Systemic lupus erythematosus, often called lupus, is an autoimmune disease that occurs primarily in women – the disease affects almost nine times as many women as men1,2. It presents differently among individuals, making it hard to diagnose, and it can affect multiple organ systems, including the kidneys and gastrointestinal tract1,2,4,5. What causes lupus? Lupus is thought to have complex origins; research suggests a strong genetic component and multiple environmental triggers, such as UV exposure, diet, stress and contact with viruses2-5. Recently, the role of gut bacteria in triggering the autoimmune response has become a focus. Research has emerged to suggest that the overgrowth of certain gut bacteria, as well as migration of gut bacteria to the organs, may also play an important role3,4. Understanding Lupus: Causes and Symptoms Lupus can have many different faces – the disease doesn’t necessarily look the same between one person and the next. What’s more, although there are genetic links that predispose someone to develop the disease, it appears that environmental factors are the ones pulling the trigger. The reason for this is that our environment regulates our genetic expression; it has been shown that some of the genetic changes observed in lupus involve immune interferons that are involved in the response to viral infections2. These interferons can break self-tolerance, promoting the autoimmune response2. For example, infection with the Epstein-Barr virus is thought to increase the risk of lupus. However, in lupus, the immune system has been found to directly attack our DNA, which can also alter the expression of genes, contributing to disease progression2. One of the biggest challenges in diagnosing and detecting signs of lupus is that its symptoms can overlap with other diseases such as rheumatoid arthritis. These symptoms include the following: Extreme fatigue Fever Loss of appetite Weight loss Joint pain that is mirrored on both sides of the body A butterfly-shaped rash across the nose and cheeks that gets worse with UV exposure Tiny red spots on the skin called petechiae Depression and anxiety Lupus, the Gut & Autoimmunity Much has been made of the connection between the digestive system and autoimmunity. The reason for this is that the gut is a critical site of immune function while playing host to trillions of bacteria; lipoproteins found on bacteria may incite innate immune responses4. Alterations in the gut barrier can allow bacteria to breach that border and trigger an immune response3. In fact, the gut microbiota has been associated with the development of multiple autoimmune diseases, including lupus3-5. One recent laboratory study from Yale found that a gut bacterium called Enterococcus gallinarum was able to decrease the function of the gut barrier, translocate into the circulation and begin to colonize the liver and lymph nodes of the animals3. It is thought that the presence of E. gallinarum may incite the immune interferon signature commonly associated with lupus3. Another human study confirmed that the gut microbiota of someone with lupus differs significantly from someone without the disease, with significantly higher levels of a bacterium called Ruminococcus gnavus, and lower levels of a bacterium with proposed anti-inflammatory properties called Bacteroides uniformus4. This trial also confirmed that gut barrier dysfunction or ‘leaky gut’ was present in the study subjects4. Living with Lupus Lupus often behaves in a relapse and remission pattern, typically getting worse over time. The kidneys and the heart can be affected, and the inflammation present can negatively impact the nervous system and digestive tract. The esophagus, the pancreas and the gallbladder may all be impacted, leading to digestive effects such as reflux or malabsorption. What’s more, medications commonly used in lupus may exacerbate digestive issues. Because there are recognized differences in lupus rates between populations, there are many theories about environmental factors that contribute to disease risk6. These include lack of exposure to harmless microbes due to over-sanitation and overuse of antibiotics in addition to the quality of our diet6. Nutrition has an impact both directly on the immune and digestive systems as well as indirectly through its impact on the communities of gut bacteria in the digestive tract6. A plant-centered diet, that is rich in dietary fiber, vitamins and minerals, may be supportive in preventing and improving lupus outcomes due to its anti-inflammatory effects and positive contribution to gut bacteria6. Omega 3 fatty acids, found in oily fish and seeds, may also be beneficial6. Gut bacteria, and probiotic bacteria, are recognized to be important mediators of immune function, in addition to helping fend off potentially harmful microbes5. As such, probiotics become an interesting potential tool for protecting against autoimmunity, albeit one that is currently under-researched. Because of the recognized dysbiosis in lupus, probiotics have been proposed as being able to rebalance the bacterial overgrowth, while calming inflammatory responses through their pro-tolerance effects on T regulatory cells5. In lab and human trials, many species of Lactobacillus and Bifidobacterium bacteria, have been found to improve tolerance5. Improving gut health is a wise prevention strategy for overall health – and may be important in the prevention of autoimmune disease. Ensuring a healthy balance of bacteria, through consumption of high fiber plant foods and the daily inclusion of a probiotic such as Bio-K+, may help prevent dysbiosis, strengthen the gut barrier and improve communication between gut microbes and the immune system. Live well, stay well Our bodies are ever evolving, and paying close attention to those changes is an important part of staying well. Small deviations, such as fatigue or a bit of tummy upset, are common occurrences that should resolve quickly. However, if you suspect that these changes aren’t related to some significant change in your lifestyle, or they don’t pass quickly, go discuss them with your doctor. Take steps to foster better digestive and immune health by eating plenty of plant foods and taking your probiotics. Do you have any other questions about your gut health? Ask us in comments below. If you are looking to stock up on Bio-K+, head to our store locator. For more information on Bio-K+, probiotics and digestive health, contact us, find us on Facebook and Instagram or join our community. References: Mechanistic insights into environmental and genetic risk factors for systemic lupus erythematosus - PMC (nih.gov) Immunogenetics of Systemic Lupus Erythematosus: A Comprehensive Review - PMC (nih.gov) https://science.sciencemag.org/content/359/6380/1156.full https://ard.bmj.com/content/early/2019/03/01/annrheumdis-2018-214856.abstract https://www.researchgate.net/profile/Seyed_Alireza_Esmaeili/publication/311780528 Significance and impact of dietary factors on systemic lupus erythematosus pathogenesis - PMC (nih.gov)
