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.
Highlights
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, where a large pool of autoantibodies are produced, causing the immune system to attack its tissues, resulting in damage to multiple organs and systems throughout the body (Mu et al, 2015; Yacoub et al, 2018)
GMNL 263(GMNL 263) showed a diverse mechanism in the NZB/W F1mouse model of SLE (Tzang et al, 2017). These probiotics strains can enhance the production of regulatory T cells (Treg) lymphocytes and the levels of transcription factor fork head box P3 (FoxP3), which is the hallmark of a natural Treg
GMNL-32 supplement attenuated left ventricular hypertrophy and the cardiac cell apoptosis in this genetic model of lupus (Hu et al, 2017; Tzang et al, 2017). These results indicated that oral supplement of several probiotic strains, such as GMNL32, L. reuteri GMNL-89, and L. reuteri GMNL263, to NZB/W F1 mice can mitigates hepatic inflammation and apoptosis caused by SLE, and presents a protective function on cardiac cells of lupus-prone mice (Hsu et al, 2017; Hu et al, 2017; Tzang et al, 2017)
Summary
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, where a large pool of autoantibodies are produced, causing the immune system to attack its tissues, resulting in damage to multiple organs and systems throughout the body (Mu et al, 2015; Yacoub et al, 2018). Its main clinical features are multiple systems and organs involvement, repeated relapse and remission, and the development of a large pool of autoantibodies against double-stranded (ds) DNA (Lisnevskaia et al, 2014; Durcan et al, 2019; Fava and Petri, 2019). Individuals affected by SLE have extensive symptoms and course of the disease, the most frequent of which are fever, fatigue, facial butterfly erythema, photosensitivity, muscle or joint pain, arthritis, and renal symptoms
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