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Gut Microbiota in Lupus: a Butterfly Effect?

  • Systemic Lupus Erythematosus (G Tsokos, Section Editor)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease that typically displays chronic inflammatory tissue damage and miscellaneous circulatory autoantibodies, as well as distinctive type 1 interferon signatures. The etiology of SLE is unclear and currently is attributed to genetic predisposition and environmental triggers. Gut microbiota has recently been considered a critical environmental pathogenic factor in immune-related disorders, and studies are ongoing to uncover the key pathogens and the imputative mechanisms. Fundamental advancements on the role of the microbiota in SLE pathology have been achieved in recent years and are summarized in this review.

Recent Findings

Recent findings suggested that gut commensals could propagate autoimmunity via molecular mimicry in which ortholog-carrying microbes cross-activate autoreactive T/B cells and trigger the response against host autoantigens, or via bystander activation by stimulating antigen-presenting cells that present autoantigens and enhancing the expression of co-stimulatory molecules and cytokines, thus leading to the loss of self-tolerance and the production of autoantibodies. Additionally, the break of gut barrier and the translocation of gut commensals to inner organs can trigger immune dysregulation and inappropriate systemic inflammation. All these microbiota-mediated mechanisms could contribute to lupus immunopathogenesis and promote disease development in susceptible individuals.

Summary

Evidence of the causative role of disturbed gut microbiome in SLE is still limited, and the related molecular mechanisms and pathways are largely elusive. However, the modification of gut microbiota, such as pathobiont vaccine, special diet, restricted consortium transplantation, as well as regulatory metabolites supplementation, might be promising strategies for lupus prophylaxis and treatment.

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Funding

This study was supported by grants from the National Natural Science Foundation of China (81788101, 81630044, 81771763, 82071840), Chinese Academy of Medical Science Innovation Fund for Medical Sciences (CIFMS2017-12M-1-008, 2016-12M-1-003, 2017-I2M-3-011, 2016-12M-1-008, 2020-12M-C&T-B-013), Beijing Capital Health Development Fund (2020-2-4019), and Grant from Medical Epigenetics Research Center, Chinese Academy of Medical Sciences (2017PT31035).

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  1. Rongli Li and Xia Meng contributed equally to this work.

Authors and Affiliations

  1. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, The Ministry of Education Key Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuai-Fu-Yuan, Dong-Cheng District, Beijing, 100730, China

    Rongli Li, Xia Meng, Beidi Chen, Lidan Zhao & Xuan Zhang

  2. National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID); State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), 41 Damucang Hutong, Xicheng District, Beijing, 100730, China

    Lidan Zhao

  3. Clinical Immunology Centre, Medical Epigenetics Research Centre, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuai-Fu-Yuan, Dong-Cheng District, Beijing, 100730, China

    Xuan Zhang

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Li, R., Meng, X., Chen, B. et al. Gut Microbiota in Lupus: a Butterfly Effect?. Curr Rheumatol Rep 23, 27 (2021). https://doi.org/10.1007/s11926-021-00986-z

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