Fecal microbiota transplantation as a promising treatment option for osteoporosis

Abstract

Osteoporosis is a systemic metabolic bone disease characterized by the descending bone mass and destruction of bone microstructure, which tends to result in the increased bone fragility and associated fractures, as well as high disability rate and mortality. The relation between gut microbiota and bone metabolism has gradually become a research hotspot, and it has been verified that gut microbiota is closely associated with reduction of bone mass and incidence of osteoporosis recently. As a novel "organ transplantation" technique, fecal microbiota transplantation (FMT) mainly refers to the transplantation of gut microbiota from healthy donors to recipients with gut microbiota imbalance, so that the gut microbiota in recipients can be reshaped and play a normal function, and further prevent or treat the diseases related to gut microbiota disorder. Herein, based on the gut-bone axis and proven regulatory effects of gut microbiota on osteoporosis, this review expounds relevant basic researches and clinical practice of FMT on osteoporosis, thus demonstrating the potentials of FMT as a therapeutic option for osteoporosis and further providing certain reference for the future researches.

Keywords: Fecal microbiota transplantation; Gut microbiota; Osteoporosis; The elderly.

Fig. 1

The development history and significant time nodes of FMT since modern times

Fig. 2

The potential mechanism diagrams of regulatory mechanisms involving FMT on bone metabolism. Based on the gut–bone axis, the underlying mechanisms of FMT mainly lie in reconstruction of normal intestinal micro-ecology, which could participate in the regulation of bone metabolism by repairing intestinal mucosal barrier, regulating immune response, improving intestinal permeability, correcting gut microbiota disorder, and reversing intestinal metabolites imbalance. FMT fecal microbiota transplantation, OB osteoblast, OC osteoclast

Fig. 3

The preparation process and current main operative approaches of FMT