Gut microbiota in osteoarthritis: Impact on disease progression and symptom management. A systematic review

Osteoarthritis (OA) is no longer seen as just wear-and-tear but as a complex condition involving inflammation and gut microbiome imbalances (dysbiosis). These gut bacteria changes may worsen OA by increasing inflammation and metabolic problems. Promisingly, probiotics and dietary changes could help manage OA symptoms by restoring gut balance. This review explores how fixing gut health might lead to new OA treatments . To analyze whether alterations in gut microbiota composition are associated with OA progression or symptom severity. This PRISMA-guided review analyzed gut microbiota's role in OA, including human/animal studies (2000 onward) assessing microbiome links to joint degeneration. PubMed searches used MeSH terms, with Rayyan.ai deduplication and dual-reviewer screening. Data covered OA severity, biomarkers, and interventions (probiotics/prebiotics), extracted independently by three researchers. Risk-of-bias tools (SYRCLE/Cochrane) confirmed most studies' methodological rigor. This systematic review analyzed 18 studies on gut microbiota's role in osteoarthritis (OA), highlighting interventions like probiotics, collagen supplements, and dietary changes that improved pain, inflammation, and mobility. Key findings included reduced inflammatory markers (e.g., CRP, ESR) and enhanced joint function, though results on radiographic changes were mixed. Most studies called for larger, long-term trials to confirm efficacy and optimize treatment strategies. This review highlights how gut-targeted interventions (probiotics, collagen supplements) improve OA symptoms by reducing inflammation (CRP, ESR) and enhancing joint function, though mechanisms remain unclear. While human and animal studies show consistent benefits for pain and mobility, limitations like small sample sizes and short durations warrant larger trials. Future research should focus on microbiota profiling and standardized methods to optimize these promising non-pharmacological therapies.