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Although indoleamine 2,3-dioxygenase 2 (IDO2) is homologous to IDO1, it differs in catalytic efficiency and tissue distribution, and is considered to potentially participate in Trp metabolic regulation in the context of certain autoimmune diseases ( In addition to host enzymatic systems, the gut microbiota can also convert Trp into a variety of indole derivatives, such as indole-3-acetic acid, and these metabolites can likewise act as AhR ligands to participate in the regulation of mucosal immune homeostasis and may alter inflammatory outcomes by affecting the immunoregulatory programs of local macrophages/mononuclear phagocytes (51)

EPS of Lactobacillus species engage with TLR2, stimulating the PI3K/Akt/mTOR pathway to enhance IFN- production and restore NK cell cytotoxicity suppressed in SLE ( Figure 2 ) (113)

Significant heterogeneity was defined as a P -value 30 kg/m 2 ), race (White vs

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These studies were deemed to be comparable in terms of their study design, where most studies were double-blind and multinational, with representation from Europe, North America, South America, Asia, Africa and Oceania