The Role of Diet in Influencing the Diversity of Gut Microbiome Related to Lupus Disease Activities: A Systematic Review

Abstract

Gut microbiome dysbiosis can affect the host immune system. The balance and activity of the gut microbiome, which are influenced by daily diet, might be associated with disease activity in systemic lupus erythematosus (SLE). Therefore, we conducted a systematic review based on the PRISMA guideline to explore the role and types of diet that affects the gut microbiome related to changes in SLE disease activity. All original and full-text English articles in the last ten years were included using predefined keywords according to PEO (population, exposure, and outcome) design in PubMed. The study subjects were carefully analyzed, including lupus-susceptible mice and humans with SLE on various diets. Children and pregnant women populations were excluded. Of 134 studies found, only seven full-text articles had met the inclusion criteria of which only one study conducted in human. This human study showed that dietary polyphenol as dihydrochalcones and flavanones affected the gut microbiome and ameliorated lupus disease activity. On the contrary, dietary flavones increased Blautia (family: Lachnospiraceae), and that often found in active lupus diseases. Furthermore, six studies in lupus-prone mice models showed that resistant starch (RS), retinoic acid (RA) or all-trans retinoic acid (tRA), and acidic water (AW) had influenced the gut microbiome, leading to an improved lupus development. Conversely, the 2018 commercial rodent diet, vitamin A-retinoic acid (VARA), neutral water (NW), and high tryptophan diet had impacted various microbiomes, resulting in increased lupus activity. Interestingly, several diets have the effect of either increasing or decreasing lupus disease activity depending on the microbiome they affect, such as AW associated with Turicibacter spp., which is frequently found in active lupus disease, and tRA in Bacteroidetes associated with renal pathology. To conclude, diet can influence the gut microbiome, which is related to the disease activity process of SLE.

The Disease with a Thousand Faces and the Human Microbiome—A Physiopathogenic Intercorrelation in Pediatric Practice

“…In agreement with them, Clancy RM. et al underline the importance of mimicry (cross-reaction to microbial peptides from the oral or intestinal flora) in defining the microbiome-autoimmunity relationship, which seems to modulate the transition from latent disease to severe clinical damage among mothers who give birth to children with neonatal lupus [19][20][21][22].…”

A Scoping Review of the Positive and Negative Bacteria Associated With the Gut Microbiomes of Systemic Lupus Erythematosus Patients

“…This is further supported by the evidence that topical hydrocortisone butyrate is used to treat cutaneous lupus erythematosus, indicating the re-addition of butyrate to the body may be useful in the therapeutic management of dermatomal manifestations [30]. The second mechanism of disease, involving Lachnospiraceae, may impair lipid and glucose metabolism, which could contribute to inflammation [31]. As support, elevated levels of Lachnospiraceae are seen in early onset type 1 diabetes and may be related to type 2 diabetes as well [31].…”

“…The second mechanism of disease, involving Lachnospiraceae, may impair lipid and glucose metabolism, which could contribute to inflammation [31]. As support, elevated levels of Lachnospiraceae are seen in early onset type 1 diabetes and may be related to type 2 diabetes as well [31]. Likewise, there may be a pro-inflammatory effect of Lachnospiraceae in SLE.…”

Microbial dysbiosis in systemic lupus erythematosus: a scientometric study

“…Incorporating a moderate intake of protein, along with supplementation of vitamins, minerals, polyunsaturated fatty acids (PUFAs), and plant estrogens, can aid in improving patients’ immune function, regulating systemic inflammation, and reducing disease activity. These dietary interventions have the potential to slow down the progression of SLE ( Vieira et al, 2014 ; Putri et al, 2022 ).…”