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Systemic lupus erythematosus and the gut microbiome: To look forward is to look within – A systematic review and narrative synthesis

2025-08-26Artigo científico Acesso aberto
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dc.contributor.authorOliveira, Daniel Guimarães
dc.contributor.authorMachado, Alexandra
dc.contributor.authorCastro, Pedro Lacerda
dc.contributor.authorKarakikla-Mitsakou, Zoe
dc.contributor.authorVasconcelos, Carlos
dc.date.accessioned2026-01-23T11:35:24Z
dc.date.available2026-01-23T11:35:24Z
dc.date.issued2025-08-26
dc.description.abstractBackground: Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease shaped by complex interactions involving genetic and environmental factors. Among these, the gut microbiome is emerging as potentially modulating immune responses and influencing disease susceptibility, progression, and activity. Objectives: To synthesize current evidence on gut microbiome changes in adult SLE patients, framed along the clinical pathway – from diagnosis to treatment – to help bridge bench and bedside for microbiome-informed SLE care and research. Methods: A systematic search identified primary research studies examining gut microbiota in adult SLE patients. Studies were reviewed in a stepwise manner by independent investigators. Findings were synthesized narratively, emphasizing human data. Results: SLE patients exhibit gut microbiome dysbiosis, with reduced microbial richness and altered bacterial taxa. A lower Firmicutes/Bacteroidetes ratio is frequently observed. Enrichment of specific taxa, such as Enterococcus, Lactobacillus, and Ruminococcus gnavus, is reported. Dysbiosis correlates with increased gut permeability, immune activation, and autoreactivity. Clinical associations include disease activity, flares, nephritis, and other manifestations. SLE treatments, such as hydroxychloroquine and corticosteroids, influence the microbiome. Emerging interventions such as dietary modulation and fecal microbiota transplantation show promise in early studies. However, considerable heterogeneity exists across studies in terms of patient characteristics, methodology, and taxa-level findings. Conclusions: The gut microbiome has multifaceted associations with SLE pathogenesis, disease activity, and therapeutic response. Translation will require standardized methods, functional validation, longitudinal followup, and clinical integration. While uncertainties remain, the gut microbiome is increasingly relevant, and clinicians caring for patients with SLE should be aware of its emerging implications.eng
dc.description.abstractHighlights: - Recent findings highlight gut microbiome alterations in adult SLE patients. - Gut microbiome dysbiosis is linked to SLE pathogenesis and disease activity. - Microbial shifts in SLE may serve as biomarkers - for diagnosis, disease activity and compliance. - Microbiome-targeted strategies, including fecal transplant, may aid SLE treatment.eng
dc.description.sponsorshipThis work was supported by a PhD grant by FCT – Fundação para a Ciência e Tecnologia to DGO (UI/BD/150742/2020) and UMIB (UIDB/00215/2020; UIDP/00215/2020; LA/P/0064/2020) and Bolsa de Doutoramento (PhD grant) Nuno Grande (2022) by Instituto de Ciências Abel Salazar, Universidade do Porto e Fundação Bial to DGO.
dc.identifier.citationAutoimmun Rev. 2025 Dec 18;24(12):103921. doi: 10.1016/j.autrev.2025.103921. Epub 2025 Aug 26
dc.identifier.doi10.1016/j.autrev.2025.103921
dc.identifier.eissn1873-0183
dc.identifier.issn1568-9972
dc.identifier.pmid40876561
dc.identifier.urihttp://hdl.handle.net/10400.18/10753
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relationUnit for Multidisciplinary Research in Biomedicine
dc.relationUnit for Multidisciplinary Research in Biomedicine
dc.relationLaboratory for Integrative and Translational Research in Population Health
dc.relationUI/BD/150742/2020
dc.relation.hasversionhttps://www.sciencedirect.com/science/article/pii/S156899722500182X?via%3Dihub
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectSystemic Lupus Erythematosus
dc.subjectGut Microbiome
dc.subjectDysbiosis
dc.subjectFecal Microbiota Transplantation
dc.subjectDoenças Genéticas
dc.subjectGenética Humana
dc.titleSystemic lupus erythematosus and the gut microbiome: To look forward is to look within – A systematic review and narrative synthesiseng
dc.typejournal article
dcterms.referenceshttps://ars.els-cdn.com/content/image/1-s2.0-S156899722500182X-mmc1.docx
dspace.entity.typePublication
oaire.awardTitleUnit for Multidisciplinary Research in Biomedicine
oaire.awardTitleUnit for Multidisciplinary Research in Biomedicine
oaire.awardTitleLaboratory for Integrative and Translational Research in Population Health
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDB%2F00215%2F2020/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDP%2F00215%2F2020/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/LA%2FP%2F0064%2F2020/PT
oaire.citation.issue12
oaire.citation.startPage103921
oaire.citation.titleAutoimmunity Reviews
oaire.citation.volume24
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStream6817 - DCRRNI ID
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
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project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
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