Gut microbiome and osteoporosis: pathogenetic relationship and perspectives of therapeutic interventions

Osteoporosis is a chronic metabolic disease of bone tissue, characterized by a decrease in bone density and microarchitectonic disorders under the influence of genetic and epigenetic factors, which makes the bone fragile and increases the risk of fractures. However, the exact mechanism for the development of osteoporosis is not fully understood. Hundreds of trillions of microorganisms live in the human gut, maintaining a close symbiotic relationship with the host's body and its health. With the development of modern sequencing platforms, there is growing evidence that the gut microbiome may play an important role in bone metabolism. This literature review is devoted to the analysis of the pathogenetic mechanisms of the involvement of the intestinal microbiota in the development of osteoporosis and possible therapeutic strategies involving probiotics, prebiotics, antibacterial drugs, and diet aimed at increasing bone density.