Department of Spine, Honghui-hospital, Xi'an Jiaotong University, School of Medicine, Xi'an, China.
Curr Med Chem. 2021;28(25):5228-5247. doi: 10.2174/0929867328666210316115126.
Osteoporosis is very common in middle-aged and elderly people, and its main feature is a disease characterized by bone mass reduction and bone microstructure changes, accompanied by a corresponding increase in the risk of fracture. This is a disease affected by many factors and is more common in postmenopausal women. Currently, the treatment of osteoporosis is mainly to prevent bone resorption and reduce the risk of fracture; a variety of drugs have been used in the treatment of osteoporosis and achieved good results. In recent years, with the in-depth study of intestinal microorganisms, a strong impact of intestinal microflora on bone metabolism in terms of immunity has been reported. It can be observed in mouse-based models, which indicates that intestinal flora may be a potential new target for changing bone mineral density (BMD). Therefore, the intestinal flora is a complex system that affects and regulates the absorption of calcium and vitamin D. It affects the permeability of the intestine through its own secretion of related influencing factors and its own activities, and further affects the secretion of human hormones and immune response. Besides that, T helper cells, lymphocytes, TNF, IL-17, and the RANKL system play a key role. The impact of probiotics and prebiotics on humans is controversial due to the scarcity of research data. However, many studies have shown that the role of probiotics in different animals varies with gender, age and hormone secretion. Changes in the intestinal flora are closely related to osteopenia and/or osteoporosis. Changing its composition and activity may be a reliable strategy for altering bone quality, although further clinical studies are needed to determine the correct human method.
骨质疏松症在中老年人中非常常见，其主要特征是一种以骨量减少和骨微观结构变化为特征的疾病，同时伴有相应的骨折风险增加。这是一种受多种因素影响的疾病，在绝经后妇女中更为常见。目前，骨质疏松症的治疗主要是预防骨吸收和降低骨折风险；已经使用了多种药物来治疗骨质疏松症并取得了良好的效果。近年来，随着对肠道微生物的深入研究，肠道微生物在免疫方面对骨代谢的强烈影响已被报道。在基于小鼠的模型中可以观察到这一点，这表明肠道菌群可能是改变骨矿物质密度（BMD）的潜在新靶点。因此，肠道菌群是一个复杂的系统，它影响和调节钙和维生素 D 的吸收。它通过自身分泌的相关影响因素及其自身的活动来影响肠道的通透性，进而影响人体激素的分泌和免疫反应。此外，辅助性 T 细胞、淋巴细胞、TNF、IL-17 和 RANKL 系统也起着关键作用。由于研究数据的缺乏，益生菌和益生元对人类的影响存在争议。然而，许多研究表明，益生菌在不同动物中的作用因性别、年龄和激素分泌的不同而不同。肠道菌群的变化与低骨量和/或骨质疏松症密切相关。改变其组成和活性可能是改变骨质量的可靠策略，尽管需要进一步的临床研究来确定正确的人类方法。
