Gut bone axis: Clinical implications

The guts is responsible for digestion and nutrient absorption, and they also play crucial roles in maintaining the microbiota, facilitating gut-brain communication, producing neuroendocrine signals, and modulating the immune response. Studies show that the gut microbiome impacts bone remodeling or bone resorption through its interactions and processes related with the immune system, endocrine system, metabolites, and extracellular vesicles. Dysbiosis causes gut inflammation and alteredgut integrity, including further inflammation with cytokine production which also inhibits bone formation. Prof. Flavia Indrio talks about the influence of gut microbiota on bone metabolism through metabolite-mediated barrier integrity and immune system. Short chain fatty acids (SCFAs) promote bone mineralization and bone formation by improving calcium availability and enhancing its absorption. The gut microbiota also confers its effect on bone homeostasis through the biphasic action of the serotonin and metabolites. Dietary supplementation with Human Milk Oligosaccharides, probiotics, postbiotics, and synbiotics are possible therapeutic interventions and useful adjuvant treatments to modulate bone metabolism management and sustain bone health.