التفاصيل البيبلوغرافية
| العنوان: |
The gut microbiome in systemic lupus erythematosus: lessons from rheumatic fever. |
| المؤلفون: |
Silverman, Gregg J.1 (AUTHOR) gregg.silverman@nyulangone.org, Azzouz, Doua F.1 (AUTHOR), Gisch, Nicolas2 (AUTHOR), Amarnani, Abhimanyu1 (AUTHOR) |
| المصدر: |
Nature Reviews Rheumatology. Mar2024, Vol. 20 Issue 3, p143-157. 15p. |
| مصطلحات موضوعية: |
*SYSTEMIC lupus erythematosus, *RHEUMATIC fever, *AUTOIMMUNE diseases, *GUT microbiome, *MICROBIAL communities, *MICROBIAL metabolism, *IMMUNE system, *MOLECULAR mechanisms of immunosuppression, *B cells |
| مستخلص: |
For more than a century, certain bacterial infections that can breach the skin and mucosal barriers have been implicated as common triggers of autoimmune syndromes, especially post-infection autoimmune diseases that include rheumatic fever and post-streptococcal glomerulonephritis. However, only in the past few years has the importance of imbalances within our own commensal microbiota communities, and within the gut, in the absence of infection, in promoting autoimmune pathogenesis become fully appreciated. A diversity of species and mechanisms have been implicated, including disruption of the gut barrier. Emerging data suggest that expansions (or blooms) of pathobiont species are involved in autoimmune pathogenesis and stimulate clonal expansion of T cells and B cells that recognize microbial antigens. This Review discusses the relationship between the gut microbiome and the immune system, and the potential consequence of disrupting the community balance in terms of autoimmune development, focusing on systemic lupus erythematosus. Notably, inter-relationships between expansions of certain members within gut microbiota communities and concurrent autoimmune responses bear features reminiscent of classical post-infection autoimmune disease. From such insights, new therapeutic opportunities are being considered to restore the balance within microbiota communities or re-establishing the gut-barrier integrity to reinforce immune homeostasis in the host. This Review discusses the interplay of the gut microbiome and the immune system in the context of systemic lupus erythematosus. Dysbiosis and gut-barrier dysfunction are implicated in promoting disease and are potential therapeutic targets. Key points: Systemic lupus erythematosus (SLE) development involves many genetic and environmental factors, and emerging data implicate various gut pathobionts as inciting and exacerbating factors. Emerging data highlight parallels between autoimmune diseases such as SLE and post-streptococcal illnesses including rheumatic fever. Increased permeability of the gut barrier allows microbes and microbial metabolites to interact with host immune cells, subsequently driving pathological progression. Additional longitudinal studies will facilitate more in-depth elucidation of the inter-relationships between SLE and gut dysbiosis in individual patients. The impact of dietary factors, antibiotics and other exposures on microbial resilience and dysbiosis, and subsequent development or flares of autoimmune disease, are also important topics for future research. Modulating the gut microbiome of patients with SLE holds promise as a therapeutic intervention that could provide a more targeted and effective approach to treating the disease than broad immunosuppression. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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