The role of microbiota in the pathogenesis of lupus: Dose it impact lupus nephritis?

Systemic lupus erythematosus (SLE) is a complex, inflammatory, and autoimmune disease triggered by complicated interactions of different factors. A major contributor to morbidity and mortality in SLE is lupus nephritis (LN). To date, the cause of SLE and LN is incompletely understood but a combination of genetic and environmental factors is thought to be involved. In recent years, there have been attempts to consider the intestinal microbial profiles, microbiota, and its role in the pathogenesis of the disease. The composition and elements of gut microbiota have major roles in antibody production, shaping the human B cell repertoire, homeostasis of different populations of helper T cell and Th17:Treg balance, and regulation of the levels of different Th17 cell subpopulations. Disturbance of gut microbiota, called dysbiosis, leads to the development of autoimmunity. To date, few studies have characterized the microbiota composition in SLE. In this review, we will highlight novel findings describing the effect of genetic, epigenetic, and environmental factors on gut microbiota and immune system. Moreover, we will discuss the possible association between SLE and microbiota composition and concerning how its changes may contribute to the onset of SLE and LN. Interest in this area has been grown to consider the microbiome as a potential therapeutic target in future.