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Gut microbiome metabolites regulate bone health via SCFAs, bile acids, and tryptophan pathwaysMulti-omics approaches reveal new links between gut microbes and bone health

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Key Takeaway
Consider that gut microbiome metabolites may regulate bone health through multiple signaling pathways, but clinical translation requires further research.

This narrative review examines the role of gut microbiome metabolites in skeletal health, focusing on osteoporosis, osteoarthritis, and bone malignancies. The authors synthesize evidence from metagenomics, metabolomics, and germ-free models to describe how microbial metabolites influence bone remodeling.

Key findings include that short-chain fatty acids (SCFAs) inhibit osteoclastogenesis via GPR43/HDAC signaling and promote osteoblast metabolic reprogramming. Bile acids enhance osteogenesis through FXR/Wnt/β-catenin activation. Tryptophan metabolites repair intestinal barrier integrity and modulate osteoimmunity via the AhR pathway. The review positions microbiome-driven immunometabolic reprogramming as a central regulator of skeletal homeostasis.

The authors acknowledge a key limitation: integration of multi-omics approaches to elucidate circadian metabolite-bone interactions remains limited. No quantitative effect sizes or clinical trial data are reported, as this is a narrative synthesis of preclinical and mechanistic studies.

Practice relevance is framed as advancing precision microbial therapeutics and chrono-nutritional strategies. However, given the preclinical nature of the evidence, direct clinical application is not yet established.

This narrative review explores how multi-omics approaches, including metagenomics and metabolomics, help explain connections between the gut microbiome and bone health. The authors examined data involving osteoporosis, osteoarthritis, and bone malignancies to understand these complex interactions. No specific patient groups or sample sizes were reported in this review.

The study highlights several key mechanisms. Short-chain fatty acids were found to inhibit osteoclastogenesis via GPR43 and HDAC signaling. Additionally, these fatty acids promote osteoblast metabolic reprogramming. Bile acids were shown to enhance osteogenesis through FXR and Wnt signaling pathways. Tryptophan metabolites also play a role by repairing intestinal barrier integrity and modulating osteoimmunity via the AhR pathway.

The review concludes that microbiome-driven immunometabolic reprogramming acts as a central regulator of skeletal homeostasis. This understanding could advance precision microbial therapeutics and chrono-nutritional strategies. However, the integration of multi-omics approaches to fully elucidate circadian metabolite-bone interactions remains limited. Readers should view these findings as a foundation for future research rather than immediate clinical solutions.

What this means for you:
Gut microbes may influence bone health through metabolic pathways, but more research is needed.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedMay 2026
View Original Abstract ↓
The gut-bone axis plays a pivotal role in skeletal health, yet the integration of multi-omics approaches to elucidate circadian metabolite-bone interactions remains limited. This review synthesizes evidence from metagenomics, metabolomics, and germ-free models to uncover how microbiota-derived metabolites—including short-chain fatty acids (SCFAs), bile acids, tryptophan derivatives, and gaseous molecules—orchestrate bone remodeling in osteoporosis, osteoarthritis, and bone malignancies. Many studies demonstrate that SCFAs inhibit osteoclastogenesis via GPR43/HDAC signaling and promote osteoblast metabolic reprogramming, while bile acids enhance osteogenesis through FXR/Wnt/β-catenin activation. Tryptophan metabolites repair intestinal barrier integrity and modulate osteoimmunity via the AhR pathway. Single-cell omics reveal circadian oscillations of metabolite receptors (e.g., GPR43, FXR) in bone stromal cells, linking microbial diurnal rhythms to epigenetic regulation of bone turnover. We propose a novel “metabolite-immune-bone triad” model, highlighting microbiome-driven immunometabolic reprogramming as a central regulator of skeletal homeostasis. These insights advance precision microbial therapeutics and chrono-nutritional strategies, bridging multi-omics discoveries with clinical applications for bone disorders.
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