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The role of diet and probiotics in prevention and treatment of bacterial vaginosis and vulvovaginal candidiasis in adolescent girls and non-pregnant women.
Mizgier, M, Jarzabek-Bielecka, G, Mruczyk, K, Kedzia, W
Ginekologia polska. 2020;91(7):412-416
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In adolescent girls and non-pregnant women, vaginitis, including fungal infections, is a common problem. Vaginitis clinically manifests as abnormal vaginal discharge, irritation, itching, burning and discomfort, and is especially prevalent with a decrease in immunity. The normal bacterial flora of the vagina and cervix protect against the development of pathogenic strains, while abnormal flora tend to be the most common starting point for the development of infections. The aim of this study was to determine the role of proper diet and probiotics and prebiotics use in relation to therapy and prophylaxis of vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV) in non-pregnant women and girls. This review shows that: - An unbalanced diet can be a risk factor for BV. Women tend to be more exposed to BV if they have poor micronutrient status, including vitamins A, E, D, C and beta carotene — indicating a lower fruit and vegetable intake. - Many studies proved that regulated use of probiotics, administered both orally and vaginally, are effective in the prevention and treatment of vaginal infections such as BV and VVC. - To create a positive environment for probiotics, it is important to provide prebiotics that support the development of probiotic strains. Authors conclude that gynaecologists, obstetricians, general practitioners and dieticians should share their findings, and raise awareness among the general population as to the importance of optimal nutrition. Probiotics and prebiotics could be considered to prevent infections of the genital tract, reduce associated disease, and maintain reproductive health.
Abstract
The article raises important issues regarding the use of diet and probiotics in prevention and treatment of vaginitis. Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge. The most common causes of vaginitis are vulvovaginal candidiasis (VVC), trichomoniasis and bacterial vaginosis (BV). Vaginitis has been linked to itching, burning, pain, discharge, irritation and also adverse reproductive and obstetric health outcomes. Moreover, microorganisms that build vaginal flora in the state of bacterial vaginosis are a source of cervicitis and endometritis (often in subclinical forms) and pelvic inflammatory disease (PID) The proper diet and probiotics consumption may influence the composition of the gut microbiota, improve gut integrity, and have an impact on maintaining and recovering the normal vaginal microbiota. Future studies and reviews investigating the role of diet and probiotics in changes to gut and vaginal microbiome need to focus on deciphering the mechanismus of host bacteria interaction in vulvovaginal health.
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The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn's Disease: A Randomized Diet Controlled Trial.
Suskind, DL, Lee, D, Kim, YM, Wahbeh, G, Singh, N, Braly, K, Nuding, M, Nicora, CD, Purvine, SO, Lipton, MS, et al
Nutrients. 2020;12(12)
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Crohn’s disease is a painful chronic lifelong condition where the digestive tract gets inflamed. Environmental insults and gut microbial changes may contribute to immune dysregulation by activating and upregulating the immune system in Crohn’s disease. During this single-centre, randomised, double-blind, diet-controlled study, ten male active Crohn's disease patients aged seven to eighteen were randomly assigned to either a specific carbohydrate diet, a modified specific carbohydrate diet, or a whole food diet. All diet groups showed a reduction in symptoms, inflammation, and a positive change in the gut microbial composition after 12 weeks, depending on the degree of variability in the dietary regimen. Based on the results of this study, an exclusionary diet eliminating grains, sugar, dairy, and processed foods may have a positive impact on reducing Crohn's disease symptoms, inflammation, and improving gut microbial composition and biochemical markers. In the future, robust studies with a larger sample size will be needed to figure out better dietary strategies for Crohn's disease. Healthcare professionals can, however, use these results to identify dietary choices that can reduce Crohn's disease symptoms.
Abstract
BACKGROUND Crohn's disease (CD) is a chronic inflammatory intestinal disorder associated with intestinal dysbiosis. Diet modulates the intestinal microbiome and therefore has a therapeutic potential. The aim of this study is to determine the potential efficacy of three versions of the specific carbohydrate diet (SCD) in active Crohn's Disease. METHODS 18 patients with mild/moderate CD (PCDAI 15-45) aged 7 to 18 years were enrolled. Patients were randomized to either SCD, modified SCD(MSCD) or whole foods (WF) diet. Patients were evaluated at baseline, 2, 4, 8 and 12 weeks. PCDAI, inflammatory labs and multi-omics evaluations were assessed. RESULTS Mean age was 14.3 ± 2.9 years. At week 12, all participants (n = 10) who completed the study achieved clinical remission. The C-reactive protein decreased from 1.3 ± 0.7 at enrollment to 0.9 ± 0.5 at 12 weeks in the SCD group. In the MSCD group, the CRP decreased from 1.6 ± 1.1 at enrollment to 0.7 ± 0.1 at 12 weeks. In the WF group, the CRP decreased from 3.9 ± 4.3 at enrollment to 1.6 ± 1.3 at 12 weeks. In addition, the microbiome composition shifted in all patients across the study period. While the nature of the changes was largely patient specific, the predicted metabolic mode of the organisms increasing and decreasing in activity was consistent across patients. CONCLUSIONS This study emphasizes the impact of diet in CD. Each diet had a positive effect on symptoms and inflammatory burden; the more exclusionary diets were associated with a better resolution of inflammation.
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Raw Cow's Milk and Its Protective Effect on Allergies and Asthma.
Sozańska, B
Nutrients. 2019;11(2)
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In the last decades, a significant increase in the prevalence of allergic diseases and asthma has been observed. Living on a farm can reduce the risk of allergen sensitisation and allergic diseases in children. Most proposed explanations have been based on variations in the “hygiene hypothesis” and a possible effects on immune balance of a farm environment. Here, the author reviews epidemiological and experimental evidence for the documented protective effects of unpasteurised milk on allergies and asthma. Epidemiological studies from a number of countries show that children who consume raw milk early in life are less likely to develop allergies, independent of other factors. In one study that looked into possible components for this effect found that certain milk proteins (α-lactalbumin, β-lactoglobulin, and bovine serum albumin whey protein) reduced the risk of developing asthma . Total fat and protein content, amount of bacteria in the milk, and lactose levels were not associated with allergies or asthma. Another study found that higher levels of total fat and of omega-3 polyunsaturated fatty acids in raw milk had protective effects. The author discusses differences between raw and treated milk. Homogenisation changes the physical structure of fats and proteins, resulting in casein proteins being more easily adsorbed. The aim of heating milk, either through pasteurisation or UHT sterilisation, is to reduce bacterial numbers and growth, but it also affects heat-sensitive milk components, including whey proteins, immunoglobulins and lactoferrin, which have been shown to modulate the immune system. The author concludes that components of raw milk can influence immune function, and acknowledges the controversy with regards to raw milk carrying a risk of bacterial pathogens and that a proof based on controlled studies in infants is not possible due to ethical reasons.
Abstract
Living on a farm and having contact with rural exposures have been proposed as one of the most promising ways to be protected against allergy and asthma development. There is a significant body of epidemiological evidence that consumption of raw milk in childhood and adulthood in farm but also nonfarm populations can be one of the most effective protective factors. The observation is even more intriguing when considering the fact that milk is one of the most common food allergens in childhood. The exact mechanisms underlying this association are still not well understood, but the role of raw milk ingredients such as proteins, fat and fatty acids, and bacterial components has been recently studied and its influence on the immune function has been documented. In this review, we present the current understanding of the protective effect of raw milk on allergies and asthma.
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Serological investigation of IgG and IgE antibodies against food antigens in patients with inflammatory bowel disease.
Wang, HY, Li, Y, Li, JJ, Jiao, CH, Zhao, XJ, Li, XT, Lu, MJ, Mao, XQ, Zhang, HJ
World journal of clinical cases. 2019;7(16):2189-2203
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Crohn's disease and ulcerative colitis are relapsing gut inflammatory diseases that are usually referred to as Inflammatory Bowel Disease (IBD). It may be triggered by an imbalance in immune response in response to environmental factors such as diet. The aim of this retrospective study was to evaluate the presence of IgG and IgE mediated antibodies to food antigens in IBD patients. There were one hundred and thirty-seven IBD patients participating in this study, including forty Ulcerative colitis patients and ninety-seven Crohn's disease patients against fifty healthy controls to test serum IgG antibodies to fourteen specific food antigens and serum IgE antibodies to fourteen specific food antigens. There were significantly higher IgG antibodies in response to food antigens in Crohn's disease patients than in Ulcerative colitis patients and healthy controls. Food antigens such as tomato, corn, egg, rice, and soybean exhibited varying levels of IgG antibody responses in Crohn's disease patients and ulcerative colitis patients. Smokers were more likely to develop IgG reactions. Further robust research is needed to examine more IgG-specific food antigens to help manage IBD with an elimination rotation diet. The results of this study can help healthcare professionals understand the importance of diagnosing food intolerances when treating IBD.
Abstract
BACKGROUND Food antigens have been shown to participate in the etiopathogenesis of inflammatory bowel disease (IBD), but their clinical value in IBD is still unclear. AIM: To analyze the levels of specific immunoglobulin G (IgG) and E (IgE) antibodies against food antigens in IBD patients and to determine their clinical value in the pathogenesis of IBD. METHODS We performed a retrospective study based on patients who visited the First Affiliated Hospital of Nanjing Medical University between August 2016 and January 2018. A total of 137 IBD patients, including 40 patients with ulcerative colitis (UC) and 97 patients with Crohn's disease (CD), and 50 healthy controls (HCs), were recruited. Serum food-specific IgG antibodies were detected by semi-quantitative enzyme-linked immunosorbent assay, and serum food-specific IgE antibodies were measured by Western blot. The value of food-specific IgG antibodies was compared among different groups, and potent factors related to these antibodies were explored by binary logistic regression. RESULTS Food-specific IgG antibodies were detected in 57.5% of UC patients, in 90.72% of CD patients and in 42% of HCs. A significantly high prevalence and titer of food-specific IgG antibodies were observed in CD patients compared to UC patients and HCs. The number of IgG-positive foods was greater in CD and UC patients than in HCs (CD vs HCs, P = 0.000; UC vs HCs, P = 0.029). The top five food antigens that caused positive specific IgG antibodies in CD patients were tomato (80.68%), corn (69.32%), egg (63.64%), rice (61.36%), and soybean (46.59%). The foods that caused positive specific IgG antibodies in UC patients were egg (60.87%), corn (47.83%), tomato (47.83%), rice (26.09%), and soybean (21.74%). Significantly higher levels of total food-specific IgG were detected in IBD patients treated with anti-TNFα therapy compared to patients receiving steroids and immunosuppressants (anti-TNFα vs steroids, P = 0.000; anti-TNFα vs immunosuppressants, P = 0.000; anti-TNFα vs steroids + immunosuppressants, P = 0.003). A decrease in food-specific IgG levels was detected in IBD patients after receiving anti-TNFα therapy (P = 0.007). Patients who smoked and CD patients were prone to developing serum food-specific IgG antibodies [Smoke: OR (95%CI): 17.6 (1.91-162.26), P = 0.011; CD patients: OR (95%CI): 12.48 (3.45-45.09), P = 0.000]. There was no difference in the prevalence of food-specific IgE antibodies among CD patients (57.1%), UC patients (65.2%) and HCs (60%) (P = 0.831). CONCLUSION CD patients have a higher prevalence of food-specific IgG antibodies than UC patients and HCs. IBD patients are prone to rice, corn, tomato and soybean intolerance. Smoking may be a risk factor in the occurrence of food-specific IgG antibodies. Food-specific IgG antibodies may be a potential method in the diagnosis and management of food intolerance in IBD.
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Reversing the immune ageing clock: lifestyle modifications and pharmacological interventions.
Duggal, NA
Biogerontology. 2018;19(6):481-496
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Advancing age is accompanied by a compromised ability of older adults to combat bacterial and viral infections, increased risk of autoimmunity, poor vaccination responses and the re-emergence of latent infections. This review discusses current understanding of immunesenescence [the gradual deterioration of our immune system as we get older] and also focuses on lifestyle interventions and therapeutic strategies that have been shown to restore immune functioning in aged individuals. Findings show that: - changes in nutrition and lifestyle can be an effective approach towards improving immune outcome in older adults but may be hard to achieve at a population level. - improving immune responses, such as the developments of vaccines, may be used as an early biomarker for anti-ageing effects. Authors conclude that immunomodulation represents a promising therapeutic approach to improve the health of older adults.
Abstract
It is widely accepted that ageing is accompanied by remodelling of the immune system, including reduced numbers of naïve T cells, increased senescent or exhausted T cells, compromise to monocyte, neutrophil and natural killer cell function and an increase in systemic inflammation. In combination these changes result in increased risk of infection, reduced immune memory, reduced immune tolerance and immune surveillance, with significant impacts upon health in old age. More recently it has become clear that the rate of decline in the immune system is malleable and can be influenced by environmental factors such as physical activity as well as pharmacological interventions. This review discusses briefly our current understanding of immunesenescence and then focuses on lifestyle interventions and therapeutic strategies that have been shown to restore immune functioning in aged individuals.
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Navy Beans Impact the Stool Metabolome and Metabolic Pathways for Colon Health in Cancer Survivors.
Baxter, BA, Oppel, RC, Ryan, EP
Nutrients. 2018;11(1)
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Colorectal cancer (CRC) is one of the leading cause of cancer-related death around the world. Emerging evidence supports that increased consumption of pulses / legumes, such as navy beans, can reduce risk. Consuming navy beans as part of one's diet has been previously shown to positively affect the relationship between a person's gut bacteria and their health status. This study looked at stool samples to assess the impact of navy bean consumption on health based on the by-products of metabolism generated by gut bacteria (metabolites). The study was a 4-week, randomised-controlled trial with overweight and obese CRC survivors and involved consumption of 1 meal and 1 snack daily. People in the intervention group ate 35g of cooked navy bean daily whereas those in the control group had 0g of navy beans. From amongst the hundreds of metabolites identified in both groups, there was a 5-fold increase in ophthalmate for navy bean consumers, which can indicate an increase in glutathione. Glutathione is an antioxidant and detoxifying substance produced in the human liver. It is involved in cancer control mechanisms such as detoxification of xenobiotics (toxins), antioxidant defense, proliferation, and apoptosis. Other interesting results include the metabolism of the amino acid lysine, which supports health immune function, and an increase in plant-based nutrients or phytochemicals in those who consumed navy bean vs the control group. These results are indicative of an acute response to increased navy bean intake, which merit further investigation for improving colonic health after long-term consumption.
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States and emerging evidence supports that increased consumption of legumes, such as navy beans, can reduce risk. Navy bean consumption was previously shown to modulate host and microbiome metabolism, and this investigation was performed to assess the impact on the human stool metabolome, which includes the presence of navy bean metabolites. This 4-week, randomized-controlled trial with overweight and obese CRC survivors involved consumption of 1 meal and 1 snack daily. The intervention contained 35 g of cooked navy bean or macronutrient matched meals and snacks with 0 g of navy beans for the control group (n = 18). There were 30 statistically significant metabolite differences in the stool of participants that consumed navy bean at day 28 compared to the participants' baseline (p ≤ 0.05) and 26 significantly different metabolites when compared to the control group. Of the 560 total metabolites identified from the cooked navy beans, there were 237 possible navy bean-derived metabolites that were identified in the stool of participants consuming navy beans, such as N-methylpipecolate, 2-aminoadipate, piperidine, and vanillate. The microbial metabolism of amino acids and fatty acids were also identified in stool after 4 weeks of navy bean intake including cadaverine, hydantoin-5 propionic acid, 4-hydroxyphenylacetate, and caprylate. The stool relative abundance of ophthalmate increased 5.25-fold for navy bean consumers that can indicate glutathione regulation, and involving cancer control mechanisms such as detoxification of xenobiotics, antioxidant defense, proliferation, and apoptosis. Metabolic pathways involving lysine, and phytochemicals were also modulated by navy bean intake in CRC survivors. These metabolites and metabolic pathways represent an acute response to increased navy bean intake, which merit further investigation for improving colonic health after long-term consumption.
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Sourdough Fermentation Favorably Influences Selenium Biotransformation and the Biological Effects of Flatbread.
Di Nunzio, M, Bordoni, A, Aureli, F, Cubadda, F, Gianotti, A
Nutrients. 2018;10(12)
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Selenium (Se) is a soil-based trace element essential for immune system functionality, hormone regulation and muscular metabolism, however several regions in the world are deficient in Se. The current approach to this global health issue is fortification with Se-enriched flour, but this comes with its trials due to a small range between deficiency and toxicity. The primary aim of this study was to identify whether sourdough fermentation increases the bioavailability of Se in a typical flatbread. Flatbreads were prepared with either control wheat flour or inorganic Se-enriched wheat flour, and both were subject to conventional and sourdough fermentation. The variations were submitted to in vitro simulation human digestion and the biological effect of products were tested using cultured liver cells. This study found the use of Se-enriched flour significantly increased Se content of the flatbread. Sourdough fermentation, compared with conventional fermentation, led to a major conversion of inorganic Se present in the flour into the organic species, which is significantly more available for absorption. Based on these results, the authors conclude sourdough fermentation is a strategy that should be utilised to improve Se deficiency throughout the world.
Abstract
Although selenium is of great importance for the human body, in several world regions the intake of this essential trace element does not meet the dietary reference values. To achieve optimal intake, fortification of bread by using selenium-enriched flour has been put forward. Less is known on the potential effect of sourdough fermentation, which might be worth exploring as the biological effects of selenium strongly depend on its chemical form and sourdough fermentation is known to cause transformations of nutrients and phytochemicals, including the conversion of inorganic selenium into organic selenocompounds. Here we investigated the bio transformation of selenium by sourdough fermentation in a typical Italian flatbread (piadina) made with standard (control) or selenium-enriched flour. The different piadina were submitted to in vitro digestion, and the biological activity of the resulting hydrolysates was tested by means of cultured human liver cells exposed to an exogenous oxidative stress. The use of selenium-enriched flour and sourdough fermentation increased the total content of bioaccessible selenium in organic form, compared to conventional fermentation, and led to protective effects counteracting oxidative damage in cultured cells. The present study suggests that selenium-rich, sourdough-fermented bakery products show promise for improving human selenium nutrition whenever necessary.
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The gut microbiome and irritable bowel syndrome.
Menees, S, Chey, W
F1000Research. 2018;7
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This study is a review of role of gut microbiome plays in the pathophysiology of Irritable bowel syndrome (IBS) sufferers. The author’s main objective was to identify the biomarkers that may lead into diagnosing and choosing best available therapy available from various interventions available for IBS that targets the gut microbiome, such as prebiotics, probiotics, non-absorbable antibiotics, diet and faecal microbial transplant (FMT). The authors concluded that to enable the right treatment for IBS sufferers it would be better to understand what constitutes a healthy gut rather than deciphering what is abnormal.
Abstract
Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders encountered in clinical practice. It is a heterogeneous disorder with a multifactorial pathogenesis. Recent studies have demonstrated that an imbalance in gut bacterial communities, or "dysbiosis", may be a contributor to the pathophysiology of IBS. There is evidence to suggest that gut dysbiosis may lead to activation of the gut immune system with downstream effects on a variety of other factors of potential relevance to the pathophysiology of IBS. This review will highlight the data addressing the emerging role of the gut microbiome in the pathogenesis of IBS and review the evidence for current and future microbiome based treatments.
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Fecal Microbiome and Food Allergy in Pediatric Atopic Dermatitis: A Cross-Sectional Pilot Study.
Fieten, KB, Totté, JEE, Levin, E, Reyman, M, Meijer, Y, Knulst, A, Schuren, F, Pasmans, SGMA
International archives of allergy and immunology. 2018;175(1-2):77-84
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Atopic diseases, such as atopic dermatitis (AD), asthma and rhinitis, are on the increase worldwide. Exposure to microbes may be important in the development of an atopic disease. Specifically, reduced early-life exposure is thought to be a contributing factor because microbial colonisation of the intestines during infancy plays a crucial role in the maturation of the immune system. AD, also called eczema, is an inflammatory skin disease often seen in small children. Food allergies are common in children with AD, the most common allergens being eggs, cow’s milk, peanuts, soy and wheat. This cross-sectional observational pilot study with 82 young children with a diagnosis of AD set out to identify distinct microbial patterns in the children’s faecal microbiomes associated with a clinical diagnosis of food allergy. Stool and blood samples were collected for a microbiome analysis and IgE antibody measurement, respectively. 20 children had a confirmed food allergy (most commonly to cow’s milk and peanuts), while almost half of the children without a diagnosed food allergy were sensitised to common food allergens after a food challenge. The study identified a faecal microbial signature in children with AD that differentiates between the presence and absence of food allergy. Children with AD and food allergy had more Escherichia coli and Bifidobacterium pseudocatenulatum species and less Bifidobacterium breve, Faecalibacterium prausnitzii and Akkermansia muciniphila species than children without food allergy. The authors concluded that the study supports a hypothesis that the intestinal microbiome differs in children with AD, depending on whether they have a food allergy or not. They call for future studies to confirm these findings.
Abstract
BACKGROUND Exposure to microbes may be important in the development of atopic disease. Atopic diseases have been associated with specific characteristics of the intestinal microbiome. The link between intestinal microbiota and food allergy has rarely been studied, and the gold standard for diagnosing food allergy (double-blind placebo-controlled food challenge [DBPCFC]) has seldom been used. We aimed to distinguish fecal microbial signatures for food allergy in children with atopic dermatitis (AD). METHODS Pediatric patients with AD, with and without food allergy, were included in this cross-sectional observational pilot study. AD was diagnosed according to the UK Working Party criteria. Food allergy was defined as a positive DBPCFC or a convincing clinical history, in combination with sensitization to the relevant food allergen. Fecal samples were analyzed using 16S rRNA microbial analysis. Microbial signature species, discriminating between the presence and absence food allergy, were selected by elastic net regression. RESULTS Eighty-two children with AD (39 girls) with a median age of 2.5 years, and 20 of whom were diagnosed with food allergy, provided fecal samples. Food allergy to peanut and cow's milk was the most common. Six bacterial species from the fecal microbiome were identified, that, when combined, distinguished between children with and without food allergy: Bifidobacterium breve, Bifidobacterium pseudocatenulatum, Bifidobacterium adolescentis, Escherichia coli, Faecalibacterium prausnitzii, and Akkermansia muciniphila (AUC 0.83, sensitivity 0.77, specificity 0.80). CONCLUSIONS In this pilot study, we identified a microbial signature in children with AD that discriminates between the absence and presence of food allergy. Future studies are needed to confirm our findings.
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The microbiome and autoimmunity: a paradigm from the gut-liver axis.
Li, B, Selmi, C, Tang, R, Gershwin, ME, Ma, X
Cellular & molecular immunology. 2018;15(6):595-609
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The incidence of autoimmune and inflammatory diseases has been increasing worldwide. Changes in environmental factors, such as modern lifestyle, diet, antibiotics and hygiene are thought to play a critical role in the development of various autoimmune diseases. It is the mucosal microbial flora that is shaped by our environment and communicates with the innate and adaptive immune systems, and when disrupted, can lead to the loss of immune tolerance and dysregulated immune cells. This review paper provides an overview of the interactions between the intestinal microbiome and the immune system. It explains how these interactions affect host autoimmunity locally and systemically and sheds light on the molecular mechanisms, utilised by microbes that may contribute to systemic autoimmunity in genetically susceptible individuals. The links between the gut microbiome and various autoimmune diseases, such as rheumatoid arthritis, type 1 diabetes and multiple sclerosis, as well as the gut-liver axis, involving intestinal microbiome and autoimmune liver diseases, are discussed in more detail.
Abstract
Microbial cells significantly outnumber human cells in the body, and the microbial flora at mucosal sites are shaped by environmental factors and, less intuitively, act on host immune responses, as demonstrated by experimental data in germ-free and gnotobiotic studies. Our understanding of this link stems from the established connection between infectious bacteria and immune tolerance breakdown, as observed in rheumatic fever triggered by Streptococci via molecular mimicry, epitope spread and bystander effects. The availability of high-throughput techniques has significantly advanced our capacity to sequence the microbiome and demonstrated variable degrees of dysbiosis in numerous autoimmune diseases, including rheumatoid arthritis, type 1 diabetes, multiple sclerosis and autoimmune liver disease. It remains unknown whether the observed differences are related to the disease pathogenesis or follow the therapeutic and inflammatory changes and are thus mere epiphenomena. In fact, there are only limited data on the molecular mechanisms linking the microbiota to autoimmunity, and microbial therapeutics is being investigated to prevent or halt autoimmune diseases. As a putative mechanism, it is of particular interest that the apoptosis of intestinal epithelial cells in response to microbial stimuli enables the presentation of self-antigens, giving rise to the differentiation of autoreactive Th17 cells and other T helper cells. This comprehensive review will illustrate the data demonstrating the crosstalk between intestinal microbiome and host innate and adaptive immunity, with an emphasis on how dysbiosis may influence systemic autoimmunity. In particular, a gut-liver axis involving the intestinal microbiome and hepatic autoimmunity is elucidated as a paradigm, considering its anatomic and physiological connections.