regulating cytokine levels in the circulation, restoring the intestinal barrier integrity, and remodeling the gut microbiome, however, to a different extent.

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“…94 Meta-regression analyses of the association between CD prevalence in patients with SLE and publication year (p=0.58), study population size (p=0.26), prevalence of CD in the general population (p=0.78), proportion of females (p=0.66) and quality assessment score (p=0. 84) showed no significant associations (online supplemental figure S4A-E). We found no significant publication bias in the funnel plot (figure 2) and Egger's test (p=0.25).…”

Section: Prevalence Of CD In Slementioning

confidence: 95%

Prevalence of coeliac disease in patients with systemic lupus erythematosus: a systematic review and meta-analysis

Sotoodeh,

Nguyen Hoang,

Hellgren

et al. 2024

Lupus Sci Med

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BackgroundThere is some evidence of a higher prevalence of coeliac disease (CD) among patients with SLE than in the general population. However, the prevalence estimates vary substantially.ObjectiveTo investigate the prevalence of CD among patients with SLE through systematic review and meta-analysis.MethodsWe performed searches in the databases of Medline, Embase, Cochrane and Web of Science Core Collection between 1 January 1990 and 9 July 2023. A total of 2053 publications were rendered in the searches, of which 68 were reviewed in full text and 14 included in the analyses. Primary analysis estimated the pooled prevalence of biopsy-verified CD in patients with SLE. In the secondary analysis, the prevalence of serological markers indicative of CD was investigated. The quality of studies was appraised using the Joanna Briggs Institute Critical Appraisal Tool. We conducted meta-regression analyses to investigate associations between the prevalence of CD in individuals with SLE and publication year, study population size, CD prevalence in the general population, proportion of females and quality assessment score.ResultsA total of 14 studies met the inclusion criteria, of which 11 were included in the primary analysis of biopsy-verified CD. Among 1238 patients with SLE, 14 had CD. The weighted pooled prevalence of CD was 0.7% (95% CI 0.0 to 1.8). The weighted pooled prevalence of CD serological markers in 1063 patients with SLE was 3.7% (95% CI 1.4 to 6.7). In meta-regression analyses, no associations between CD prevalence and study characteristics, demographics and quality assessment scores were found.ConclusionsIn this meta-analysis, we found a weighted pooled prevalence of biopsy-verified CD in patients with SLE comparable with the prevalence in the general population. Our findings do not support routine screening for CD in patients with SLE. However, individual screening could be considered in cases of clinical suspicion and additional risk factors for CD.PROSPERO registration numberCRD42022339594.

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Relevance of gastrointestinal manifestations in a large Spanish cohort of patients with systemic lupus erythematosus: what do we know?

Cited by 6 publications

References 32 publications

Gastrointestinal Manifestations in Patients with Systemic Lupus Erythematosus

Gastrointestinal Manifestations in Patients with Systemic Lupus Erythematosus

Akkermansia muciniphila and Lactobacillus plantarum ameliorate systemic lupus erythematosus by possibly regulating immune response and remodeling gut microbiota

Prevalence of coeliac disease in patients with systemic lupus erythematosus: a systematic review and meta-analysis

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