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. 2023 Oct 23;6(10):e1640.
doi: 10.1002/hsr2.1640. eCollection 2023 Oct.

Probiotics as a complementary treatment in systemic lupus erythematosus: A systematic review

Zahra Mirfeizi  1 , Mahmoud Mahmoudi  2   3 , Arezoo Faridzadeh  2   3
Affiliations

Probiotics as a complementary treatment in systemic lupus erythematosus: A systematic review

Zahra Mirfeizi et al. Health Sci Rep. .

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that primarily affects young women. SLE has no recognized etiology but it is believed to be triggered by a number of factors, including genetic predisposition, hormonal influences, and environmental conditions. Dysbiosis in the gut microbiota has emerged as a potential mechanism connecting the intestinal microbiome to the breakdown of self-tolerance and chronic inflammation. This review aims to investigate the role of probiotics in modulating the gut microbiome and their potential therapeutic benefits in managing SLE, providing insights for future research and clinical practice.

Methods: We conducted a thorough search for papers published up to June 2023 in databases such as PubMed/MEDLINE, Web of Science, Scopus, and Cochrane Library.

Results: The systematic review identified 22 articles examining the effects of probiotics on SLE. These studies-which include in vivo tests, in vitro research, and clinical trials-indicate that probiotics may be effective against inflammation, and improve immunological responses and metabolic profiles in SLE patients. Most in vivo studies were assessed as medium to high quality, while the randomized controlled trial was deemed of high quality.

Conclusion: According to the findings of our systematic review, probiotics may be used in conjunction with other treatments to manage SLE. Nonetheless, current data is limited, and more randomized controlled trials would be required to fully examine their effectiveness.

Keywords: prebiotics; probiotic; synbiotic; systematic review; systemic lupus erythematosus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of study selection for inclusion in the systematic review.
Figure 2
Figure 2
Overview of the effects of probiotics in various studies of SLE disease. ANA, antinuclear antibody; B.bi, Bifidobacterium bifidum; B.br, Bifidobacterium breve; B.f, Bacteroides fragilis; B.i, Bifidobacterium infantis; CCR, C chemokine receptor; Cu/Zn‐SOD, copper/zinc superoxide dismutase; CXCR, C‐X‐C chemokine receptor; dsDNA, double‐stranded deoxyribonucleic acid; Enos, Endothelial nitric oxide synthase; IDO, Indoleamine 2,3‐dioxygenase; IFN‐γ, interferon γ; IL, interleukin; IκB‐α, inhibitor of NF‐Κb; L.ac, Lactobacillus acidophilus; L.an, Lactobacillus animalis; L.c, Lactobacillus casei; L.d, Lactobacillus delbrueckii; L.d, Lactobacillus delbrueickii; L.g, Lactobacillus gasseri; L.h, Lactobacillus helveticus; L.j, Lactobacillus johnsonii; L.o, Lactobacillus oris; L.pa, Lactobacillus paracasei; L.pl, Lactobacillus plantarum; L.re, Lactobacillus reuteri; L.rh, Lactobacillus rhamnosus; miR, microRNA; Mn‐SOD, manganese superoxide dismutase; NADPH, nicotinamide adenine dinucleotide phosphate; NF‐Κb, nuclear factor kappa‐B; RNP, ribonucleoprotein; SLE, Systemic lupus erythematosus; TGF, Transforming growth factor; Th, T helper cell; TLR, toll like receptors; TNF‐α, tumor necrosis factor alpha; Treg, T regulatory; VEGF, vascular endothelial growth factor.
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