January 30, 2020

Why does the immune system turn on itself to attack the body it’s supposed to protect?  That question has many possible answers – and one may be the microbiome – the trillions of bacteria living inside our bodies that, in people with lupus, may trigger autoimmune attacks.

An article in this week’s Nature special supplement Outlook features work by two of our funded-scientists and pioneers in the field, Drs. Gregg Silverman at the NYU School of Medicine and Martin Kriegel at Yale University School of Medicine.

Dr. Silverman’s work revealed that the balance of microbial species was out of whack in the intestines of patients with lupus. “We are beginning to wonder if the shifts in the microbiome in lupus patients contribute to disease flares,” commented Dr. Silverman.  “Treating the autoimmune disease may not be enough, and we need to explore how to make our inner communities healthy as well.”

With his grant from the LRA, Dr. Kriegel published a study finding that about half of patients with lupus produce antibodies against the protein Ro60 found in human cells. Dr. Kriegel showed that several kinds of microbes that live in the body make proteins that are very similar to Ro60 and may trigger the immune system to make antibodies that also damage cells carrying Ro60. Recently he showed that a type of dietary fiber may lessen the severity of lupus by stopping some bacteria from leaving the intestines.

Dr. Fabienne Mackay at University of Melbourne, one of our latest recipients of the Dr. William E. Paul Distinguished Innovator Award in Lupus and Autoimmunity, is testing whether removing harmful immune cells combined with different diets can alter the gut microbiome and lead to reduced immune system attacks in lupus. “If this approach works, clinical trials could test it in people,” noted Dr. Mackay.

To allow scientists to learn from each other’s work, the LRA recently brought together 40 researchers working in lupus and other diseases like cancer at an international conference. Attendees discussed new directions in microbiome research, challenges faced by researchers and potential applications for therapies.  The overall takeaway: altering the microbiome is a new frontier in lupus, and the LRA is leading the way.