骨质疏松症与菌群的相关性及机制研究进展

The advancing research progress of the correlation and mechanism between osteoporosis and bacterial flora

骨质疏松症(osteoporosis,OP)患病率不断升高,若其并发脆性骨折严重影响患者生活质量,已成为重要的公共健康问题。已有的研究结果显示,OP与菌群失调有密切联系,菌群失调参与多种全身性疾病,越来越引起人们的重视。肠道菌群、口腔菌群作为人体菌群重要组成部分,可以引起多种生理、病理改变。本文综述菌群与OP相关基础研究、临床研究,总结肠道菌群和口腔菌群在OP中的发病机制和表征菌群变化,关注具体菌种、菌属的作用。菌群主要通过介导激素作用、产生特定代谢物、诱导免疫细胞分化以及炎症因子水平改变影响OP发病相关通路。不同菌属参与疾病发病过程呈现不同作用,肠道菌群中乳酸杆菌属、双歧杆菌属、梭菌属等具有保护作用,沙雷氏菌属等是危险因素;口腔菌群中TM7、乳酸杆菌属可能具有保护作用,放线菌、福赛斯坦纳菌可能通过炎症反应促进骨吸收。此外,部分菌属具有维持菌群平衡的作用。本文对OP与菌群的联系、相互作用机制进行回顾总结,以期为OP治疗提供思路与参考。

Osteoporosis(OP)is a serious public health problem that affects the quality of life of patients and can lead to fragility fracture.Various studies have shown that OP is closely associated with dysbiosis,which refers to an imbalance of the body's microbiota.Dysbiosis has been linked to a range of systemic diseases,including OP.This paper provides an overview of both fundamental and clinical studies related to flora and OP,summarizing the underlying mechanisms behind alterations in intestinal and oral flora with a specific focus on distinct bacterial species and genera.Bacterial flora affects pathways related to OP pathogenesis by mediating hormonal effects,producing specific metabolites,inducing immune cell differentiation,and altering the levels of inflammatory factors.Different genera have different roles in the pathogenesis of the disease.Lactobacillus,bifidobacterium and fusobacterium in the intestinal flora have protective roles,while Serratia marcescens is a risk factor.TM7 and Lactobacillus in oral flora may have protective effects,and actinomyces and Forsestanella may promote bone resorptive through inflammatory response.Some genera also play a role in maintaining flora balance.This review aims to provide ideas and references for the treatment of OP by summarizing the connection and interaction mechanism between OP and flora.