Dysbiosis, or disruption of the gut microbiota, leads to the onset of autoimmunity. Increasing data suggest that the gut microbiota is changed in various murine lupus models as well as in human systemic lupus erythematosus SLE patients. Ingestion of lactobacilli, which have immunoregulatory properties, may be a viable strategy for controlling disease development and progression in patients with lupus, such as increasing the remission period and decreasing flare frequency.
1. Patients will be recruited and evaluated for eligibility. 2. Patients who met the eligibility criteria will be randomly assigned to either control or interventional group. 3. Patients in the control group will receive their standard therapy for 12 weeks and patients in the interventional group will receive their standard therapy plus one sachet daily of lacteol forte sachets for 12 weeks. 4. Collection of demographic data, full medication history, and full medical history will be performed at baseline and every 4 weeks. 5. Assessment of disease activity using SLEDAI-2K score, quality of life using the validated Arabic LupusPROv1.8 questionnaire, and Pain assessment using the validated Arabic version of the Short-Form McGill Pain Questionnaire will be performed at baseline and at the end of the study. 6. Safety and tolerability monitoring will be performed weekly using a side effect and/or adverse effect monitoring sheet. 7. Blood and urine samples for laboratory investigations will be withdrawn at baseline and at the end of the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
probiotic Lacteol Forte® capsules (5 billion heat-killed Lactobacillus LB, corresponding to lactobacillus delbruekii and lactobacillus fermentum) Two capsules are To be taken once daily
Ain Shams University Hospitals
Cairo, Abbasseya, Egypt
Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)
Change in disease activity measured by SLEDAI-2K score. The most appropriate SLEDAI-2K cut-off score for definition of active disease which links to the need to increase therapy is 3 or 4
Time frame: At baseline and at 12 weeks
Improvement of immunologic parameters
Anti-dsDNA levels
Time frame: At baseline and at 12 weeks
Improvement of serum complement
Complements 3 and 4
Time frame: At baseline and at 12 weeks
patients' quality of life
Assessment of patients' quality of life using the validated Arabic Lupus Patient-reported outcome survey version 1.8 (LupusPROv1.8)
Time frame: At baseline and at 12 weeks
Pain assessment
Pain assessment using the validated Arabic version of the Short-Form McGill Pain Questionnaire
Time frame: At baseline and at 12 weeks
Incidence of potential adverse effects
Monitoring for side and/or adverse effects
Time frame: Weekly up to 12 weeks
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