The gut microbiota (GM), the commensal bacteria living in our intestine, performs numerous useful functions, including modulating host metabolism and immune status. Our recent studies demonstrate that the GM is also a regulator of bone mass and we propose that the effect of the GM on bone mass is mediated via effects on the immune system, which in turn regulates osteoclastogenesis. A role of the GM in bone metabolism is further supported by studies demonstrating that antibiotic, probiotic, and prebiotic treatments that impact GM composition regulate bone metabolism. Collectively, these studies suggest that the GM may be a novel therapeutic target for osteoporosis. Treatment with probiotics has already been shown to improve bone mass in rodent models of bone loss, but future randomized clinical trials are required to determine the possible effect of probiotics and other novel therapies modulating the GM composition on bone mass and fracture risk in patients with osteoporosis. Access to cheaper sequencing and improved bioinformatics tools will allow metagenomic sequencing for the analysis of the GM composition in large prospective clinical cohort studies. This can be used to evaluate the predictive value of the GM composition as a biomarker for low bone mass and fracture risk. In addition, metatranscriptomics and metaproteomics will most likely be used to identify the microbial genes and proteins that have an impact on bone mass and fracture risk. We propose a new cross-disciplinary GMbone research field called osteo-microbiology, bridging the gaps between bone physiology, gastroenterology, immunology, and microbiology. Future studies are clearly warranted in this new research field to determine if the GM composition might be used as a biomarker for fracture risk prediction and to validate the GM as a possible novel therapeutic target for osteoporosis.
20 - 23 May 2017
European Society of Endocrinology