{
  "abstract": "Osteoporosis (OP) remains a major global health burden, yet current pharmacological interventions are constrained by adverse effects, limited efficacy, and a bone-centric therapeutic paradigm that overlooks upstream pathogenic drivers. Emerging evidence positions the gut microbiota (GM) as a critical rheostat of bone homeostasis, operating through a gut–immune–bone axis that integrates microbial metabolism, intestinal barrier integrity, and systemic immune regulation. This review systematically examines the immunopathological mechanisms of OP, with particular emphasis on the GM-derived metabolites—short-chain fatty acids, secondary bile acids, tryptophan derivatives, lipopolysaccharide, and trimethylamine N-oxide—that orchestrate osteoclastogenic versus osteoprotective outcomes via key immune checkpoints including the Th17/Treg, macrophage phenotypic polarization, and regulatory B cell axes. We further delineate the subtype-specific heterogeneity of this axis across postmenopausal, senile, glucocorticoid-induced, and diabetic osteoporosis, highlighting distinct microbial and immune signatures that mandate stratified therapeutic approaches. Importantly, we evaluate the translational potential of GM-targeted interventions—probiotics, prebiotics, fecal microbiota transplantation, and dietary modulation—as adjunctive or standalone strategies, and discuss their synergistic interplay with conventional anti-osteoporotic agents. By reframing OP as a systems-level disorder of the gut–immune–bone circuitry, this review establishes a mechanistic groundwork for precision medicine, identifies novel druggable targets, and charts a course toward safer, more durable, and disease-modifying anti-osteoporotic therapies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pharmacy, Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology; The Third Affiliated Hospital, Guangzhou Medical University",
    "Department of Pharmacy, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People’s Hospital)",
    "Department of Pharmacy, Central Hospital of Guangdong Prison"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Minying Huang"
    },
    {
      "affs": [
        1
      ],
      "name": "Baocheng Xie"
    },
    {
      "affs": [
        2
      ],
      "name": "Hongyu Liu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fb428z5vzrwx1.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1879472",
  "fulltext_url": "https://europepmc.org/articles/PMC13692714",
  "id": "fb428z5vzrwx1",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1879472/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "1312|Gut microbiota and health"
    ]
  ],
  "openalex": "W7221087904",
  "pdf_url": "https://europepmc.org/articles/PMC13692714?pdf=render",
  "pmcid": "PMC13692714",
  "pmid": "42921032",
  "published": "2026-10-09",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/fb428z5vzrwx1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "10.3389/fphar.2026.1879472",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1879472/full"
    },
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42921032",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42921032"
    }
  ],
  "subjects": [
    {
      "field": "biochemistry",
      "origin": "openalex:1312|Gut microbiota and health",
      "subfield": "molecular-biology"
    }
  ],
  "title": "Gut microbiota-immune-bone axis in osteoporosis: mechanisms and intervention strategies",
  "title_text": "Gut microbiota-immune-bone axis in osteoporosis: mechanisms and intervention strategies",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/fb428z5vzrwx1",
  "venue": "Frontiers in Pharmacology",
  "versions": []
}