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Scientific article
Review
Open access
English

Interactions of the microbiome with pharmacological and non-pharmacological approaches for the management of ageing-related musculoskeletal diseases

Published inTherapeutic Advances in musculoskeletal Disease, vol. 13, 1759720X2110090
Publication date2021
Abstract

Despite major progress in the understanding of the pathophysiology and therapeutic options for common ageing-related musculoskeletal conditions (i.e. osteoporosis and associated fractures, sarcopenia and osteoarthritis), there is still a considerable proportion of patients who respond sub optimally to available treatments or experience adverse effects. Emerging microbiome research suggests that perturbations in microbial composition, functional and metabolic capacity (i.e. dysbiosis) are associated with intestinal and extra-intestinal disorders including musculoskeletal diseases. Besides its contributions to disease pathogenesis, the role of the microbiome is further extended to shaping individuals' responses to disease therapeutics (i.e. pharmacomicrobiomics). In this review, we focus on the reciprocal interactions between the microbiome and therapeutics for osteoporosis, sarcopenia and osteoarthritis. Specifically, we identify the effects of therapeutics on microbiome's configurations, functions and metabolic output, intestinal integrity and immune function, but also the effects of the microbiome on the metabolism of these therapeutics, which in turn, may influence their bioavailability, efficacy and side-effect profile contributing to variable treatment responses in clinical practice. We further discuss emerging strategies for microbiota manipulation as preventive or therapeutic (alone or complementary to available treatments) approaches for improving outcomes of musculoskeletal health and disease.

Keywords
  • Ageing
  • Bone health
  • Microbiome
  • Osteoarthritis
  • Osteoporosis
  • Prebiotics
  • Probiotics
  • Sarcopenia
Citation (ISO format)
PAPAGEORGIOU, Maria, BIVER, Emmanuel. Interactions of the microbiome with pharmacological and non-pharmacological approaches for the management of ageing-related musculoskeletal diseases. In: Therapeutic Advances in musculoskeletal Disease, 2021, vol. 13, p. 1759720X2110090. doi: 10.1177/1759720X211009018
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ISSN of the journal1759-720X
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