The Dual Role of Microbiota as a Therapeutic Target in Lupus Nephritis

Abstract: Lupus nephritis, a severe manifestation of systemic lupus erythematosus (SLE), involves kidney inflammation driven by immune dysregulation. Emerging evidence highlights gut microbiota as a key factor in lupus nephritis pathogenesis, with dysbiosis contributing to inflammation, tissue damage, and disease progression. In lupus nephritis, alterations in the gut microbiome have been observed, including an increased abundance of pathogenic bacteria and a decrease in beneficial microbes. These imbalances can trigger immune system dysregulation, leading to inflammation, tissue damage, and worsening disease symptoms. Research has shown that the gut microbiota influences systemic inflammation and autoimmunity through mechanisms such as the modulation of immune cell activation, regulation of cytokine production, and interactions with the intestinal epithelial barrier. Thus, targeting the gut microbiota has gained attention as a potential therapeutic strategy for lupus nephritis. Fiber-rich foods support gut health and may reduce inflammation, offering protective benefits for kidney function. Therapeutic strategies targeting the microbiome, including probiotics, fecal microbiota transplantation, and dietary interventions, are gaining attention as potential treatments. Probiotics may restore microbial balance, enhance intestinal barrier function, and modulate immune responses to alleviate lupus nephritis symptoms. Fecal microbiota transplantation, while promising in animal models, requires further investigation in humans. Targeting the microbiota represents a promising therapeutic approach for lupus nephritis, and ongoing research may lead to microbiota-based therapies as a crucial component of lupus nephritis management.

Cite this article as: Bhat RS. The dual role of microbiota as a therapeutic target in lupus nephritis. Turk J Nephrol. Published online July 3, 2025. doi: 10.5152/turkjnephrol.2025.25981.