Review rticle
The Role of Diet in Influencing the Diversity of Gut Microbiome
Related to Lupus Disease Activities: A Systematic Review
Prisly Z. Putri ,
1
Laniyati Hamijoyo ,
2,3
and Edhyana Sahiratmadja
4
1
Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia
2
Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran,
Dr. Hasan Sadikin General Hospital, Bandung 40161, Indonesia
3
Immunology Study Center, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia
4
Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia
Correspondence should be addressed to Edhyana Sahiratmadja; e.sahiratmadja@unpad.ac.id
Received 15 August 2022; Revised 26 November 2022; Accepted 10 December 2022; Published 31 December 2022
Academic Editor: Todd R. Callaway
Copyright © 2022 Prisly Z. Putri et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gut microbiome dysbiosis can afect the host immune system. Te balance and activity of the gut microbiome, which are
infuenced by daily diet, might be associated with disease activity in systemic lupus erythematosus (SLE). Terefore, we conducted
a systematic review based on the PRISMA guideline to explore the role and types of diet that afects the gut microbiome related to
changes in SLE disease activity. All original and full•text English articles in the last ten years were included using predefned
keywords according to PEO (population, exposure, and outcome) design in PubMed. Te study subjects were carefully analyzed,
including lupus•susceptible mice and humans with SLE on various diets. Children and pregnant women populations were
excluded. Of 134 studies found, only seven full•text articles had met the inclusion criteria of which only one study conducted in
human. Tis human study showed that dietary polyphenol as dihydrochalcones and favanones afected the gut microbiome and
ameliorated lupus disease activity. On the contrary, dietary favones increased Blautia (family: Lachnospiraceae), and that often
found in active lupus diseases. Furthermore, six studies in lupus•prone mice models showed that resistant starch (RS), retinoic
acid (RA) or all•trans retinoic acid (tRA), and acidic water (AW) had infuenced the gut microbiome, leading to an improved
lupus development. Conversely, the 2018 commercial rodent diet, vitamin A•retinoic acid (VARA), neutral water (NW), and high
tryptophan diet had impacted various microbiomes, resulting in increased lupus activity. Interestingly, several diets have the efect
of either increasing or decreasing lupus disease activity depending on the microbiome they afect, such as AW associated with
Turicibacter spp., which is frequently found in active lupus disease, and tRA in Bacteroidetes associated with renal pathology. To
conclude, diet can infuence the gut microbiome, which is related to the disease activity process of SLE.
1.Introduction
Systemic lupus erythematosus (SLE) is an autoimmune
disease resulting from a loss of immune tolerance. About 0.3
to 23.7 per 100,000 individuals globally have been diagnosed
with SLE yearly. Te prevalence varies from 6.5 to 178.0 per
100,000 population, predominantly in productive•age
women and more frequent in adults than children [1, 2].
SLE is a unique disease with various atypical manifes•
tations, making it challenging to recognize, prevent, and
treat [1, 3]. On the other hand, the pathogenesis of SLE is still
unclear and multifactorial [4]. Te environmental triggers
play an important role in SLE development in genetically
susceptible individuals, including hormones (e.g., prolactin
and estrogen), drugs (e.g., oral contraceptive and post•
menopausal hormone therapy), UV light, infections (e.g.,
cytomegalovirus and Ebstein–Barr virus), toxins (e.g., silica
dust), and cigarette smoking, as well as dietary factors and
gut microbiota [5, 6].
In the last 20 years, many studies on a diet have been
associated with SLE and ofer a promising alternative treatment
as it has many advantages in improving the quality of life to the
potential for prophylactic efects [7–10]. Nowadays, the
microbiome is a hot topic in research as it infuences the
Hindawi
International Journal of Microbiology
Volume 2022, Article ID 6908677, 13 pages
https://doi.org/10.1155/2022/6908677