REVIEW article
Front. Immunol.
Sec. Microbial Immunology
Osteoporosis and gut microbiota: current understandings
Provisionally accepted
- 1Beijing Jishuitan Hospital Affiliated to Capital Medical University, Beijing, China
- 2Beijing Research Institute of Traumatology and Orthopaedics, Beijing, China
- 3Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
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Osteoporosis (OP), a prevalent disease among middle-aged and elderly individuals, is characterized by a decrease in bone mineral density (BMD), which predisposes individuals to fragile fractures. The core pathological process involves excessive bone resorption over bone formation. The etiology of OP is intricate, and increasing recent studies have focused on the role of gut microbiota (GM) in its pathogenesis. Harmful bacteria exacerbate OP, whereas probiotics are beneficial for bone metabolism and delay the progression of OP. GM influences the progression of OP through various mechanisms, including the production of metabolites, modulation of the intestinal barrier, and regulation of intestinal immunity and osteoimmunology. In this review, we summarize the role of GM in the pathogenesis of OP based on the latest understandings, and highlight the promising potential of strategies targeting GM for the intervention and management of OP.
Keywords: bone metabolism, Gut Microbiota, leaky gut, Osteoporosis, Probiotics
Received: 05 Dec 2025; Accepted: 04 Feb 2026.
Copyright: © 2026 Liu, Lu, Bai, Han, Zha and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xieyuan Jiang
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.