Osteoporosis is a prevalent metabolic skeletal disorder characterized by reduced bone mass, deteriorated trabecular microarchitecture, and increased fragility fracture risk, imposing substantial global medical, social and economic burdens. Current first-line antiresorptive and anabolic therapeutics are severely constrained by long-term adverse reactions, insufficient patient adherence, and compromised bone microenvironment remodeling capacity, leaving a large unmet clinical demand for multitargeted and translational interventions.
The gut–bone axis has been recognized as a core interorgan regulatory signaling network, in which gut microbiota orchestrates bone homeostasis through multiple cascaded mechanisms, including microbial metabolite production (short-chain fatty acids, tryptophan derivatives and bile acids), osteoimmune balance modulation (Th17/Treg axis and macrophage polarization), intestinal barrier maintenance, as well as the regulation of estrogen bioavailability, calcium-phosphorus absorption and vitamin D/VDR signaling. In parallel, advanced functional biomaterials, including modified bone cements, injectable hydrogels, intelligent nanocarriers and immune-regulatory scaffolds, have overcome the defects of conventional bone grafts and inert implant materials, exhibiting tunable mechanical properties, controllable degradation and precise bioactive cargo delivery for osteoporotic bone repair.
Frontiers in Immunology published a clinical update in Infectious Disease on 20 May 2026.
The item focuses on The role of gut microbiota in osteoporosis: underlying mechanisms, clinical associations, and emerging biomaterials.
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