Battaglia Michael, Garrett-Sinha Lee Ann
Department of Biochemistry, State University of New York at Buffalo, Buffalo, NY, 14203, USA.
J Transl Autoimmun. 2020 Dec 23;4:100078. doi: 10.1016/j.jtauto.2020.100078. eCollection 2021.
Bacterial infections of the lung, skin, bloodstream and other tissues are common in patients with systemic lupus erythematosus (lupus) and are often more severe and invasive than similar infections in control populations. A variety of studies have explored the changes in bacterial abundance in lupus patients, the rates of infection and the influence of particular bacterial species on disease progression, using both human patient samples and mouse models of lupus.
The aim of this review is to summarize human and mouse studies that describe changes in the bacterial microbiome in lupus, the role of a leaky gut in stimulating inflammation, identification of specific bacterial species associated with lupus, and the potential roles of certain common bacterial infections in promoting lupus progression.
Information was collected using searches of the Pubmed database for articles relevant to bacterial infections in lupus and to microbiome changes associated with lupus.
The reviewed studies demonstrate significant changes in the bacterial microbiome of lupus patients as compared to control subjects and in lupus-prone mice compared to control mice. Furthermore, there is evidence supporting the existence of a leaky gut in lupus patients and in lupus-prone mice. This leaky gut may allow live bacteria or bacterial components to enter the circulation and cause inflammation. Invasive bacterial infections are more common and often more severe in lupus patients. These include infections caused by , , , and mycobacteria. These bacterial infections can trigger increased immune activation and inflammation, potentially stimulating activation of autoreactive lymphocytes and leading to worsening of lupus symptoms.
Together, the evidence suggests that lupus predisposes to infection, while infection may trigger worsening lupus, leading to a feedback loop that may reinforce autoimmune symptoms.
肺部、皮肤、血液及其他组织的细菌感染在系统性红斑狼疮（狼疮）患者中很常见，且往往比对照组人群中类似感染更为严重和具有侵袭性。多项研究利用人类患者样本和狼疮小鼠模型，探讨了狼疮患者细菌丰度的变化、感染率以及特定细菌种类对疾病进展的影响。
本综述旨在总结人类和小鼠研究，这些研究描述了狼疮患者细菌微生物群的变化、肠道渗漏在刺激炎症中的作用、与狼疮相关的特定细菌种类的鉴定，以及某些常见细菌感染在促进狼疮进展中的潜在作用。
通过检索PubMed数据库收集与狼疮细菌感染及与狼疮相关的微生物群变化相关的文章信息。
综述研究表明，与对照组相比，狼疮患者的细菌微生物群以及与狼疮易感小鼠相比，对照小鼠有显著变化。此外，有证据支持狼疮患者和狼疮易感小鼠存在肠道渗漏。这种肠道渗漏可能使活细菌或细菌成分进入循环并引发炎症。侵袭性细菌感染在狼疮患者中更为常见，且往往更严重。这些感染包括由[具体细菌名称未给出]、[具体细菌名称未给出]、[具体细菌名称未给出]、[具体细菌名称未给出]和分枝杆菌引起的感染。这些细菌感染可引发免疫激活和炎症增加，可能刺激自身反应性淋巴细胞的激活，导致狼疮症状恶化。
综合来看，证据表明狼疮易引发感染，而感染可能触发狼疮病情恶化，导致一个可能强化自身免疫症状的反馈循环。
