Systemic lupus erythematosus (SLE), the embodiment of a multi-organ autoimmune disease, results from hyperactivation of host-defence pathways and immune recognition of the most fundamental building blocks of life. In 2018, key advances have placed intestinal immunity and dysregulated expansions of candidate pathobionts at the forefront of SLE pathogenesis.
Pathobiont translocation from the small intestine to the liver in lupus-prone mice, and in a subset of patients with systemic lupus erythematosus (SLE), might drive the expression of interferon-related genes and autoantibody production2.
Immune priming to primitive bacterial commensal orthologues of the ribonucleoprotein Ro60 results in both physiological autoimmunity and disease-associated autoimmunity in predisposed individuals4.
Patients with SLE had a restricted gut microbiota diversity of similar composition to patients with Sjögren syndrome; by contrast, the oral microbiota composition of these two patient groups differed substantially7.
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Bengtsson, A. A. & Ronnblom, L. Role of interferons in SLE. Best Pract. Res. Clin. Rheumatol. 31, 415–428 (2017).
Manfredo Vieira, S. et al. Translocation of a gut pathobiont drives autoimmunity in mice and humans. Science 359, 1156–1161 (2018).
Chen, Y. et al. Microbial symbionts regulate the primary Ig repertoire. J. Exp. Med. 215, 1397–1415 (2018).
Greiling, T. M. et al. Commensal orthologs of the human autoantigen Ro60 as triggers of autoimmunity in lupus. Sci. Transl Med. 10, eaan2306 (2018).
Rosenbaum, J. T. & Silverman, G. J. The microbiome and systemic lupus erythematosus. N. Engl. J. Med. 378, 2236–2237 (2018).
Morgan, X. C. et al. Dysfunction of the intestinal microbiome in inflammatory bowel disease and treatment. Genome Biol. 13, R79 (2012).
van der Meulen, T. A. et al. Shared gut, but distinct oral microbiota composition in primary Sjogren’s syndrome and systemic lupus erythematosus. J. Autoimmun. https://doi.org/10.1016/j.jaut.2018.10.009 (2018).
Silverman, G. J. et al. Lupus nephritis is linked to immunity to an intestinal commensal lachnospiraceae species [abstract]. Arthritis Rheumatol. 69 (Suppl. 10), 1786 (2018).
Silverman, G. J. et al. Identification of a gut pathobiont immunostimulatory lipoglycan antigen linked to lupus nephritis [abstract]. Arthritis Rheumatol. 70 (Suppl. 10), 104 (2018).
Taroncher-Oldenburg, G. et al. Translating microbiome futures. Nat. Biotechnol. 36, 1037–1042 (2018).
The author declares that he is supported by grants from the NIH and the Judith and Stewart Colton Autoimmunity Center.
The author declares no competing interests.
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Silverman, G.J. The microbiome in SLE pathogenesis. Nat Rev Rheumatol 15, 72–74 (2019). https://doi.org/10.1038/s41584-018-0152-z
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