The gut–bone axis in osteoporosis: a multifaceted interaction with implications for bone health

With the accelerated aging of the population, degenerative orthopedic diseases, particularly osteoporosis, have become a major public health challenge, threatening bone health and affecting the quality of life. Existing anti-osteoporosis regimens remain rather unitary or poorly adhered, which also l...

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Main Authors: Chunli Gu, Hong Du, Ningying Li, Yunlong Zhou, Sha Li, Yuchen Sun, Yiyang Han, Xuan Xu, Xianrong Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1569152/full
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author Chunli Gu
Chunli Gu
Hong Du
Ningying Li
Yunlong Zhou
Sha Li
Yuchen Sun
Yiyang Han
Xuan Xu
Xianrong Li
author_facet Chunli Gu
Chunli Gu
Hong Du
Ningying Li
Yunlong Zhou
Sha Li
Yuchen Sun
Yiyang Han
Xuan Xu
Xianrong Li
author_sort Chunli Gu
collection DOAJ
description With the accelerated aging of the population, degenerative orthopedic diseases, particularly osteoporosis, have become a major public health challenge, threatening bone health and affecting the quality of life. Existing anti-osteoporosis regimens remain rather unitary or poorly adhered, which also limits the maintenance of bone health to some extent. Given the increasingly elucidated prominence of gut-related factors in osteoblasts/osteoclasts and bone formation/metabolism/maintenance, focusing on intestinal microecology and then targeting the distal bone tissue via the gut–bone axis have been recognized as a feasible intervention strategy. This review systematically summarized the interaction of the gut–bone axis while highlighting the physicochemical barriers formed by intestinal intrinsic structures, the gut microbiota, and related molecules for bone health maintenance through the immune and endocrine pathways. Meanwhile, we emphasized the ideal anti-osteoporotic property and individual achievability of methods like fecal microbiota transplantation, probiotic and prebiotic supplementation, and dietary pattern modification. The conceptual framework of the gut–bone axis plus X was innovatively proposed, given the potential synergy among different organs in disease characterization and pathogenesis, which may help better explain the etiology and manage other co-morbidities concurrent with or secondary to osteoporosis. Since the intersection of orthopedics with other subjects, we also supported the application of nano-biomaterials, bacterial synthetic biology, and novel small molecules in anti-osteoporosis, which is expected to unlock broader prospects for the multidisciplinary integration of the gut–bone axis.
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spelling doaj-art-988c114df8934106969d569e30faabd62025-08-20T02:39:09ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.15691521569152The gut–bone axis in osteoporosis: a multifaceted interaction with implications for bone healthChunli Gu0Chunli Gu1Hong Du2Ningying Li3Yunlong Zhou4Sha Li5Yuchen Sun6Yiyang Han7Xuan Xu8Xianrong Li9School of Nursing, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Orthopedics, The People’s Hospital of Leshan, Leshan, Sichuan, ChinaSchool of Clinical Medicine, Southwest Medical University, Luzhou, Sichuan, ChinaSchool of Nursing, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Orthopedics, The People’s Hospital of Leshan, Leshan, Sichuan, ChinaDepartment of Orthopedics, The People’s Hospital of Leshan, Leshan, Sichuan, ChinaDepartment of Clinical Medicine, University of Hong Kong, Hongkong, Hongkong SAR, ChinaInstitute of Translational Medicine, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaInstitute of Translational Medicine, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaSchool of Nursing, Southwest Medical University, Luzhou, Sichuan, ChinaWith the accelerated aging of the population, degenerative orthopedic diseases, particularly osteoporosis, have become a major public health challenge, threatening bone health and affecting the quality of life. Existing anti-osteoporosis regimens remain rather unitary or poorly adhered, which also limits the maintenance of bone health to some extent. Given the increasingly elucidated prominence of gut-related factors in osteoblasts/osteoclasts and bone formation/metabolism/maintenance, focusing on intestinal microecology and then targeting the distal bone tissue via the gut–bone axis have been recognized as a feasible intervention strategy. This review systematically summarized the interaction of the gut–bone axis while highlighting the physicochemical barriers formed by intestinal intrinsic structures, the gut microbiota, and related molecules for bone health maintenance through the immune and endocrine pathways. Meanwhile, we emphasized the ideal anti-osteoporotic property and individual achievability of methods like fecal microbiota transplantation, probiotic and prebiotic supplementation, and dietary pattern modification. The conceptual framework of the gut–bone axis plus X was innovatively proposed, given the potential synergy among different organs in disease characterization and pathogenesis, which may help better explain the etiology and manage other co-morbidities concurrent with or secondary to osteoporosis. Since the intersection of orthopedics with other subjects, we also supported the application of nano-biomaterials, bacterial synthetic biology, and novel small molecules in anti-osteoporosis, which is expected to unlock broader prospects for the multidisciplinary integration of the gut–bone axis.https://www.frontiersin.org/articles/10.3389/fendo.2025.1569152/fullgut-bone axisosteoporosisgut microbiotaimmune and endocrine regulationorthopedic diseasesbone metabolism
spellingShingle Chunli Gu
Chunli Gu
Hong Du
Ningying Li
Yunlong Zhou
Sha Li
Yuchen Sun
Yiyang Han
Xuan Xu
Xianrong Li
The gut–bone axis in osteoporosis: a multifaceted interaction with implications for bone health
Frontiers in Endocrinology
gut-bone axis
osteoporosis
gut microbiota
immune and endocrine regulation
orthopedic diseases
bone metabolism
title The gut–bone axis in osteoporosis: a multifaceted interaction with implications for bone health
title_full The gut–bone axis in osteoporosis: a multifaceted interaction with implications for bone health
title_fullStr The gut–bone axis in osteoporosis: a multifaceted interaction with implications for bone health
title_full_unstemmed The gut–bone axis in osteoporosis: a multifaceted interaction with implications for bone health
title_short The gut–bone axis in osteoporosis: a multifaceted interaction with implications for bone health
title_sort gut bone axis in osteoporosis a multifaceted interaction with implications for bone health
topic gut-bone axis
osteoporosis
gut microbiota
immune and endocrine regulation
orthopedic diseases
bone metabolism
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1569152/full
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