Dietary and Nutritional Factors in Systemic Lupus Erythematosus Pathophysiology: A Scoping Review of the Evidence from In-Vitro, In-Vivo and Human Studies

Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease whose pathogenesis involves interplay between genetic predisposition and environmental factors, including diet. This scoping review maps and synthesizes current evidence from human and animal studies on the relationships between dietary factors and lupus pathophysiology. Following PRISMA guidelines, we identified 139 relevant studies from Scopus, PubMed, and EBSCO published between 2012-2023. Our analysis reveals that specific dietary components significantly influence lupus risk and disease activity. Diets high in sugar, carbohydrates, and sodium were associated with increased inflammation and exacerbated disease severity. Conversely, several factors demonstrated protective effects. Higher intake of omega-3 polyunsaturated fatty acids (PUFAs) was consistently linked to reduced inflammatory markers and improved patient-reported outcomes, while a higher omega-6 to omega-3 ratio correlated with worsened disease activity. Moderate alcohol consumption, particularly wine, was associated with a reduced risk of SLE incidence. Adequate vitamin D levels were connected to attenuated disease progression and immunomodulation. Furthermore, natural products like olive oil phenolic compounds and curcumin showed promise in reducing oxidative stress and inflammatory pathways in murine models. The evidence underscores that dietary modification presents a viable strategy for modulating immune function and inflammation in SLE. Integrating nutritional guidance with conventional therapies could improve disease management. Future large-scale randomized controlled trials are essential to establish precise dietary recommendations and elucidate the mechanisms underlying diet-lupus interactions.