Osteoarthritis and intestinal microbiota: pathogenetic significance of the joint — gut — microbiome axis

Abstract

Introduction. Osteoarthritis (ОА) is a disease leading to joint degeneration, accompanied by constant pain, inflammation, and functional failure of the joints. Although many factors contribute to the development of ОА, the gut microbiome has recently emerged as an important pathogenic factor in ОА initiation and progression. The purpose of the study was to analyze modern literature data regarding the link between the gut microbiome and ОА. Materials and methods. The available data of clinical studies and scientific reviews were analyzed, and modern meta-analyses on the influence of gut microbiota on the development and progression of ОА were evaluated. Results. Gut microbiota is responsible for a number of metabolic, immunological, and structural and neurological functions, potentially elucidating the heterogeneity of OA phenotypes and formation of individual features of the course of the disease. Numerous studies support the hypothesis of the existence of a gut – joint axis and the interaction between gut microbiota and OA-relevant risk factors. The proposed concept begins with intestinal disruption and dysbacteriosis, disruption of microbiota homeostasis, continuous changes in microbial composition and genomic plasticity for optimal adaptation of bacteria to the host environment, accompanied by both adaptive and innate immune responses due to translocation of bacteria and bacterial products into the bloodstream to the joint. This cascade ultimately leads to inflammation in the joint and contributes to the development and progression of OA. Interpretion of the potential mechanisms of OA pathogenesis is essential for the development of new preventive and disease-modifying therapeutic interventions. In addition, gut microbiota is also a potential biomarker related to inflammation and gut dysbiosis to predict the progression of ОА and monitor the effectiveness of therapeutic interventions. Conclusions. In this review, we summarized research data that are supporting the hypothesis of a “joint – gut – microbiota axis” and the interaction between gut microbiota and the OA-relevant factors, including age, gender, metabolism, obesity.