The role of microbiota and oxidative stress axis and the impact of intravenous immunoglobulin in systemic lupus erythematosus

IF 9.2 1区 医学 Q1 IMMUNOLOGY Autoimmunity reviews Pub Date : 2024-09-01 DOI:10.1016/j.autrev.2024.103607
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Abstract

Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by widespread inflammation affecting various organs. This review discusses the role of oxidative stress and gut microbiota in the pathogenesis of SLE and evaluates the therapeutic potential of intravenous immunoglobulins (IVIg). Oxidative stress contributes to SLE by causing impairment in the function of mitochondria, resulting in reactive oxygen species production, which triggers autoantigenicity and proinflammatory cytokines. Gut microbiota also plays a significant role in SLE. Dysbiosis has been associated to disease's onset and progression. Moreover, dysbiosis exacerbates SLE symptoms and influences systemic immunity, leading to a breakdown in bacterial tolerance and an increase in inflammatory responses.

High-dose IVIg has emerged as a promising treatment for refractory cases of SLE. The beneficial effects of IVIg are partly due to its antioxidant property, reducing oxidative stress markers and modulating the immune responses. Additionally, IVIg can normalize the gut flora, as demonstrated in a case of severe intestinal pseudo-obstruction.

In summary, both oxidative stress and dysregulation of microbiota are pivotal in the pathogenesis of SLE. The use of IVIg may improve the disease's outcome. Future research should be directed to elucidating the precise mechanisms by which oxidative stress and microbiota are linked with autoimmunity in SLE in developing targeted therapies.

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系统性红斑狼疮中微生物群和氧化应激轴的作用以及静脉注射免疫球蛋白的影响。
系统性红斑狼疮(SLE)是一种复杂的自身免疫性疾病,其特点是影响各器官的广泛炎症。这篇综述讨论了氧化应激和肠道微生物群在系统性红斑狼疮发病机制中的作用,并评估了静脉注射免疫球蛋白(IVIg)的治疗潜力。氧化应激会导致线粒体功能受损,从而产生活性氧,引发自身抗原性和促炎细胞因子,从而导致系统性红斑狼疮。肠道微生物群在系统性红斑狼疮中也起着重要作用。菌群失调与疾病的发病和进展有关。此外,菌群失调还会加重系统性红斑狼疮的症状并影响全身免疫力,导致细菌耐受性下降和炎症反应增加。大剂量IVIg已成为治疗难治性系统性红斑狼疮的一种有前途的方法。IVIg的有益作用部分是由于它的抗氧化特性,可减少氧化应激标记物并调节免疫反应。此外,IVIg 还能使肠道菌群恢复正常,这一点已在一例严重的肠道假性梗阻病例中得到证实。总之,氧化应激和微生物群失调在系统性红斑狼疮的发病机制中起着关键作用。使用IVIg可能会改善疾病的预后。今后的研究应致力于阐明氧化应激和微生物群与系统性红斑狼疮自身免疫的确切联系机制,以开发有针对性的疗法。
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来源期刊
Autoimmunity reviews
Autoimmunity reviews 医学-免疫学
CiteScore
24.70
自引率
4.40%
发文量
164
审稿时长
21 days
期刊介绍: Autoimmunity Reviews is a publication that features up-to-date, structured reviews on various topics in the field of autoimmunity. These reviews are written by renowned experts and include demonstrative illustrations and tables. Each article will have a clear "take-home" message for readers. The selection of articles is primarily done by the Editors-in-Chief, based on recommendations from the international Editorial Board. The topics covered in the articles span all areas of autoimmunology, aiming to bridge the gap between basic and clinical sciences. In terms of content, the contributions in basic sciences delve into the pathophysiology and mechanisms of autoimmune disorders, as well as genomics and proteomics. On the other hand, clinical contributions focus on diseases related to autoimmunity, novel therapies, and clinical associations. Autoimmunity Reviews is internationally recognized, and its articles are indexed and abstracted in prestigious databases such as PubMed/Medline, Science Citation Index Expanded, Biosciences Information Services, and Chemical Abstracts.
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