Lupus and Gut Microbes | Psychology Today



Your life doesn’t have to be less cool, or less interesting, or less fun now that you have lupus. You can still have a fabulous and exciting life, and do all the things you want to do. —Jessica Kundapur and Jodie Nimigon-Young

That quote is from Fabulupus, a book on how to manage lupus as a young adult. Sadly, lupus can hit kids as young as 15, setting them up for a lifelong roller coaster of pain and emotional turmoil.

Lupus is a nasty autoimmune disease that causes a range of issues including rashes, hair loss, fatigue, joint pain, and kidney inflammation. It also leads to psychiatric disorders like brain fog and memory problems. Although the main antagonists of our story are gut microbes and the immune system, there are other factors at play, including genetics and the environment.

Lupus may start early in life, with a paucity of pathogens to properly challenge the immune system. This is the hygiene hypothesis, which postulates that an overly pristine environment can impair the development of a robust immune system. Indeed, in the relatively cleaner developed countries, allergies and autoimmune diseases are more prevalent.

Basically, lupus is what happens when your immune system runs wild and targets your own cells, leading to chronic systemic inflammation and autoimmunity. The current treatment includes powerful steroids that suppress the immune system. But these drugs come with their own set of issues, including high blood pressure, diabetes, and infections.

So, there is a lot of interest in finding less drastic solutions. Surprisingly, there is something close at hand that has a big influence on your immune system: your gut microbes.

Some 80% of your immune system is centered in your gut, which makes sense because that’s where most of the pathogens lurk. The lining of the gut is gossamer thin in order to let nutrients in, making it vulnerable to bacterial invasion and keeping the immune system constantly on guard.

Importantly, our beneficial gut microbes play a role as well, often clearing pathogens without any help from the immune system. A healthy gut has very few bad guys and billions of good guys.

In a new Korean study using mice bred to have lupus, multiple microbial differences were noted. Compared to normal mice, the lupus mice harbored pathogenic bacteria like Streptococcus, Ruminococcus gnavus, and Clostridium saudiense, bad actors that cause the immune system to go into overdrive, increasing the severity of lupus symptoms.

As well as pathogens, mice with lupus often lack beneficial bacteria like Lactobacillus johnsonii that produces lactate and Ruminiclostridium cellulolyticum that produces butyrate.

Lactate reduces the pH in the gut and discourages the growth of pathogens. Butyrate nourishes the gut lining and calms the immune system. Via the gut-brain axis, butyrate also improves cognition and memory. Lactate and butyrate are thus a one-two punch against inflammation and psychiatric deficits.

The authors of the study conclude, “our findings highlight the potential for gut microbiota to serve as both biomarkers and therapeutic targets for lupus. The modulation of gut microbiota through probiotic interventions or microbiome-targeted therapies could offer novel avenues to mitigate disease severity…”

The study was done in mice, and it is noteworthy that they were bred to get lupus, emphasizing that there is a genetic component to the disease. We also know that mice microbes are not the same as human microbesbut they are similar. Lactate- and butyrate-producing microbes are known to lower inflammation in humans too.

Microbiome Essential Reads

Like all microbial stories, it’s complicated. Although studies like this show a correlation between microbes and lupus, the direction of causality goes both ways. Microbes exacerbate lupus symptoms, and lupus disrupts gut microbes in return. That can set up a vicious cycle.

Regardless of the complexity, breaking any link in this painful chain reaction can wind down the inflammation and provide some relief. That’s where specific microbes may come into play. Soon, we could see probiotic blends that directly address the missing microbes in lupus.

In the meantime, readers of this page know that beneficial microbes feast on fiber, so diet may help symptoms of lupus. In particular, fruits (especially berries), veggies (like onions, asparagus, and beans), and ferments (like yogurt or kraut) can genuinely improve your gut microbiome. If you can’t manage to get enough fiber in your diet, a prebiotic (basically fiber) might do the trick.

At least one case study has shown that people can significantly decrease or even eliminate lupus symptoms with diet and meditation. However, other studies show that it can be hard to change a gut microbiome that got off to a bad start in childhood.

If your lupus has progressed to nephritis, you may need to limit certain foods. Talk to your doctor before you make major changes to your diet.

A Mediterranean diet could be just the thing to reduce your bouts of lupus misery, but it may take some time to kick in. Take notes to see if any particular food seems to help or hurt.

Fortunately, this prescription is painless and delicious. The Mediterranean diet is highly recommended in general, not just for people with lupus. It might even be fabulous.


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