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Systemic lupus erythematosus (SLE) disease – characterized by attack of the joints, skin and kidneys by the body's immune system – is linked to an abnormal mixture of bacteria in the intestine. This is according to a new study conducted by scientists at the NYU School of Medicine.
While bacterial imbalances have been linked to many immune diseases, including inflammatory bowel disease, arthritis and some cancers, the authors of this study claim that their experiments are the first detailed evidence of a link between bacterial imbalances in the intestine and potentially life-long forms of SLE treatment
The new study, the publication in the Annals of rheumatic diseases February 19, showed that 61 women diagnosed with SLE had about five times more intestinal bacteria known as Ruminococcus gnavus, more than 17 women of different ages and races who did not have the disease and were in good health. Lupus is more common in women than in men.
In addition, the results of the study showed that the "flare-ups" of the disease, which can range from skin rash and joint pain to severe renal dysfunction requiring a dialysis, follow closely the major increases in the cancer rate. R. Gnavus Bacterial growth in the intestine, as well as the presence in blood samples of immune proteins called antibodies, specifically designed to attach to the bacteria. Study participants with renal flares had particularly high levels of anti-virus antibodies. R. Gnavus.
The authors explain that the specific causes of lupus, which affects 1.5 million Americans, are unknown, although many suspect that genetic factors are partly responsible.
"Our study strongly suggests that in some patients, bacterial imbalances may be at the origin of lupus and its relapses badociated with the disease," says lead investigator and immunologist Gregg Silverman, MD of the study. . "Our results also indicate that bacterial leakage from the intestine is a possible trigger for the disease by the immune system and suggest that the internal gut environment could therefore play a more crucial role than genetics in renal eruptions." of this all too often fatal disease, "says Silverman, a professor in the departments of medicine and pathology at NYU Langone Health. He also suspects that anti R. Gnavus induce a "continuous and relentless" immune attack on the organs involved in the outbreaks.
According to Silverman, one of the most practical consequences of the new research could be the development of relatively simple blood tests to detect antibodies directed against leaked bacteria, which could also be used to diagnose and monitor the disease. evolution and treatment of lupus, even from the onset of the disease. steps. Current tests, he says, are often inconclusive and rely on signs and symptoms that only appear when the disease has already progressed.
Silverman, who is also badociate director of rheumatology at NYU Langone, warns that more important studies are needed to confirm how this bacteria could cause lupus. But if future experiments yield similar positive results, this could lead to a change in current approaches to treating the disease, which focus on immunosuppressive anticancer drugs to alleviate kidney symptoms and lesions.
If the results of the study team are validated, some current treatments may actually cause harm if they alter the overall immune defenses against the infection.
According to Silverman, future treatments could include inexpensive probiotics or diets that hinder R. Gnavus growth and prevent breakouts. Fecal transplants of healthy subjects would also be possible.
According to Silverman, new treatments could also be used to promote the growth of Bacteroides uniformis, bacteria thought to hinder the growth of R. Gnavus in the intestine and whose number has decreased up to four times in study participants with lupus compared to those without the disease. Experts say that more than 1000 different types of bacteria make up the human intestinal microbiome.
For this study, researchers badyzed blood and stool samples from participants. The researchers were surprised to find strong reactions of immune antibodies against R. Gnavus in the blood because the intestinal lining prevents the bacteria from escaping to other parts of the body. The researchers say this suggests that small fragments of bacteria, called antigens, must have "penetrated" into the intestine to trigger the immune response.
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The National Institute of Health subsidized the subsidies R01 AI090118, R01 AI068063, R01 AR42455, AR070591 P50, HHSN272201400019C, AR42271 N01, R01 AR061569 and AR070591 P50. Additional financial support has been provided by the Lupus Research Institute, the Judith and Stewart Colton Auto-Immunity Center of NYU Langone and Fr. Robert Majumder Charitable Trust.
In addition to Silverman, other NYU Langone researchers participating in this study are lead investigator Doua Azzouz, PhD; and co-investigators Aidana Omarbekova, BS; Adriana Heguy, PhD; and Jill Buyon, MD. Co-researchers Dominic Schwudke, PhD, and Nicolas Gisch, PhD, both from the Borstel Center in Germany, provided additional support for the research. Brad Rovin, MD, of Ohio State University in Columbus; Robert Caricchio, MD, of Temple University in Philadelphia; and Alexander Alekseyenko, PhD, at the Medical University of South Carolina in Charleston.
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