Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.


The microbiome in SLE pathogenesis

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.

Key advances

  • 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.

This is a preview of subscription content

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1: Potential pathobiont mechanisms that contribute to SLE pathogenesis.


  1. 1.

    Bengtsson, A. A. & Ronnblom, L. Role of interferons in SLE. Best Pract. Res. Clin. Rheumatol. 31, 415–428 (2017).

    Article  Google Scholar 

  2. 2.

    Manfredo Vieira, S. et al. Translocation of a gut pathobiont drives autoimmunity in mice and humans. Science 359, 1156–1161 (2018).

    CAS  Article  Google Scholar 

  3. 3.

    Chen, Y. et al. Microbial symbionts regulate the primary Ig repertoire. J. Exp. Med. 215, 1397–1415 (2018).

    CAS  Article  Google Scholar 

  4. 4.

    Greiling, T. M. et al. Commensal orthologs of the human autoantigen Ro60 as triggers of autoimmunity in lupus. Sci. Transl Med. 10, eaan2306 (2018).

    Article  Google Scholar 

  5. 5.

    Rosenbaum, J. T. & Silverman, G. J. The microbiome and systemic lupus erythematosus. N. Engl. J. Med. 378, 2236–2237 (2018).

    Article  Google Scholar 

  6. 6.

    Morgan, X. C. et al. Dysfunction of the intestinal microbiome in inflammatory bowel disease and treatment. Genome Biol. 13, R79 (2012).

    CAS  Article  Google Scholar 

  7. 7.

    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. (2018).

    Article  PubMed  Google Scholar 

  8. 8.

    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).

    Google Scholar 

  9. 9.

    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).

    Google Scholar 

  10. 10.

    Taroncher-Oldenburg, G. et al. Translating microbiome futures. Nat. Biotechnol. 36, 1037–1042 (2018).

    CAS  Article  Google Scholar 

Download references


The author declares that he is supported by grants from the NIH and the Judith and Stewart Colton Autoimmunity Center.

Author information



Corresponding author

Correspondence to Gregg J. Silverman.

Ethics declarations

Competing interests

The author declares no competing interests.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Silverman, G.J. The microbiome in SLE pathogenesis. Nat Rev Rheumatol 15, 72–74 (2019).

Download citation

Further reading


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing