Gut microbiota and bone aging: Focusing on the gut-X axis modes

作者：Yuan-Wei Zhang, Rui-Yang Li, Yan Wu, Peng Wang, Qirong Zhou, Jiacan Su · 发表于：Journal of Orthopaedic Translation · 年份：2026 · DOI：10.1016/j.jot.2026.101064 · 被引用次数：8 · 研究领域：Gut microbiota and health、Bone health and osteoporosis research、Bone Metabolism and Diseases

As studies have continuously advanced, cross-linking interplay between various organs in aging individuals have continuously emerged as research hotspots. The role of gut microbiota in bone aging-related diseases, including osteoporosis, osteoarthritis, and intervertebral disc degeneration, has been extensively probed. This review first summarized the inseparable association between gut microbiota and osteoporosis, osteoarthritis, and intervertebral disc degeneration, which then explored potential mechanisms of gut-X axis through neuromodulation (microbiota-gut-brain-bone axis), immunomodulation (Th17 and Treg balance), endocrine regulation (gut-derived hormones and 5-HT), metabolite-mediated regulation (SCFAs), bacterial extracellular vesicles, and changes in microbial niche and gut microbiome-associated biomarkers. Moreover, potential intervention strategies including diet, probiotics, fecal microbiota transplantation, and physical activity were summarized to enhance clinical translation applicability. This review creatively exhibited integrated concept of "gut-X axis" to explore common, patterned mechanisms underlying "gut-bone axis", "gut-joint axis", and "gut-disc axis". Furthermore, it delves into potential mechanisms by which this shared pattern regulates bone aging-related diseases and prospectively outlines therapeutic strategies for bone aging based on this axis. The translational potential of this article: This review presents crucial role and regulatory significan...