Interdisciplinary Department of Medicine, School of Medicine, University of Bari Aldo Moro, Bari, Italy.
Endocr Metab Immune Disord Drug Targets. 2023;23(10):1278-1290. doi: 10.2174/1871530323666230330121301.
Bone health relies on the equilibrium between resorption and new bone generation. Postmenopausal osteoporosis depends on estrogen deficiency which favorite bone resorption and elevated risk of fractures. Moreover, osteoporosis is characterized by a high release of proinflammatory cytokines suggesting the role of the immune system in the pathogenesis of this complex disease (immunoporosis).
To review the pathophysiology of osteoporosis from an endocrinological and immunological viewpoint and treatments with a specific focus on nutraceuticals.
PubMed/MEDLINE, Scopus, Google Scholar, and institutional web site were searched. Original articles and reviews were screened and selected by September 2022.
The activation of the Gut Microbiota-Bone Axis contributes to bone health by releasing several metabolites, including short-chain fatty acids (SCFAs), that facilitate bone mineralization directly and indirectly by the induction of T regulatory cells, triggering anti-inflammatory pathways.
Treatments of postmenopausal osteoporosis are based on lifestyle changes, calcium and vitamin D supplementation, and anti-resorptive and anabolic agents, such as bisphosphonates, Denosumab, Teriparatide, Romosozumab. However, phytoestrogens, polyphenols, probiotics, and polyunsaturated fatty acids may improve bone health by several mechanisms, including anti-inflammatory properties. Specific clinical trials are needed to assess the efficacy/effectiveness of the possible anti-osteoporotic activity of natural products as add on to background treatment.
骨骼健康依赖于吸收和新骨生成之间的平衡。绝经后骨质疏松症依赖于雌激素缺乏，这有利于骨吸收并增加骨折风险。此外，骨质疏松症的特点是促炎细胞因子的大量释放，表明免疫系统在这种复杂疾病（免疫性骨质疏松症）的发病机制中起作用。
从内分泌和免疫学的角度综述骨质疏松症的病理生理学，并特别关注营养疗法的治疗。
在 2022 年 9 月之前，通过 PubMed/MEDLINE、Scopus、Google Scholar 和机构网站搜索了原始文章和综述文章，并进行了筛选和选择。
肠道微生物群-骨骼轴的激活通过释放几种代谢物来促进骨骼健康，包括短链脂肪酸（SCFAs），它们通过诱导 T 调节细胞直接和间接促进骨矿化，从而触发抗炎途径。
绝经后骨质疏松症的治疗基于生活方式的改变、钙和维生素 D 的补充，以及抗吸收和合成代谢药物，如双磷酸盐、地舒单抗、特立帕肽、罗莫佐单抗。然而，植物雌激素、多酚、益生菌和多不饱和脂肪酸可能通过多种机制改善骨骼健康，包括抗炎特性。需要进行特定的临床试验来评估天然产物可能的抗骨质疏松活性作为背景治疗的附加治疗的疗效/有效性。
