Gut permeability and osteoarthritis, towards a mechanistic understanding of the pathogenesis: a systematic review

Osteoarthritis (OA) is the most common condition affecting human joints. Along with mechanical and genetic factors, low-grade inflammation is increasingly supported as a causal factor in the development of OA. Gut microbiota and intestinal permeability, via KEY MESSAGES: Previous studies and methods have underestimated the impact of the gut-joint axis in osteoarthritis and have focussed on the characterisation of microbiota phenotypes rather than clear molecular mediators of disease. Gut dysbiosis is related to higher levels of bacterial toxins that elicit cartilage and synovium inflammatory pathways. Future research may benefit from focussing on both tight junctions and bacterially-produced products.