The brain–bone–gut axis: a microbial bridge underlying multisystem comorbidities

Mar 16, 2026Frontiers in endocrinology

How Gut Microbes Connect the Brain, Bones, and Digestive System in Multiple Related Health Conditions

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Abstract

Multi-axis interactions among the skeletal system, immune system, and gut microbiota are examined within an integrative physiological framework.

  • The brain-bone-gut axis describes a regulatory network linking the central nervous system, bone metabolism, and gut microbiota.
  • There are three core pathways identified: the brain-bone axis, the gut-bone axis, and the gut-brain axis.
  • Immune-inflammatory processes may connect gut dysbiosis with bone metabolic disturbances and changes in brain function.
  • An integrated approach combining microecological interventions, nutrition, and exercise management is proposed to improve gut health and support skeletal and brain function.

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