Role of Dietary Supplements and Probiotics in Modulating Microbiota and Bone Health: The Gut-Bone Axis

Abstract

Osteoporosis is characterized by an alteration of bone microstructure with a decreased bone mineral density, leading to the incidence of fragility fractures. Around 200 million people are affected by osteoporosis, representing a major health burden worldwide. Several factors are involved in the pathogenesis of osteoporosis. Today, altered intestinal homeostasis is being investigated as a potential additional risk factor for reduced bone health and, therefore, as a novel potential therapeutic target. The intestinal microflora influences osteoclasts’ activity by regulating the serum levels of IGF-1, while also acting on the intestinal absorption of calcium. It is therefore not surprising that gut dysbiosis impacts bone health. Microbiota alterations affect the OPG/RANKL pathway in osteoclasts, and are correlated with reduced bone strength and quality. In this context, it has been hypothesized that dietary supplements, prebiotics, and probiotics contribute to the intestinal microecological balance that is important for bone health. The aim of the present comprehensive review is to describe the state of the art on the role of dietary supplements and probiotics as therapeutic agents for bone health regulation and osteoporosis, through gut microbiota modulation.

Pharmacological, Nutritional, and Rehabilitative Interventions to Improve the Complex Management of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease: A Narrative Review

“…In recent years, a growing number of reports suggested a strict link between gut microbiome and several chronic pathological conditions, such as the obesity and the osteoporosis [ 122 , 123 ]. The gut microbiome comprises approximately 10–100 trillion microorganisms living in mutually beneficial partnership with the human host, although recent research highlighted that gut microbiome alterations play a role in the pathogenesis and progression of several pathological conditions [ 124 ].…”

Lactobacillus acidophilus Mitigates Osteoarthritis-Associated Pain, Cartilage Disintegration and Gut Microbiota Dysbiosis in an Experimental Murine OA Model

“…The OA-associated microbial imbalance (dysbiosis) [ 9 ] can potentially be rectified by reintroducing specific and non-pathogenic bacteria and yeast (probiotics), which reduce systemic inflammation [ 10 ]. Oral microbiome and probiotic applications to improve bone health and OA have been extensively considered [ 11 , 12 , 13 ]. Lactobacillus species represent well-characterized probiotics with established antimicrobial and anti-inflammatory effects [ 14 ].…”

Use of the Probiotic Bifidobacterium animalis subsp. lactis HN019 in Oral Diseases

“…In addition to modulating and promoting intestinal health, hormones and immune cells present in the gastrointestinal tract act to maintain bone health by regulating the balance between resorption by osteoclasts and bone neoformation by osteoblasts. The epithelial barrier plays a key role in the absorption of components involved in bone mineralization, such as calcium, phosphorus and magnesium, and they produce endocrine cell factors that carry signals to bone cells, such as incretin and serotonin [ 14 , 20 ]. Therefore, due to these different mechanisms, the manipulation of the microbiota can assist in bone development [ 36 ].…”

“…Therefore, due to these different mechanisms, the manipulation of the microbiota can assist in bone development [ 36 ]. The receptor activator of NF-kappaβ (RANK), receptor activator of NF-kappaβ ligand (RANKL) and osteoprotegerin (OPG) system responsible for osteoclastogenesis can be regulated by modifications in the microbiota [ 14 ]. These potential mechanisms may also be at play in the context of bone changes in periodontal disease, since B. lactis HN019 can decrease several bone loss parameters in experimental periodontitis in rats [ 54 ].…”

“…The intestine is one of the main targets for the use of probiotics [ 3 , 4 ], defined as live microorganisms that, when administered in adequate amounts, improve the health of the host [ 6 , 7 ]. Thus, probiotics are used as preventive or therapeutic strategies in various conditions associated with disease, such as obesity, pre-diabetes and diabetes, gastrointestinal diseases, functional abdominal pain, atopic dermatitis, and for oral applications) [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”