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Review 10.1172/JCI128521

The gut-bone axis: how bacterial metabolites bridge the distance

Mario M. Zaiss,1 Rheinallt M. Jones,2 Georg Schett,1 and Roberto Pacifici3,4

1Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.

2Department of Pediatrics and

3Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University, Atlanta, Georgia, USA.

4Immunology and Molecular Pathogenesis Program, Emory University, Atlanta, Georgia, USA.

Address correspondence to: Roberto Pacifici, Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, 101 Woodruff Circle, Room 1309, Atlanta, Georgia 30322, USA. Phone: 404.712.8420; Email: roberto.pacifici@emory.edu.

Find articles by Zaiss, M. in: JCI | PubMed | Google Scholar

1Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.

2Department of Pediatrics and

3Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University, Atlanta, Georgia, USA.

4Immunology and Molecular Pathogenesis Program, Emory University, Atlanta, Georgia, USA.

Address correspondence to: Roberto Pacifici, Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, 101 Woodruff Circle, Room 1309, Atlanta, Georgia 30322, USA. Phone: 404.712.8420; Email: roberto.pacifici@emory.edu.

Find articles by Jones, R. in: JCI | PubMed | Google Scholar

1Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.

2Department of Pediatrics and

3Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University, Atlanta, Georgia, USA.

4Immunology and Molecular Pathogenesis Program, Emory University, Atlanta, Georgia, USA.

Address correspondence to: Roberto Pacifici, Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, 101 Woodruff Circle, Room 1309, Atlanta, Georgia 30322, USA. Phone: 404.712.8420; Email: roberto.pacifici@emory.edu.

Find articles by Schett, G. in: JCI | PubMed | Google Scholar

1Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.

2Department of Pediatrics and

3Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University, Atlanta, Georgia, USA.

4Immunology and Molecular Pathogenesis Program, Emory University, Atlanta, Georgia, USA.

Address correspondence to: Roberto Pacifici, Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, 101 Woodruff Circle, Room 1309, Atlanta, Georgia 30322, USA. Phone: 404.712.8420; Email: roberto.pacifici@emory.edu.

Find articles by Pacifici, R. in: JCI | PubMed | Google Scholar

First published July 15, 2019 - More info

Published in Volume 129, Issue 8 on August 1, 2019
J Clin Invest. 2019;129(8):3018–3028. https://doi.org/10.1172/JCI128521.
© 2019 American Society for Clinical Investigation
First published July 15, 2019 - Version history

The gut microbiome is a key regulator of bone health that affects postnatal skeletal development and skeletal involution. Alterations in microbiota composition and host responses to the microbiota contribute to pathological bone loss, while changes in microbiota composition that prevent, or reverse, bone loss may be achieved by nutritional supplements with prebiotics and probiotics. One mechanism whereby microbes influence organs of the body is through the production of metabolites that diffuse from the gut into the systemic circulation. Recently, short-chain fatty acids (SCFAs), which are generated by fermentation of complex carbohydrates, have emerged as key regulatory metabolites produced by the gut microbiota. This Review will focus on the effects of SCFAs on the musculoskeletal system and discuss the mechanisms whereby SCFAs regulate bone cells.

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