"Lupus Studies Point to Gut Microbes, Epigenetics"

"The complex network of genetic, environmental, and hormonal factors believed to contribute to systemic lupus erythematosus (SLE) is slowly being dissected, researchers report in a special issue of Lupus devoted to environmental causes of SLE. Several lines of research converged on the commensal bacteria in the gastrointestinal tract (the gut microbiota), which can be influenced by dietary and other external factors to alter immune response, and on environmental agents that inhibit epigenetic T-cell DNA methylation, which can trigger lupus flares in the genetically predisposed.

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"n the clinical setting, Dr. Kriegel recommended that patients pay a little more attention to what effects various diets may have on their disease. "The long-standing anecdotal patient reports of certain diets worsening or improving flares might be more real than we thought. They should be studied more systematically, now that we know that almost any dietary component acts on the gut microbiota, [which] in turn has profound effects on the immune system," Dr. Kriegel said. He also warned that patients should not assume that the various "probiotic" products now available to consumers would have a beneficial effect in lupus. "Probiotics could theoretically even worsen a disease state, since it is possible that physiologic immune responses against benign commensals could fuel autoimmune responses via cross-reactivity (as we hypothesize) or other mechanisms," he said.

Dr. Kriegel concluded, "I think the best will be to wait until we have a better understanding of which commensals or commensal-derived products might be driving which autoimmune disease and then target those with a diet that is known to modulate these strains or products. Ideally, the field will also develop eventually novel types of antibiotics or vaccinations against certain commensals. Such approaches would allow us, in the future, to more specifically modulate the gut microbiota in autoimmunity.""

http://www.medscape.com/viewarticle/825045