Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by periods of relapse and remission, in which gut microbiota imbalance plays a role in triggering and sustaining inflammation through pro‑inflammatory cytokines. Therapeutic approaches targeting the gut microbiota, such as probiotics and synbiotics, have the potential to regulate disease activity by restoring microbial balance and reducing systemic inflammation. Several randomized controlled trials (RCTs) have explored the effects of microbiota‑based interventions in autoimmune diseases; however, comprehensive meta‑analyses summarizing their efficacy remain limited.
Objective: To explore the potential benefit of probiotics and synbiotics supplementation in improving SLE disease activity and inflammatory markers.
Methods: RCTs relevant to the treatment of SLE with probiotics and synbiotics were systematically retrieved from Pubmed, EMbase, Cochrane, Sinomed in accordance with the PRISMA guideline. The meta‑analysis was performed using RevMan 5.4.1 software. A fixed‑effects model was applied, Cochrane Risk of Bias 2 (ROB 2.0) was used as a bias assessment tool.
Results: Seven studies with a total 460 subjects were included in this meta‑analysis. Data consisting of SLEDAI‑2K, IL‑17 and IgG from studies RCTs. The pooled analysis demonstrated that probiotic or synbiotic supplementation significantly reduced disease activity of SLE as assessed by the SLEDAI‑2K score (MD = ‑2.33, 95% CI ‑2.49, ‑2.16; P < 0.00001; I² = 61%). Similarly, the pro‑inflammatory markers of IL‑17 (MD = ‑1.04, 95% CI ‑1.55, ‑0.52; P < 0.0001) and IgG (MD = ‑2.64, 95% CI ‑2.77, ‑2.51; P < 0.00001) revealed a significant reduction compared to control group.
Conclusion: Gut microbiota‑based therapies, including synbiotics and probiotics supplementation, demonstrate the potential benefit to reduce systemic inflammation and improve SLE disease activity through modulating gut microbiota composition and function. While promising as an adjunctive treatment for SLE, further studies are required to investigate its mechanisms and therapeutic efficacy.
