肠道-骨轴串扰：微生物驱动的免疫代谢神经网络在骨疾病和精确干预中的应用
Gut-bone axis crosstalk: Microbiota-driven immune-metabolic-neural networks in bone disorders and precision interventions.
摘要(中文译文)
肠道微生物群通过复杂的肠道-骨骼轴调节骨代谢，涉及短链脂肪酸（SCFA）、免疫调节和神经内分泌信号。然而，确切的机制尚不清楚，针对微生物群的干预措施（益生菌、益生元、粪便微生物群移植）尚未针对临床使用进行优化。本综述系统地综合了肠-骨轴内的免疫代谢神经相互作用网络，强调了SCFA、胆汁酸、色氨酸衍生物、免疫细胞（巨噬细胞、Treg/Th17）和迷走神经信号之间的非线性串扰。我们批判性地评估转化障碍，包括异质性研究设计、混杂因素和缺乏因果证据。基于这种网络视角，我们提出了一个未来研究的框架，该框架优先考虑多组学方法、分层干预和严格试验。这一综合推进了对肠道生态失调如何导致骨骼疾病的理解，并为精确的骨骼医学铺平了道路。本综述确定了骨代谢紊乱风险分层的微生物标志物，并讨论了基于SCFA的策略和粪便微生物群移植（FMT）在骨质疏松症、骨折愈合受损、类风湿性关节炎和糖皮质激素相关性骨坏死等疾病中的应用。它为大规模随机对照试验（RCT）提供了可检验的假设，直接支持将微生物组研究转化为骨疾病的临床实践。
Abstract
The gut microbiota regulates bone metabolism via a complex gut-bone axis involving short-chain fatty acids (SCFAs), immune modulation, and neuroendocrine signals. However, the precise mechanisms remain unclear, and microbiota-targeted interventions (probiotics, prebiotics, fecal microbiota transplantation) are not yet optimized for clinical use. This review systematically synthesizes the immune-metabolic-neural interaction network within the gut-bone axis, highlighting non-linear crosstalk among SCFAs, bile acids, tryptophan derivatives, immune cells (macrophages, Treg/Th17), and vagus nerve signaling. We critically assess translational hurdles, including heterogeneous study designs, confounding factors, and lack of causal evidence. Based on this network perspective, we propose a framework for future research that prioritizes multi-omics approaches, stratified interventions, and rigorous trials. This synthesis advances understanding of how gut dysbiosis drives bone disorders and paves the way for precision skeletal medicine. This review identifies microbial markers for risk stratification of bone metabolic disorders and discusses SCFA-based strategies and fecal microbiota transplantation (FMT) in conditions including osteoporosis, impaired fracture healing, rheumatoid arthritis, and glucocorticoid-associated osteonecrosis. It provides testable hypotheses for large-scale randomized controlled trials (RCTs), directly supporting translation of microbiome research into clinical practice for bone disorders.
如何引用
AMA
Rong Qin, Peng Yu, Hui Wang, Jing Zhou, Rui Gong, Yiyao Duan, et al. Gut-bone axis crosstalk: Microbiota-driven immune-metabolic-neural networks in bone disorders and precision interventions.. Journal of orthopaedic translation. 2026; doi:10.1016/j.jot.2026.101126.
APA
Rong Qin, Peng Yu, Hui Wang, Jing Zhou, Rui Gong, Yiyao Duan, et al (2026). Gut-bone axis crosstalk: Microbiota-driven immune-metabolic-neural networks in bone disorders and precision interventions.. Journal of orthopaedic translation. https://doi.org/10.1016/j.jot.2026.101126
GB/T 7714
Rong Qin, Peng Yu, Hui Wang, Jing Zhou, Rui Gong, Yiyao Duan, et al. Gut-bone axis crosstalk: Microbiota-driven immune-metabolic-neural networks in bone disorders and precision interventions.[J]. Journal of orthopaedic translation, 2026 doi:10.1016/j.jot.2026.101126.
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