Association Between Gut Microbiota and Osteoarthritis: A Review of Evidence for Potential Mechanisms and Therapeutics

Abstract

Osteoarthritis (OA) is a multifactorial joint disease characterized by degeneration of articular cartilage, which leads to joints pain, disability and reduced quality of life in patients with OA. Interpreting the potential mechanisms underlying OA pathogenesis is crucial to the development of new disease modifying treatments. Although multiple factors contribute to the initiation and progression of OA, gut microbiota has gradually been regarded as an important pathogenic factor in the development of OA. Gut microbiota can be regarded as a multifunctional “organ”, closely related to a series of immune, metabolic and neurological functions. This review summarized research evidences supporting the correlation between gut microbiota and OA, and interpreted the potential mechanisms underlying the correlation from four aspects: immune system, metabolism, gut-brain axis and gut microbiota modulation. Future research should focus on whether there are specific gut microbiota composition or even specific pathogens and the corresponding signaling pathways that contribute to the initiation and progression of OA, and validate the potential of targeting gut microbiota for the treatment of patients with OA.

Oral Administration of Clostridium butyricum GKB7 Ameliorates Signs of Osteoarthritis in Rats

“…OA was originally thought to be a degenerative disease caused by mechanical stress, particularly on load-bearing joints (knees and hips). It has now become clear that systemic inflammation, immune dysfunction, disorders in metabolism, and dysregulation of the gut microbiome are important factors in OA pathology [ 11 , 12 ]. Probiotics are known to be capable of ameliorating gut dysbiosis and multiple probiotic strains have demonstrated therapeutic effects in OA.…”

“…The microbiota is involved in many important activities including host immune functioning, regulation of intestinal permeability, nutrient absorption, pathogen resistance, neurotransmitter synthesis and secretion, and metabolic homeostasis [ 10 ]. Gut dysbiosis, or disturbance of normal gut microflora, is increasingly recognized as a key factor in the development of OA [ 11 , 12 ], causing permeability of the gut mucosa and disruption of metabolic homeostasis, the generation of systemic inflammation, increasing collagen cleavage in cartilage, and disturbance of the gut-brain axis [ 11 , 13 ]. Amongst the many therapeutic strategies aimed at restoring the gut microbiota ecosystem is the use of probiotics, consisting of a single or combination of bacterial strains [ 14 , 15 , 16 , 17 ].…”

Roles of Gut Microbiome in Bone Homeostasis and Its Relationship with Bone-Related Diseases

“…Osteoarthritis (OA) can be defined by joint symptoms, structural pathology or both [ 140 ]. It is characterized by degeneration of articular cartilage, leading to joint pain and disability [ 141 ]. OA is a multifactorial disorder; thus, both the systemic and local factors (e.g., age, sex, ethnic characteristics, BMD, genetics, obesity, joint injury and muscle weakness) must be taken into account [ 142 ].…”

The Role of AIM2 Inflammasome in Knee Osteoarthritis

“…However, with the current advances in detection technology and related theories, especially the gut microbiota theory, this concept is gradually changing. 29,30 The gut microbiota is considered as a "microbial organ" whose functions are closely intertwined with host physiology and pathology, and which has an…”