Cross-talks between osteoporosis and gut microbiome

Table 1 Summary of microbial-related therapeutics and their effects on bone health

Therapeutic type	Microbial strains	Mechanisms of action	Clinical outcomes
Probiotics	Lactobacillus reuteri, Lactobacillus paracasei, B. longum	Inhibit osteoclastogenesis, promote osteoblast activity, enhance calcium and vitamin D absorption	Increased BMD, reduced bone resorption, prevention of bone loss in clinical trials
Prebiotics	Galacto-oligosaccharides, fructo-oligosaccharides, Inulin-type fructans	Stimulate growth of Bifidobacteria and Lactobacillus, increase short-chain fatty acid production, enhance mineral absorption	Improved calcium absorption, increased bone strength, reduced markers of bone resorption
Synbiotics	Combination of prebiotics and B. longum, Bifidobacterium bifidum	Enhanced probiotic proliferation, increased calcium absorption, reduced inflammation	Greater improvement in bone mineral content and strength compared to prebiotics or probiotics alone
Fermented foods	Lactobacillus, Bifidobacterium strains in yogurt, kefir, tempeh	Natural source of probiotics and prebiotics, enhanced nutrient absorption	Improved calcium and vitamin D absorption, increased BMD in consumers

B. longum: Bifidobacterium longum; BMD: Bone mineral density.

Table 2 Future research directions in gut microbiota and osteoporosis

Research direction	Focus areas	Potential outcomes
Microbiome-targeted therapies	Identification of beneficial strains, optimal delivery methods	Effective prevention and treatment strategies
Multi-omics integration	Combining genomics, proteomics, metabolomics, microbiomics	Comprehensive understanding of gut-bone mechanisms
Gut-brain-bone axis	Interaction between gut microbiota, brain function, bone metabolism	Novel therapeutic targets and interventions
Characterization of metabolites	Detailed study of short-chain fatty acids, bile acids, indole propionic acid	Development of targeted supplements or drugs
Personalized medicine	Microbiome profiling for tailored treatments	Enhanced efficacy and personalized prevention
Longitudinal studies	Tracking microbiota and bone health over time	Robust data on causality and intervention effects
Optimization of therapies	Delivery mechanisms, dosage, adherence strategies	Improved therapeutic outcomes and patient compliance
Ethical and regulatory frameworks	Safety, consent, accessibility of microbiota-based therapies	Safe and regulated clinical applications