Chen Yao, Xie Ying, Yu Xijie
Department of Internal medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
Front Med. 2025 May 10. doi: 10.1007/s11684-025-1129-3.
Postmenopausal osteoporosis (PMOP) is a systemic metabolic bone disease caused by the decrease in estrogen levels after menopause. It leads to bone loss, microstructural damage, and an increased risk of fractures. Studies have found that the gut microbiota and its metabolites can regulate bone metabolism through the gut-bone axis and the gut-brain axis. As research progresses, PMOP has been found to be associated with gut microbiota dysbiosis and Th17/Treg imbalance. The gut microbiota is closely related to the development and differentiation of Treg and Th17 cells. Among them, the metabolites of the gut microbiota such as short-chain fatty acids (SCFAs) can regulate the differentiation of effector T cells by acting on molecular receptors on immune cells, thereby regulating the bone immune process. The multifaceted relationship among the gut microbiota, SCFAs, Th17/Treg cell-mediated bone immunity, and bone metabolism is eliciting attention from researchers. Through a review of existing literature, we have comprehensively summarized the effects of the gut microbiota and SCFAs on PMOP, especially from the perspective of Th17/Treg balance. Regulating this balance may provide new opportunities for PMOP treatment.
绝经后骨质疏松症（PMOP）是一种由绝经后雌激素水平下降引起的全身性代谢性骨病。它会导致骨质流失、微结构损伤以及骨折风险增加。研究发现，肠道微生物群及其代谢产物可通过肠-骨轴和肠-脑轴调节骨代谢。随着研究的进展，已发现PMOP与肠道微生物群失调和Th17/Treg失衡有关。肠道微生物群与Treg和Th17细胞的发育及分化密切相关。其中，肠道微生物群的代谢产物如短链脂肪酸（SCFAs）可通过作用于免疫细胞上的分子受体来调节效应T细胞的分化，从而调节骨免疫过程。肠道微生物群、SCFAs、Th17/Treg细胞介导的骨免疫和骨代谢之间的多方面关系正引起研究人员的关注。通过对现有文献的综述，我们全面总结了肠道微生物群和SCFAs对PMOP的影响，特别是从Th17/Treg平衡的角度。调节这种平衡可能为PMOP治疗提供新的机会。
