Researchers at The University of Alabama, including faculty with the College of Community Health Sciences, found in a preclinical study that combining an immunosuppressant drug and a dietary-derived compound showed a greater benefit in treating lupus than either treatment alone.
The dietary compound, Urolithin A, is designated by the U.S. Food and Drug Administration as “generally regarded as safe” and is widely available as an over-the-counter supplement. The GRAS designation means it can be translated into commercial dietary supplements and functional foods without the additional regulatory hurdles required for new food additives.
The research, conducted in UA’s Drug Research and Engineering for Advanced Medicine Laboratory, is part of a broader effort to explore if carefully tested and widely available compounds can play a role alongside traditional pharmaceutical treatments. The research team is led by Dr. M.N.V. Ravi Kumar, Distinguished University Research Professor with CCHS and professor in the College’s Department of Translational Science and Medicine. Kumar also serves as UA’s vice president for Interdisciplinary Research and is the founding director of the University’s Center for Convergent Bioscience & Medicine.
Lupus is a chronic autoimmune disease and existing treatments, like cyclosporine, are often taken with steroids to manage inflammation. This study explored whether molecules like Urolithin A, a compound naturally metabolized by gut bacteria from precursors in pomegranates, berries and nuts but administered here as a synthetic compound, could eventually manage that inflammation with fewer side effects. Utilizing a synthetic form is a critical distinction, as only about 30% to 40% of the population naturally possesses the specific gut microbiome required to covert these dietary sources into active Urolithin A.
Researchers tested the two substances alone and then in combination. The study used a well-established rodent model, selecting only females to reflect the way lupus occurs at higher rates in women than men.
By itself, urolithin showed limited effect on the disease progression. Cyclosporine alone showed some benefit, mirroring its existing use in lupus treatment. The combination performed significantly better than either treatment alone.
Supplements are sometimes marketed with exaggerated claims, making it important for consumers to consult a doctor before adding a new supplement to their existing treatment plan. However, certain supplements on the market do offer real clinical value. Kumar has worked for two decades to gather reliable data on molecules derived from dietary sources. His goal is to systematically evaluate these kinds of molecules so physicians have reliable science rather than anecdotal claims.
“The goal is not to promote supplements but to systematically test whether compounds known to be safe can support existing therapies and ultimately benefit patients,” Kumar said.
Unlike many early-stage studies, this research focused on a straightforward combination of already available products, offering a potentially more practical path for future translational work. While this is a preclinical trial, and patients shouldn’t replace prescribed medications with an over-the-counter supplement, Kumar is optimistic about the result.
“With further work in the long term, approaches like this could potentially help reduce reliance on treatments for lupus with more severe side effects,” he said.
The study, published recently in the Journal of Immunology, was co-authored with researchers from the University of Houston, the University of Alabama at Birmingham and Baylor University in Waco, Texas.
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