Table 1

Gut microbiome manipulation as a therapy
Diet	Prebiotics and probiotics	Faecal microbial transplant (FMT)
Fish and vegetable consumption were associated with lower odds of having Sjögren’s.43 Mice on a high-fat diet had inflammatory changes in the eye and decreased lacrimal gland function.46	Prebiotics were associated with a reduced incidence of GVHD post stem cell transplant and maintained or improved gut microbial diversity.47 Probiotics were associated with improved RA activity and decreased inflammatory markers.48	Some patients with Sjögren’s and non-Sjögren’s dry eye who received FMT had subjectively improved dry eye symptoms.41 FMT improved symptoms and signs of patients with ulcerative colitis, metabolic syndrome and multiple sclerosis.52–54