Gut microbiota in systemic lupus erythematosus pathogenesis: an in-depth view of mechanisms inside

Abstract

Systemic lupus erythematosus (SLE), an autoimmune disease that is known to be prototypic, brings systemic influence via abnormal production of autoantibodies targeting nuclear acid, possesses highly sophisticated pathogenesis related to genetic and environmental factors. In current studies, gut microbiota draws increasing attention from researchers as it is considered to trigger local and systemic immune responses. Researchers have detected a wide range of alterations happen in SLE cases and revealed a series of potential mechanisms of how microbiome and metabolites are involved in the development and progression of SLE: translocation of pathobionts out of their normal niches; molecular mimicry inducing cross-activity to initiate autoimmune response; and epitope spreading to widen the target of autoantibodies. Based on the understanding of the microenvironment, treatments aiming at adjusting gut microbiota are proposed, including but not limited to the usage of probiotics or prebiotics, narrow-spectrum antibiotics or phages, dietary management and faecal microbiota transplantation. In this article, research progress showing the connection of gut microbiome with SLE and potential mechanisms as well as suggesting more efficient therapeutic strategies for SLE are reviewed. Although more detailed pathogenesis mechanisms and theories of treatments remain unclear while integration of courses along with advanced techniques are required to reveal the complicated connection shown in clinical trials, research in this territory still shows a promising prospect.