Microbial messengers: decoding the gut microbiota’s role in bone health through immunomodulation and exosomal signaling

The human gut harbors a complex microbial ecosystem that supports host homeostasis. Gut microbiota (GM) ferment dietary fiber to produce short-chain fatty acids (SCFAs), which modulate immune function and influence osteoclastogenesis and osteoblast activity. Exosomes, derived from gut and bone cells, containing proteins, lipids, and RNA, mediated bioactive signaling that affects bone metabolism. This review focuses on how GM maintains health through immunomodulation and suppression of gastrointestinal inflammation, while exerting distal effects on bone physiological and pathological conditions.