SynthesisFrontiers in cellular and infection microbiology2026
Effects of gut microbiota-targeted interventions on pain, physical function, and inflammatory biomarkers in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Frontiers in cellular and infection microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
Background: Gut microbiota dysbiosis has been implicated in osteoarthritis (OA) through the gut-joint axis, but the clinical efficacy of gut microbiota-targeted interventions remains unclear. This systematic review and meta-analysis evaluated the effects of these interventions on clinical outcomes and inflammatory biomarkers in OA. Methods: PubMed, Embase, Web of Science, CNKI, and Wanfang were searched from inception to 20 January 2026 for randomized controlled trials (RCTs) of probiotics, prebiotics, synbiotics, or dietary modification in adults with OA. Primary outcomes were visual analog scale (VAS) pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, WOMAC function, and WOMAC total score; secondary outcomes included WOMAC stiffness, body weight, knee flexion angle, cartilage oligomeric matrix protein (COMP), high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), interleukin (IL)-1β, and IL-6. Standardized mean differences (SMDs) with 95% CIs were pooled using random-effects models; risk of bias was assessed with RoB 2.0. Subgroup analyses, univariable meta-regression, trial sequential analysis (TSA), and GRADE were used to grade certainty. Results: Eighteen RCTs (2,080 participants) were included. Interventions reduced VAS pain (SMD = -0.66, 95% CI: -1.27 to -0.06, Conclusion: Gut microbiota-targeted interventions, particularly probiotics, may improve pain, physical function, and systemic inflammation in OA. The evidence is compatible with symptomatic benefit but does not support cartilage protection or disease modification. Because certainty ranges from high to very low and information accrual is incomplete for most outcomes, these findings are provisional pending larger standardized RCTs. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/home, identifier CRD42023472181.
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