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Gut microbiota plays a pivotal role in skeletal development. Diverse bacteria act synergistically to optimize the uptake and utilization of various nutrients, maintain immune homeostasis, and regulates hormone levels. Probiotics, prebiotics, and related agents actively stimulate the skeletal growth via the gut-bone axis, representing a promising strategy for skeletal development management. • Gut microbiota plays a key role in skeletal development by modulating nutrient absorption, hormonal secretion, and immune. • SCFAs are key factors that mediated the regulation of skeletal development by gut microbiota. • Gut microbiota-targeted interventions (probiotics, prebiotics) have shown clinical potential in promoting bone development. • Gut–bone axis provides a new intervention target for the skeletal development. The preadolescent period is a rapid and critical stage of skeletal development. Poor skeletal development during this period can exert profound impacts on children’s growth, motor function, psychosocial adaptability, and long-term quality of life. Current interventional strategies for poor skeletal development primarily focus on improving nutrition, enhancing physical activity, maintaining healthy lifestyle habits, and supplementing calcium preparations or growth hormone (GH). However, these approaches yield limited efficacy, and GH supplementation may induce adverse effects. Therefore, identifying safe and effective strategies for improving skeletal development remain a persistent clinical challenge. Recently, the discovery of the “gut-bone axis” has introduced a novel direction for improving skeletal development through gut microbiota modulation. Nonetheless, research in this field remains in its nascent stage. Animal experiments and clinical trials are scarce, mechanistic explorations are insufficient, and clinical translation is constrained. To systematically elucidate the role of gut microbiota in skeletal development (rather than bone-related diseases). Our review revealed that the “gut-bone axis” plays a crucial role in the process of skeletal development. Certain bacteria (e.g., Lactobacillus and Bifidobacterium ) can serve as probiotics to promote skeletal development, which expanding novel application scenarios for probiotics. Mechanically, gut microbiota-derived metabolites—particularly short-chain fatty acids (SCFAs)—improving skeletal development through multiple pathways, including enhancing nutrient absorption, regulating the GH/IGF-1 signaling pathway, modulating immune function and inhibiting inflammatory responses, as well as directly modulating the expression of bone-related factors. Altogether, the potential of gut microbiota in skeletal development merits attention, yet its efficacy validation and mechanistic exploration require further research support. Future investigations in this field are poised to provide innovative solutions for pediatric growth and development issues, facilitating breakthroughs in clinical challenges.
Liu et al. (Sat,) studied this question.