Abstract
Osteoarthritis (OA) is one of the most frequent musculoskeletal diseases characterized by degeneration of articular cartilage, subchondral bone remodeling, and synovial membrane inflammation, which is a leading cause of global disability, morbidity, and decreased quality of life. Interpreting the potential mechanisms of OA pathogenesis is essential for developing novel prevention and disease-modifying therapeutic interventions. Gut microbiota is responsible for a series of metabolic, immunological, and structural and neurological functions, potentially elucidating the heterogeneity of OA phenotypes and individual features. In this narrative review, we summarized research evidence supporting the hypothesis of a “gut-joint axis” and the interaction between gut microbiota and the OA-relevant factors, including age, gender, genetics, metabolism, central nervous system, and joint injury, elucidating the underlying mechanisms of this intricate interaction. In the context, we also speculated the promising manipulation of gut microbiota in OA management, such as exercise and fecal microbiota transplantation (FMT), highlighting the clinical values of gut microbiota. Additionally, future research directions, such as more convincing studies by the interventions of gut microbiota, the gene regulation of host contributing to or attributed to the specific phenotypes of gut microbiota related to OA, and the relevance of distinct cell subgroups to gut microbiota, are expected. Moreover, gut microbiota is also the potential biomarker related to inflammation and gut dysbiosis that is able to predict OA progression and monitor the efficacy of therapeutic intervention.
Highlights
Osteoarthritis (OA) is one of the most frequent musculoskeletal diseases characterized by degeneration of articular cartilage, subchondral bone remodeling, synovial membrane inflammation causing pain, morning stiffness, swelling, limited range of joint motion, and poor physical function, which is a leading cause of global disability, morbidity, and decreased quality of life [1]
Interpreting the potential mechanisms of OA pathogenesis is essential for developing novel prevention and disease-modifying therapeutic interventions
We summarized the evidence supporting the hypothesis of “gut-joint axis” and the interaction between gut microbiota and the OA-relevant factors and provided the reasonable speculations of the promising manipulation of gut microbiota in OA management
Summary
Osteoarthritis (OA) is one of the most frequent musculoskeletal diseases characterized by degeneration of articular cartilage, subchondral bone remodeling, synovial membrane inflammation causing pain, morning stiffness, swelling, limited range of joint motion, and poor physical function, which is a leading cause of global disability, morbidity, and decreased quality of life [1]. OA is recognized as a collection of multiple subgroups, each with specific pathophysiological and clinical features dependent on the risk factors involved, such as metabolic syndrome-associated osteoarthritis, posttraumatic osteoarthritis, and aging-associated osteoarthritis [5–7] These risk factors independently or intricately contribute to a complex interaction between mechanical, biochemical, and cellular factors, leading to the pathogenesis of OA. A recent interesting study performed by Christopher et al identified a microbial DNA signature, for the first time, in human and mouse cartilage, the alternation of which is associated with the development and progression of human OA [24] These findings suggest a potential involvement of microbiota by direct inoculation or the transportation of immune cells, while it is still a puzzle the detailed role of this specific bacterial DNA in cartilage tissue in OA pathogenesis.
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