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Exploring the Gut Microbiome Immune Axis: Potential Benefit of Probiotics and Synbiotics in Systemic Lupus Erythematosus, a Meta Analysis of Randomized Control Trials

Muhammad Ifham Hanif, M. M. Sholihah, A. Nurudhin, Y. Werdiningsih, Indrayana Sunarso, N. Prabowo, T. R. H. Kusuma, Dwiana Kartikawati et al.

Modern Medicine, 2026

460 participants

Abstract

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,…

How strong is the evidence?

Evidence Hub reads this as a randomized trial. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 460 participants or records.

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