肠道菌群：绝经后骨质疏松防治新靶点

Intestinal microbiota:the new target for the treatment of postmenopausal osteoporosis

绝经后骨质疏松是一类由雌激素缺乏引起的,以骨量减少和骨微结构破坏为特点的骨骼疾病,可诱发脆性骨折的发生率增加。绝经后骨质疏松因其较高的发病率和严重的并发症受到越来越多的关注。目前绝经后骨质疏松的治疗药物存在诸多副作用,部分药物甚至对器官、系统造成严重损害,因此亟待寻求一条新的安全有效的治疗途径。肠道菌群是定植在人体肠道内的微生物总集,而益生菌是由肠道有益菌组成的膳食或药物补剂。近年来多项研究表明,肠道菌群和机体正常骨改建与骨代谢疾病的发生息息相关,并且益生菌在部分骨代谢疾病治疗中已初步展现了较好疗效,提示肠道菌群可作为绝经后骨质疏松防治的潜在靶点并且益生菌的应用作为绝经后骨质疏松新治疗方法的可能性。本文通过对肠道菌群与绝经后骨质疏松的相关研究进行综述,归纳总结了肠道菌群与绝经后骨质疏松发生发展的相关性以及益生菌对其的治疗效果,并从肠道菌群多样性、肠道上皮屏障功能以及机体免疫系统调控3方面探讨肠道菌群、雌激素和益生菌在绝经后骨质疏松的致病与治疗过程中的相关作用机制。

Postmenopausal osteoporosis is a bone metabolic disease characterized by bone loss and structural destruction,which is induced by estrogen deficiency and leads to an increased frequency of fracture in postmenopausal women.Postmenopausal osteoporosis has attracted increasing attention due to its high morbidity and serious complications nowadays.Current medications of postmenopausal osteoporosis are accompanied with many side effects,sometimes even causing disorders of the organs and systems.Hence,it is imperative to seek a newapproach both safe and effective for the treatment of postmenopausal osteoporosis.The intestinal microbiota is the collection of all microorganisms colonized in the gastrointestinal tract,and a probiotic is a dietary or medical supplement consisting of beneficial intestinal bacteria.Current studies have revealed the close relationship between intestinal microbiota and bone remodeling or bone metabolic diseases.The significant efficacy of probiotics therapy for bone metabolic diseases has also been demonstrated.It suggests that intestinal microbiota may act as a potential target for the prevention and treatment of postmenopausal osteoporosis,and the application of probiotics may establish a newand efficacious therapy.This reviewaims to illustrate the correlation between intestinal microbiota and postmenopausal osteoporosis as well as the critical effect of probiotics on postmenopausal osteoporosis,with a particular focus on the molecular mechanism of pathogenesis and treatment from three dimensions of intestinal microbial diversity,intestinal epithelial barrier,and host immune responses.