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Mechanistic insights into gut microbiota dysbiosis in osteoarthritis based on the gut-joint axis.

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Title: Mechanistic insights into gut microbiota dysbiosis in osteoarthritis based on the gut-joint axis.
Authors: Liu Y; Rehabilitation Department of Spinal Related Diseases, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, China., Guo X; Rehabilitation Department of Spinal Related Diseases, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, China., Zhang S; Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, China., Kuang X; Department of Hip Joint Surgical Diagnosis and Treatment Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, China., Yan J; Department of Hip Joint Surgical Diagnosis and Treatment Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, China., Tian K; Department of Hip Joint Surgical Diagnosis and Treatment Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, China., Fan K; Department of Hip Joint Surgical Diagnosis and Treatment Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, China., Ma W; Department of Hip Joint Surgical Diagnosis and Treatment Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, China., Chen K; Department of Hip Joint Surgical Diagnosis and Treatment Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, China.
Source: Frontiers in immunology [Front Immunol] 2026 Sep 03; Vol. 17, pp. 1892592. Date of Electronic Publication: 2026 Sep 03 (Print Publication: 2026).
Publication Type: Journal Article; Review
Language: English
Journal Info: Publisher: Frontiers Research Foundation] Country of Publication: Switzerland NLM ID: 101560960 Publication Model: eCollection Cited Medium: Internet ISSN: 1664-3224 (Electronic) Linking ISSN: 16643224 NLM ISO Abbreviation: Front Immunol Subsets: MEDLINE
Imprint Name(s): Original Publication: [Lausanne : Frontiers Research Foundation]
MeSH Terms: Dysbiosis*/immunology , Dysbiosis*/microbiology , Osteoarthritis*/microbiology , Osteoarthritis*/immunology , Osteoarthritis*/metabolism , Osteoarthritis*/etiology , Gastrointestinal Microbiome*/immunology , Joints*/immunology , Joints*/microbiology , Joints*/metabolism, Humans ; Animals
Abstract: Osteoarthritis (OA) is a highly prevalent degenerative joint disease characterized by articular cartilage degradation, extracellular matrix disruption, subchondral bone sclerosis, and osteophyte formation, pathological features that collectively impair joint function and significantly reduce patients' quality of life. Therefore, elucidating the systemic pathogenic mechanisms of OA is essential for enabling early diagnosis and implementing disease modifying interventions. Recent studies demonstrate that the gut microbiota, as a key regulatory factor, actively participates in OA pathogenesis via the bidirectional "gut-joint axis." Gut microbiota dysbiosis, including depletion of beneficial commensal bacteria, Th17/Treg imbalance, aberrant macrophage polarization, and impaired intestinal barrier integrity, disrupts host microbiota symbiosis and promotes low-grade systemic inflammation, thereby amplifying synovial inflammation, cartilage catabolism, and subchondral bone remodeling. Although accumulating evidence robustly links gut dysbiosis to OA progression, the precise molecular and cellular mechanisms, particularly how specific alterations in gut microbiota composition and metabolites contribute to OA onset and development, remain incompletely defined. This article summarizes current insights into the gut-joint axis in OA and OA-related risk factors, focusing on structural alterations in the gut microbiota and shifts in key metabolites driven by intestinal dysbiosis in OA. Based on this, targeting the gut microbiota is proposed as a promising therapeutic strategy for OA.
(Copyright © 2026 Liu, Guo, Zhang, Kuang, Yan, Tian, Fan, Ma and Chen.)
Competing Interests: The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Contributed Indexing: Keywords: gut microbiota dysbiosis; gut-joint axis; intestinal immune; knee osteoarthritis; osteoarthritis
Entry Date(s): Date Created: 20260918 Date Completed: 20260918 Latest Revision: 20260919
Update Code: 20260919
PubMed Central ID: PMC13581703
DOI: 10.3389/fimmu.2026.1892592
PMID: 42755648
Database: MEDLINE
Description
ISSN:1664-3224
DOI:10.3389/fimmu.2026.1892592