Immunopathogenesis: The role of mucosal and skin microbiota in SLE

The human microbiota forms a life-long reciprocal relationship with the host influencing the innate and adaptive immune system. The pathogenesis of systemic lupus erythematosus (SLE) involves dysregulation of innate and adaptive immune mechanisms that normally function to defend against microbes, but instead turn against self-antigens. Loss of self-tolerance is one of the fundamental mechanisms of autoimmunity and the influence of the microbiota on this process is increasingly recognized. Loss of beneficial microbes or outgrowth of certain pathobionts driving innate or adaptive immune responses have recently been discovered in rheumatic diseases and will be reviewed in this chapter with a focus on SLE.