Lupus and gut dysbiosis

Healthylife Pharmacy22 March 2022|3 min read

Lupus, also known as systemic lupus erythematosus (SLE), is a chronic autoimmune disease affecting many systems of the body. It is a disorder where the immune system produces immune proteins (antibodies) that mistakenly target certain body tissue and organs causing inflammation and damage. Areas most affected include skin, joints, heart, lungs, kidneys, brain and the circulatory system.

The immune system is normally able to distinguish between “self” and “non-self” (pathogenic microbes, pollens, dust for example).

While the reason some people develop SLE is not known, environmental factors are thought responsible for its development in those which are genetically predisposed - resulting in disruption of immune self-tolerance and activation. One of the aims of autoimmune disease research is to identify ways to reset the immune system and restore the state of tolerance.

Symptoms and signs of SLE

Symptoms can vary in intensity and include joint pain, fatigue, fever, chest pain, headache, dry eyes and rashes, making it hard to diagnose due to its similarity to other diseases. A butterfly shaped rash which occurs across the nose and cheeks can sometimes be an identifying feature of SLE, but does not present in all cases.

Symptoms of SLE are individual to the sufferer, with no two people experiencing the same. They can be mild or severe, come on slowly or appear suddenly. They are often characterized by triggers causing flare ups in which symptoms are worse for a while then reduce or disappear altogether.

SLE can affect many areas of the body

  • Arthritis and arthralgias (joint pain, stiffness and swelling).
  • Raynaud’s syndrome - affecting blood vessels and circulation to fingers and toes when exposed to cold and stress – indicated by digits turning white then blue.
  • Pleuritis and pericarditis (inflammation of the membranes lining the heart - causing pain).
  • Lung inflammation.
  • Light sensitivity.
  • Skin rashes and lesions often made worse by sun exposure.
  • Brain and central nervous system (vision changes, headaches, dizziness and changes to behaviour).
  • Blood and blood vessels (Haematologic cytopenia’s -a reduction in the number of mature blood cells, blood clotting, bleeding disorders and blood vessel inflammation.
  • Kidneys – causing serious damage.

Other complications include a susceptibility to infection, increased risk of cancer (small), bone tissue decline and complications in pregnancy.

Triggering factors

Triggering factors may include infection, medication and even sunlight. One area of research looks at gut dysbiosis as a role in the exacerbation of symptoms or possible causative factor.

Gut dysbiosis is characterized as a disruption in the normal microbiology of the bowel caused by an imbalance of microflora which results in changes to the bowel and its function. This imbalance can have an affect on skin flora, vaginal flora as well as bowel flora which see an under representation of normal species and other species filling the void. Normal species are known as beneficial bacteria and aid the body with digestion and protection. When the normal homeostasis is interrupted the effect on the bowel can result in a condition known as gut permeability or leaky gut.

What causes changes to gut flora?

  • Diet. Increases in sugar, protein, processed foods, food additives, pesticides on foods (unwashed fruits and vegetables), caffeine (coffee, most teas, cocoa, cola and guarana) and excessive alcohol consumption are considered common causes.
  • Poor dental hygiene which results in gingivitis (an over population of pathogenic oral bacteria).
  • Antibiotics which can cause a disruption to the balance of normal bacteria.
  • Poor immune function.
  • Stress and anxiety.

The gut connection to SLE

Many diseases are associated with inflammation and dysregulated immunity due to gut dysbiosis.

Probiotics intake has been shown to alter the composition of gut microbiota, helping with the regulation of the immune system and down-regulating inflammatory responses. Documented research has shown people suffering with SLE have a gut microbiome which is altered in composition to that of healthy people (in experimental models), suggesting the microbiota is involved in various stages of SLE (1)

Probiotic as an adjuvant therapy

Probiotics are “commensal or non-pathogenic microbes that colonize the gastrointestinal tract and confer beneficial effects on the host through several mechanisms”. Excluding other pathogens from taking up residence, offering an anti-bacterial action against pathogenic bacteria and modulating immune responses are some of the benefits offered by these “good’ microbes. Lactobacillus can restore dysbiosis and enhance intestinal barrier function.

What some studies have revealed

Restoring tolerance and reducing inflammation. Experimental and clinical trials showed B.bifidum LMG13195, Ruminococcus obeum DSM25238, Blautia coccoides DSM935, L. casei Shirota, and Synergistetes ameliorated inflammation and restored tolerance in SLE models and patients (2).

Decreased intestinal permeability and improve kidney function. Adding lactobacillus to the diets of mice with SLE induced kidney inflammation significantly decreased intestinal permeability which led to an improvement in kidney function. Previous studies had revealed a decrease in the number of lactobacilli in the gut of mice with SLE (3).

Disease flares associated with bacteria imbalances and intestinal permeability. Research has suggested bacterial imbalances in some patients with lupus may be responsible for disease flares, and point to leakages of bacteria from the gut as a possible immune system trigger of the disease (4).

Reducing dysbiosis and improving gut barrier function may be helped by application of beneficial bacteria, such as L. fermentum. Research indicates this may also help with preventing associated vascular complications in people with SLE (5).

Whilst studies are limited on the use of probiotics for SLE patients, investigations on other autoimmune diseases have shown a beneficial action on inflammatory and autoimmune conditions.

Probiotic strains which may help with autoimmune and inflammatory conditions

Probiotic strains offering an immunoregulatory effect

  • B. longum BB536
  • L. rhamnosus GG

L rhamnosus offers protective immunological effects

Probiotics which offer an anti-inflammatory action

  • L. salivarius Ls33
  • L. plantarum
  • L. acidophilus
  • L. reuteri strain
  • L. casei strain NIZO B255
  • L. rhamnosus strain JB-1
  • B. breve yakult strain
  • B. lactis
  • B. longum
  • L. paracasei
  • L. plantarum

Whilst lupus is a disease of unknown origin and with no known cure, research is indicating the application of probiotics may be beneficial in preventing disease progression and is generally considered a safe adjuvant therapy.

References

  1. https://www.msdmanuals.com/en-au/professional/musculoskeletal-and-connective-tissue-disorders/autoimmune-rheumatic-disorders/systemic-lupus-erythematosus-sle?query=lupus%20erythematosus
  2. https://www.mayoclinic.org/diseases-conditions/lupus/symptoms-causes/syc-20365789
  3. Autoreactive T-Lymphocytes in Inflammatory Skin Diseases Autoreactive T-Lymphocytes in Inflammatory Skin Diseases - PubMed (nih.gov)
  4. (1) The Microbiota in Systemic Lupus Erythematosus: An Update on the Potential Function of Probiotics https://www.frontiersin.org/articles/10.3389/fphar.2021.759095/full
  5. (2) https://www.researchgate.net/profile/Seyed-Alireza-Esmaeili/publication/311780528_Tolerogenic_Probiotics_Potential_Immunoregulators_in_Systemic_Lupus_Erythematosu/links/5afdd5070f7e9b98e0e599db/Tolerogenic-Probiotics-Potential-Immunoregulators-in-Systemic-Lupus-Erythematosu.pdf
  6. (3) Control of lupus nephritis by changes of gut microbiota https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-017-0300-8
  7. (4) Lupus strongly linked to imbalances in gut microbiome https://www.eurekalert.org/news-releases/565184
  8. (5) Lactobacillus fermentum CECT5716: a novel alternative for the prevention of vascular disorders in a mouse model of systemic lupus erythematosus https://pubmed.ncbi.nlm.nih.gov/31173526/
  9. Dysbiosis - Wikipedia
  10. Dysbiosis of the gut microbiota in disease Dysbiosis of the gut microbiota in disease (nih.gov)
  11. Current understanding of dysbiosis in disease in human and animal models Current understanding of dysbiosis in disease in human and animal models (nih.gov)
  12. Probiotics in Autoimmune and Inflammatory Disorders https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213508/
  13. Protective Effects of Probiotic Consumption in Cardiovascular Disease in Systemic Lupus Erythematosus https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893408/
Spread the word

This article is for informational purposes only and does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice. If you have any concerns or questions about your health you should consult with a health professional.