Review Article

The Role of Diet in Influencing the Diversity of Gut Microbiome Related to Lupus Disease Activities: A Systematic Review

Table 1

Main characteristics of the studies about diet that affect the gut microbiome related to SLE disease activity.

NoAuthorsStudy designPopulationsExposuresTarget phyla/genera/families/othersIndicators for assessing the activity of SLEResults

Human study

1.Cuervo et al. [25]Case controlFemale SLE patients (n = 20)Dihydrochalcones (from apple)BifidobacteriumNot informedIncreased microbial diversity in line with polyphenol intake
Flavanones (95% from oranges and their products)Lactobacillus
Flavones (mainly from oranges and their products)Blautia
Mice model studies

2.Zhang et al. [14]Clinical trialMRL/Mp-Faslpr (MRL/lpr) miceRetinoic acid (RA) suspended in canola oil as the vehicle; 6 mg RA/kgBW daily from 6 to 14 weeks of ageLactobacillaceaeLupus disease parameter: lymphadenopathy and glomerulonephritisSignificant improvement of lupus symptoms
ErysipelotrichaceaeNot informed
Vitamin A-retinoic acid (VARA) consists of 11.2 mg all-trans-retinyl palmitate (RP)/kgBW was mixed with 0.6 mg RA/kgBB daily from 6 to 14 weeks of ageLachnospiraceaeLupus disease parameter: lymphadenopathy and glomerulonephritisWorsened lupus symptoms
RikenellaceaeNot informed
ErysipelotrichaceaeCombination with RA decreased Erysipelotrichaceae composition

3.Johnson et al. [30]Clinical trialFemale SWR x NZB F1 (SNF1) miceNeutral water (NW) pH 7.0–7.2Rikenellaceae familyNot informedIn prenephritic stage: positive correlation between Rikenellaceae with NW treatment
Pedobacter kwangyangensis and Flavobacterium antarcticumIn prenephritic stage: higher level of Bacteroidetes and low ratio of Firmicutes/Bacteroidetes
Acidic water (AW) pH 3.0–3.2Lactobacillus reuteri and Turicibacter spp.In nephritic stage: contributes to higher average Firmicutes/Bacteroidetes ratio than the NW group
Christensenellaceae family, Ruminococcus gnavus, Peptoniphilus coxii, Caloramator mitchellensis, Lactobacillus hayakitensis, L. intermedius, L. siliginis, L. equi, Peptoniphilus methioninivorax, Trichodesmium hildebrandti, Hydrocarboniphaga daqingensis, Polaribacter butkevichiiPositive association between AW diet and microbial diversity

4.Edwards et al. [28]Clinical trialFemale MRL/MpJ-Faslpr/J (MRL/lpr) miceChow diets (3 until 16 weeks of age):LachnospiraceaeNot informedLachnospiraceae higher in 2018 diet compared to RD diet and 7013 diet
(1) RD diet (open standard diet D11112226 purified-ingredients diet):
(i) Casein (undetectable level of isoflavones)
(ii) Slightly lower in vitamin A, vitamin K, niacin, and pantothenic acid
(iii) Soluble fiber inulin
(iv) Higher concentration of carbohydrates
(2) 7013 diet (7013 NIH-31 modified 6% mouse/rat sterilizable diet)
(i) Fish meal, soybean meal, and alfalfa meal (moderate level of isoflavones)
(ii) Mixture of plant-derived soluble and insoluble fibers
(3) 2018 diet (Commercial 2018 Teklad Global 18% Protein Rodent Diet):
(i) Soybean meal (highest level of isoflavones)
(ii) Higher concentrations of vitamin E and B vitamins riboflavin, biotin and pyridoxine–HCl than RD diet and 7013 diet
(iii) Mixture of plant-derived soluble and insoluble fibersLactobacillaceaeOnly negligible levels among all diet groups

5.Zegarra-Ruiz et al. [27]Clinical trialFemale lupus-prone TLR7.1Tg C57BL/6 (TLR7.1Tg) miceRS diet (TD. 150492 for SPF and TD. 160604 for GF mice) enriched for hi-maize 260 (40 g/kg) (7 or 11 weeks according to the experimental setup or up to 32 weeks of age or time of death for survival studies)ClostridialesIntegrity of epithelial using FITC-dextran (Growth and translocation)Positive association between diet and microbial composition. Capable of fermenting RS into SCFAs.
L. reuteriInverse correlation between diet and microbial composition. Decreased translocation in RS diet has a positive effect on SLE.

6.Choi et al. [26]Clinical trialFemale triple congenic lupus-prone mice (B6.Sle1.Sle2.Sle3) stimulated (TC mice)High dietary tryptophan (at 6 weeks of age for 4 months)Paraprevotella, Lactobacillus, Prevotellaceae, and Bacteroides doreiFecal transfers from TC mice fed tryptophan into GF B6 mice to test functional consequences due to microbial changesLupus-associated phenotypes (higher cell number in mesenteric lymph node and serum anti-dsDNA IgM, number of Tfh, Th17, germinal center B cell, and plasma cell)

7.Abdelhamid et al. [29]Clinical trialPristane-treated Balb/c miceDaily all-trans-retinoic acid (tRA) diet 1 mg/kg body weight and adjusted according to body weight obtained biweekly from 3 to 9 months of ageClostridialesNot informedIncreased microbial diversity in line with the treatment at 2 weeks after pristane injection
BacteroidalesGlomerular pathological score and proteinuria levelPositive correlation between diet, microbial composition, and glomerular pathological scores at 10 weeks after pristane injection
FirmicutesNot informedDecreased Firmicutes/Bacteoidetes ratio, similar in active disease of SLE