The Gut-Muscle Axis in Sarcopenia: Mechanisms, Evidence Gaps and Translational Challenges

Area of Science:

• Gerontology
• Microbiology
• Muscle Physiology

Background:

• Sarcopenia is a significant age-related muscle disorder linked to poor health outcomes.
• The gut microbiota is increasingly recognized for its role in systemic health, including muscle function.
• The microbiota-gut-muscle axis is a proposed pathway influencing muscle health.

Purpose of the Study:

• To review the evidence linking gut dysbiosis (microbiota imbalance) to sarcopenia.
• To explore mechanistic, clinical, and translational data on this relationship.
• To identify future research directions for microbiota-targeted interventions.

Main Methods:

• Narrative review synthesizing preclinical and clinical studies.
• Analysis of evidence from microbiota modulation studies (antibiotics, probiotics, etc.).
• Examination of human observational and interventional trial data.

Main Results:

• Preclinical studies demonstrate microbiota modulation impacts muscle parameters via inflammation, metabolism, and signaling pathways.
• Human observational studies show associations between lower microbial diversity and poorer muscle outcomes.
• Interventional trials are limited, with mixed results, particularly for muscle mass.

Conclusions:

• Gut microbiota alterations are a modifiable factor in sarcopenia's complex etiology.
• Targeting the gut microbiota holds potential for sarcopenia management.
• Further well-designed clinical trials integrating multi-omics are necessary to define the role and optimize interventions.