Text By: Charmaine A. Lingdas

UP Manila Chancellor and renowned rheumatologist Dr. Michael Tee emphasized the urgency of collaborative efforts in shedding light on Systemic Lupus Erythematosus (SLE) through the groundbreaking project “Single Nucleotide Polymorphisms (SNPs), Microbiome, and Inflammatory Biomarkers in Filipino patients with Systemic Lupus Erythematosus (SMILE Filipino patients).” This initiative aims to delve into the genetic, immunological, and microbial facets of SLE among Filipino patients.

“We would like to request that you participate in SMILE Filipino patients,” expressed Dr. Tee during the 21st Dr. Lourdes Manahan Lecture on April 18, 2024, at Henry Sy. Sr. Building, UP College of Medicine. 

SLE is a chronic autoimmune disease that can affect various parts of the body, including the skin, joints, kidneys, heart, lungs, brain, and blood cells. In this condition, the body’s immune system becomes hyperactive and attacks its own healthy tissues and organs, leading to inflammation, tissue damage, and a range of symptoms. 

“It is multifactorial—genetic plus environment equals disease development,” stressed Dr. Tee. SLE is primarily seen in women of childbearing age and may result in skin rashes, arthritis, hair loss, and serious complications like kidney and central nervous system issues, he noted.

In Asia, the prevalence of lupus is approximately 30 to 50 cases per 100,000 people. 

The dilemma in treating SLE is balancing symptom management with the potential risks of medication side effects. Medications used to treat SLE,such as corticosteroids and immunosuppressants, can lead to increased susceptibility to infections, bone loss, and long-term organ damage. Finding the right treatment regimen for each patient is challenging. Healthcare providers must consider factors such as disease severity, organ involvement, and individual response to therapy while minimizing treatment-related risks.

Emerging research suggests a connection between SLE and changes in the gut microbiome. Differences in gut bacteria composition and function may contribute to immune dysregulation and inflammation seen in SLE. Modifying the gut microbiome through probiotics, antibiotics, or diet may influence disease activity. However, more research is needed to understand this relationship fully and its therapeutic potential for SLE management.

Dr. Tee explains the comprehensive research roadmap of the “SMILE Filipino patients” Project, encompassing gut microbial profiling, genotyping, and immunophenotyping. The “SMILE Filipino patients” Project aims to achieve several critical goals: first, to characterize the gut microbiome of adult Filipinos diagnosed with SLE; second, to compare the gut microbiome of Filipino SLE patients with asymptomatic household members; third, to correlate the gut microbial profile with disease activity and immune status among adult Filipino SLE patients; fourth, to establish associations between identified SNPs related to SLE development and the gut microbial profile of Filipino SLE patients; and finally, to validate genetic risk scores based on eight identified population SNPs.

“In future applications, gagawa tayo ng sarili nating probiotic—we can do that. We have scientists in the University of the Philippines Manila who are able to do that,” Dr. Tee enthused. “I hope you support this, and we will be happy to present the results in the future,” he concluded.