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Review
. 2025 Jun 17;17(1):45.
doi: 10.1186/s13099-025-00702-7.

The role of probiotics in promoting systemic immune tolerance in systemic lupus erythematosus

Affiliations
Review

The role of probiotics in promoting systemic immune tolerance in systemic lupus erythematosus

Asma'a H Mohamed et al. Gut Pathog. .

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disorder branded via over-activation of the immune system, resulting in atypical roles of natural and adaptive immune cells and the making of numerous autoantibodies against nuclear components. The causes and pathogenesis of this disease are not completely realized. The gut microbiota plays a significant character in human health and disorder, particularly in autoimmune diseases.Gut microbiome dysbiosis can affect the host immune system as suggested by several recent studies, balance and activity of the gut microbiome, which are influenced by daily diet, might be associated with disease activity in SLE. There are rising signs to support the immunomodulatory abilities of certain probiotics. Numerous investigational and clinical surveys have demonstrated the useful effects of certain probiotic bacteria, mainly strains of Lactobacillus and Bifidobacterium, in patients with SLE. Various species of bacteria were found to be positively or negatively associated with SLE gut microbiomes. A better comprehension of the Studying the gut microbiota will provide a good opportunity to identify microbes involved in tolerance in systemic lupus patients. The purpose of this study is to review the existing literature on probiotics that have the ability to restore tolerance and modulate the levels of inflammatory or anti-inflammatory cytokines that play a role in SLE.

Keywords: Cytokines; Immune dysregulation; Immunoregulatory probiotics; Microbiota; Probiotic; Systemic lupus erythematosus.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The pathogenesis of SLE and the effect of tolerogenic probiotics. In SLE patients, different factors such as autoantibodies, autoreactive or inflammatory T cells, and proinflammatory cytokines resulted in different organ damage. Also, in this disease, the decreased Treg cells, laterally by the growth of Th17 and Th1, could react in contradiction of tissue straightly and abolish them or irritate the making of proinflammatory cytokines. However, the use of tolerogenic probiotics causes the healing of tissue damage and also causes a rise in Treg cells and a reduction in Th1 and Th17 cells. In this disease, pro-inflammatory cytokines are also reduced, and anti-inflammatory cytokines induced by probiotics, for example, TGF-β and interleukin 10, are increased
Fig. 2
Fig. 2
Potential beneficial functions of probiotics and their bioactive derived metabolites, for example, short-chain fatty acids, can improve the symptoms of SLE disease in different ways. SCFAs, Short-chain fatty acids; Th17: T helper
Fig. 3
Fig. 3
The effect of probiotics in improving autoimmune disease. Probiotics, via increasing the manufacture of regulatory T cells, show a significant character in reducing inflammation caused by autoimmune diseases. Probiotics reduce cytokines created by Th1 cells and increase cytokines via Th2 cells, thereby reducing inflammation caused by autoimmune diseases

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