Shedding Light on Lupus
Systemic Lupus Erythematosus (SLE or Lupus)
Too often, patients are given a lupus diagnosis and a prescription for some heavy duty medication with no explanation for where the Lupus came from and what to really do about it. Doctors and their lupus patients generally watch and wait for organ failure.
But there is an explanation! The latest scientific information points out the clear connection between the gut and Lupus and this information has been validated to basically the highest scientific rigor. 1 (“Journal of Autoimmunity” A Hen in the Wolf Den: A Pathobiont Tale)
What is Lupus?
To answer this, we look to Kelley’s Textbook of Rheumatology which is the authority on all things rheumatic and especially on what we know about lupus. 2
-Lupus is a systemic condition that is often widespread.
-The symptoms of lupus will manifest on skin, or in the heart, lungs, kidneys, brain, joints.
-Lupus is Latin for “wolf”. When first described, the Lupus rash looked like bites and hence the wolf name. Today, this rash is often described as a butterfly-like rash on the face. It also manifests as rashes in other places on the body.
Often, patients that present with lupus are 20-30 year old women experiencing joint pain, fatigue, and alopecia (hair falling out in chunks or spots.) They show signs of these antibodies possibly before the symptoms get more severe.
Some key features of Lupus are: “Butterfly” rash, sun sensitivity, oral ulcers, joint swelling and tenderness, seizures, psychosis, hemolytic anemia, low white count, low platelets, pleuritis and pericarditis, positive labs (+ANA, +dsANA, + SmAntibody, +Cardiolipin/APS, low lymphocytes). 3
It is important to note that no two lupus patients are the same and there is no particular test to diagnose Lupus. Doctors generally reach a diagnosis based on a variety of blood and urine test results, the symptoms a patient is experiencing and findings in a physical examination.
The causes of Lupus include genetics, Epstein Barr Virus, UVB light, estrogen and prolactin (9:1 female/male) imbalances, medications (such as hydralazine, isoniazid, methyldopa, TNF alpha inhibitors, penicillamine, minocycline, etc.) bacterial DNA, retroviruses, and endotoxins (lipopolysaccharides). 4
Doctors have found that “Systemic Lupus Erythematosus results from failure to regulate production of pathogenic autoantibodies, which appear years before the first clinical symptom of disease.” 5
This means that lupus results in failure to regulate the production of autoantibodies. Antibodies attack our own bodies and lupus fails to regulate these. These antibodies appear long before lupus symptoms start.
Here is an illustration of a normal antibody response:
And what happens in an autoimmune response:
Our latest understanding of the causes of Lupus comes from “Journal of Autoimmunity” A Hen in the Wolf Den: A Pathobiont Tale.
This is a nice overview of the seminal article published in the Journal of Science. The Journal of Science is one of the highest respected scientific journals and publishing in this Journal could be considered second to winning a Nobel prize.
In this study, they found that gut bacteria (in this case Enterococcus Gallinarum) is a trigger for inducing lupus in a type of lupus prone mice. These mice are lupus prone because they altered their genetics. 1
Notice in the figure above, the diversity of the microbiota of the healthy mouse while the lupus prone mouse does not have a very diverse microbiome.
Enterococcus gallinarum bacteria (which can be innocuous) gets through what is called a "leaky" gut and causes disease. Bacteria then finds its way to the liver and produces autoantibody responses and lupus results. They found this bacteria in the liver, veins, and lymph nodes of the mice with lupus.
This E. gallinarum bacteria has a tail that allows it to swim like a tadpole. They believe that it is because of this tail that this particular bacteria is able to more easily go through the intestinal walls and be found in other places like the liver.
In humans, Researchers found an abnormal presence of serum protein in their stool, reaffirming that there was permeability in the gastrointestinal tract that leaks into the bloodstream and thus comes out in our stool. They also found this bacteria (E. Gallinarum) “in liver biopsies of patients with lupus or autoimmune hepatitis but not in the livers of healthy transplant donors or in patients with hepatic cirrhosis.” It was also found that the lupus patients had higher autoantibodies against that bacteria, but not other bacteria. This is big news for lupus patients.
After the mice had lupus, they treated them with an antibiotic called Vancomycin. (This antibiotic is only used as a last line antibiotic and it has particular effect on regulating gastrointestinal infections.) When they gave the mice Vancomycin, it “extended their lifespan and lowered serum levels of antibodies against SLE autoantigens such as beta2 glycoprotein I (B2-GPI) and endogenous retrovirus glycoprotein 70 (Erv gp70).” Or in other words, the number of autoimmune antibodies went down with the use of this antibiotic.
Another interesting feature of this article is when the mice were given Lactobacillus (one of the most popular probiotics), it really helped the nephritis (inflammation of the kidneys), which is one of the biggest concerns of Lupus.
Remember, lupus is a failure to calm down the production of autoantibodies. 2
However, the science from these new studies shows that antibodies are probably being spurned by the gut bacteria coming from the small intestines going to the liver.
Wait...gut bacteria causes lupus?
Not only did the medical community validate “leaky gut” in this study, (which has been something only alternative doctors have talked about while the medical community insisted it was a farce) but they also then showed that gut bacteria was involved specifically with the development of lupus.
So what to do for lupus?
We believe the key to lupus is in the gut, just as the cause is. We work to heal the leaky gut, reduce inflammation and to ultimately reduce the production of autoantibodies. This work is done through specific diet changes, supplementation and promoting health in the brain through neuroplasticity exercises that promote healing through the rest of the body.
Written by Gemma Ward based on information shared by Dr. Gates here.
You may learn more about leaky gut here in a video or here in a newsletter.
1. Guerrini, Matteo M., Alexis Vogelzang, and Sidonia Fagarasan. “A Hen in the Wolf Den: A Pathobiont Tale.” Immunity 17 Apr. 2018: 628–631. Immunity. Web.
2. Firestein, GS et al. “Kelley’s Textbook of Rheumatology” 8th edition Saunders Elsevier 2009
3. Firestein, GS et al. “Kelley’s Textbook of Rheumatology.” 8th ed. Saunders Elsevier 2009; pg 1264.
4. Firestein, GS et al. “Kelley’s Textbook of Rheumatology.” 8th ed. Saunders Elsevier 2009; pg 1242.
5. Firestein, GS et al. “Kelley’s Textbook of Rheumatology.” Saunder Elsevier 2009; pg 1233.
-Guerrini, Matteo M., Alexis Vogelzang, and Sidonia Fagarasan. “A Hen in the Wolf Den: A Pathobiont Tale.” Immunity 17 Apr. 2018: 628–631. Immunity. Web.