The Microbiota in Systemic Lupus Erythematosus: An Update on the Potential Function of Probiotics

Abstract

Systemic lupus erythematosus (SLE) is a kind of chronic diffuse connective tissue illness characterized by multisystem and multiorgan involvement, repeated recurrence and remission, and the presence of a large pool of autoantibodies in the body. Although the exact cause of SLE is not thoroughly revealed, accumulating evidence has manifested that intake of probiotics alters the composition of the gut microbiome, regulating the immunomodulatory and inflammatory response, which may be linked to the disease pathogenesis. Particularly, documented experiments demonstrated that SLE patients have remarkable changes in gut microbiota compared to healthy controls, indicating that the alteration of microbiota may be implicated in different phases of SLE. In this review, the alteration of microbiota in the development of SLE is summarized, and the mechanism of intestinal microbiota on the progression of immune and inflammatory responses in SLE is also discussed. Due to limited reports on the effects of probiotics supplementation in SLE patients, we emphasize advancements made in the last few years on the function and mechanisms of probiotics in the development of SLE animal models. Besides, we follow through literature to survey whether probiotics supplements can be an adjuvant therapy for comprehensive treatment of SLE. Research has indicated that intake of probiotics alters the composition of the gut microbiome, contributing to prevent the progression of SLE. Adjustment of the gut microbiome through probiotics supplementation seems to alleviate SLE symptoms and their cardiovascular and renal complications in animal models, marking this treatment as a potentially novel approach.

Gut Microbiota From Sjögren syndrome Patients Causes Decreased T Regulatory Cells in the Lymphoid Organs and Desiccation-Induced Corneal Barrier Disruption in Mice

“…In agreement with previously published results using 16S sequencing ( 10 , 13 ), we observed a decrease in the diversity of SS patient gut microbiota relative to healthy controls that correlates with ocular disease severity. Decreased microbial gut diversity has been observed in other autoimmune diseases including systemic lupus erythematosus (SLE) and rheumatoid arthritis ( 43 – 45 ). We observed that the decrease in diversity is accompanied by shifts in the composition of the community, with depletion of specific microbes that may be protective of the ocular surface, including several Bacteroides species.…”

The Role of the Microbiome in Connective-Tissue-Associated Interstitial Lung Disease and Pulmonary Vasculitis

“…Some probiotics, such as Lactobacillus , can restore dysbiosis and enhance intestinal barrier function and alleviate SLE symptoms. Data supports that probiotics may restore the abnormal T cell subsets, particularly the abnormal levels of naïve CD4+T, γδT, Tfh, Treg, and Th17 cells seen in SLE [ 74 ]. In a recent meta-analysis, probiotics reduced inflammation in patients with RA, measured with C-reactive protein levels [ 75 ].…”

Association of Clinical Manifestations of Systemic Lupus Erythematosus and Complementary Therapy Use in Taiwanese Female Patients: A Cross-Sectional Study

“…Animal studies have shown that probiotics could modify various immune parameters, such as the innate immune response of macrophages and dendritic cells [ 35 ], and the cell wall structure of probiotic Lactobacillus casei could potently induce IL-12 production [ 36 ]. In contrast, animal studies suggested that intake of Lactobacillus casei Shirota could alleviate SLE symptoms and their cardiovascular and renal complications [ 37 ]. More research is required to establish the safety and efficacy of probiotics for the prevention and treatment of photosensitivity in patients with SLE.…”