Exploring the role of intestinal pathogenic bacteria in metronidazole-induced bone loss: focus on Klebsiella variicola

Abstract Antibiotic use is known to contribute to the development of osteoporosis, although the exact mechanisms remain poorly understood. Metronidazole (MET), a commonly prescribed antibiotic for treating anaerobic infections, has been linked to alterations in the gut microbiota (GM), which in turn...

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Main Authors: Xia Chen, Hongming Li, Guang Wang, Zhenxing Wang, Yan Lv, Hui Xie, Sheng Zhu
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Gut Pathogens
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Online Access:https://doi.org/10.1186/s13099-025-00713-4
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author Xia Chen
Hongming Li
Guang Wang
Zhenxing Wang
Yan Lv
Hui Xie
Sheng Zhu
author_facet Xia Chen
Hongming Li
Guang Wang
Zhenxing Wang
Yan Lv
Hui Xie
Sheng Zhu
author_sort Xia Chen
collection DOAJ
description Abstract Antibiotic use is known to contribute to the development of osteoporosis, although the exact mechanisms remain poorly understood. Metronidazole (MET), a commonly prescribed antibiotic for treating anaerobic infections, has been linked to alterations in the gut microbiota (GM), which in turn are associated with various adverse side effects in the host. Recent studies have shown that the GM plays a key role in regulating bone homeostasis, though the underlying mechanisms remain under investigation. In this study, we demonstrate for the first time that MET promotes inflammatory osteoporosis through gut dysbiosis, with Klebsiella variicola (K. variicola) identified as a major pathogen influencing bone metabolism. The pro-inflammatory extracellular vesicles (EVs) secreted by K. variicola induce enhanced inflammatory responses and osteoclastic differentiation in both bone macrophages and bone tissue. Notably, the use of antibiotics that target K. variicola effectively mitigates MET-induced bone loss in vivo. This study expands our understanding of the mechanisms underlying antibiotic-induced bone loss and underscores the significant role of the pathogenic bacterium K. variicola in the development of osteoporosis, providing new avenues for future research on the microbiota-gut-bone axis in bone-related diseases.
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spelling doaj-art-7be47a044bd04598988545f17730ee152025-08-20T02:05:13ZengBMCGut Pathogens1757-47492025-06-0117111410.1186/s13099-025-00713-4Exploring the role of intestinal pathogenic bacteria in metronidazole-induced bone loss: focus on Klebsiella variicolaXia Chen0Hongming Li1Guang Wang2Zhenxing Wang3Yan Lv4Hui Xie5Sheng Zhu6Department of Orthopedics, Movement System Injury and Repair Research Center, Xiangya Hospital, Central South UniversityDepartment of Orthopedics, Movement System Injury and Repair Research Center, Xiangya Hospital, Central South UniversityDepartment of Orthopedics, Movement System Injury and Repair Research Center, Xiangya Hospital, Central South UniversityDepartment of Orthopedics, Movement System Injury and Repair Research Center, Xiangya Hospital, Central South UniversityDepartment of Clinical Laboratory, Xiangya Hospital, Central South UniversityDepartment of Orthopedics, Movement System Injury and Repair Research Center, Xiangya Hospital, Central South UniversityDepartment of Orthopedics, Movement System Injury and Repair Research Center, Xiangya Hospital, Central South UniversityAbstract Antibiotic use is known to contribute to the development of osteoporosis, although the exact mechanisms remain poorly understood. Metronidazole (MET), a commonly prescribed antibiotic for treating anaerobic infections, has been linked to alterations in the gut microbiota (GM), which in turn are associated with various adverse side effects in the host. Recent studies have shown that the GM plays a key role in regulating bone homeostasis, though the underlying mechanisms remain under investigation. In this study, we demonstrate for the first time that MET promotes inflammatory osteoporosis through gut dysbiosis, with Klebsiella variicola (K. variicola) identified as a major pathogen influencing bone metabolism. The pro-inflammatory extracellular vesicles (EVs) secreted by K. variicola induce enhanced inflammatory responses and osteoclastic differentiation in both bone macrophages and bone tissue. Notably, the use of antibiotics that target K. variicola effectively mitigates MET-induced bone loss in vivo. This study expands our understanding of the mechanisms underlying antibiotic-induced bone loss and underscores the significant role of the pathogenic bacterium K. variicola in the development of osteoporosis, providing new avenues for future research on the microbiota-gut-bone axis in bone-related diseases.https://doi.org/10.1186/s13099-025-00713-4MetronidazoleGut microbiotaOsteoporosisKlebsiella variicolaExtracellular vesicles
spellingShingle Xia Chen
Hongming Li
Guang Wang
Zhenxing Wang
Yan Lv
Hui Xie
Sheng Zhu
Exploring the role of intestinal pathogenic bacteria in metronidazole-induced bone loss: focus on Klebsiella variicola
Gut Pathogens
Metronidazole
Gut microbiota
Osteoporosis
Klebsiella variicola
Extracellular vesicles
title Exploring the role of intestinal pathogenic bacteria in metronidazole-induced bone loss: focus on Klebsiella variicola
title_full Exploring the role of intestinal pathogenic bacteria in metronidazole-induced bone loss: focus on Klebsiella variicola
title_fullStr Exploring the role of intestinal pathogenic bacteria in metronidazole-induced bone loss: focus on Klebsiella variicola
title_full_unstemmed Exploring the role of intestinal pathogenic bacteria in metronidazole-induced bone loss: focus on Klebsiella variicola
title_short Exploring the role of intestinal pathogenic bacteria in metronidazole-induced bone loss: focus on Klebsiella variicola
title_sort exploring the role of intestinal pathogenic bacteria in metronidazole induced bone loss focus on klebsiella variicola
topic Metronidazole
Gut microbiota
Osteoporosis
Klebsiella variicola
Extracellular vesicles
url https://doi.org/10.1186/s13099-025-00713-4
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