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Scoliosis, traditionally understood as a musculoskeletal disorder with idiopathic origins, has been found to have a direct causal link between specific gut bacteria and the risk of developing the condition.

 

Scoliosis

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  • Karen Pendergrass ID
    Karen Pendergrass

    User avatarKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

  • Jonathan Pendergrass ID
    Jonathan Pendergrass

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June 20, 2024

Scoliosis, a spinal curvature over 10°, is influenced by gut microbiome variations, affecting spinal, respiratory, and cardiovascular health.

research-feed Research feed

Researched by:

  • Karen Pendergrass ID
    Karen Pendergrass

    User avatarKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

  • Jonathan Pendergrass ID
    Jonathan Pendergrass

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Last Updated: June 20, 2024

Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.

Karen Pendergrass

Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

Overview

Scoliosis is a medical condition characterized by an abnormal lateral curvature of the spine, identified when the curvature exceeds a Cobb angle of 10 degrees. It includes types such as idiopathic, congenital, and neuromuscular scoliosis. Idiopathic scoliosis, the most common type, accounts for approximately 80% of cases and mainly affects adolescents, historically with no identifiable cause. Severe cases can lead to complications like spinal cord compression, respiratory difficulties, and cardiovascular issues. Traditional treatments focus on symptom management rather than addressing the root cause. However, recent research has discovered that gut microbiome disturbances are a causal factor in scoliosis development. [1] This insight opens a new frontier for treatment: Microbiome-Targeted Interventions (MBTIs). By correcting gut microbiome imbalances, MBTIs aim to address the root causes of scoliosis, offering a revolutionary approach that could improve patient outcomes and transform scoliosis care.

Causes

Scoliosis, traditionally understood as a musculoskeletal disorder with idiopathic origins, has been found to have a direct causal link with specific gut bacteria, influencing the risk of developing the condition. Recent studies using Mendelian randomization have identified that certain gut microbiota, such as Bilophila and Prevotella9, provide protective effects against scoliosis. Conversely, other bacterial taxa like Mollicutes RF9 and Lachnospiraceae FCS020 group increase the risk of the disease. This groundbreaking discovery suggests that microbial imbalances in the gut could play a significant role in the development of scoliosis, shifting the paradigm from solely structural or genetic causes to include the microbiome’s impact​. [2]

Interventions

Supplementation should be considered as part of a comprehensive management plan for scoliosis, which may include physical therapy, bracing, microbiome-based interventions, and other treatments as necessary.

What supplements have support for Scoliosis?

Vitamin D: Based on the meta-analysis findings, scoliosis patients, particularly those with adolescent idiopathic scoliosis (AIS), might benefit from vitamin D supplements. AIS patients had significantly lower serum vitamin D levels, [x] potentially disrupting calcium-phosphorus metabolism crucial for bone health. Adequate vitamin D levels facilitate calcium absorption necessary for healthy bone formation. Thus, supplementing vitamin D could improve bone metabolism in AIS patients, potentially stabilizing or preventing scoliosis progression by ensuring proper calcium absorption and bone mineralization.

Research Feed

Causal effects of gut microbiota on scoliosis: A bidirectional two-sample mendelian randomization study.
October 27, 2023

The study used a bidirectional two-sample Mendelian randomization approach to investigate whether variations in gut microbiome taxa affect the risk of developing scoliosis. Data from 18,340 individuals from the MiBioGen consortium and 1168 scoliosis cases with 164,682 controls from the FinnGen consortium were analyzed. Key findings identified specific gut bacteria that either increased (e.g., Mollicutes RF9, Catenibacterium) or decreased (e.g., Bilophila, Prevotella9) scoliosis risk. These results suggest that gut microbiota alterations play a role in scoliosis pathogenesis, offering potential biomarkers for early detection and novel therapeutic interventions.

What was studied?
The study investigated the causal effects of gut microbiota on scoliosis using a bidirectional two-sample Mendelian randomization (MR) approach. Specifically, it aimed to determine whether variations in the composition of gut microbiome taxa could influence the risk of developing scoliosis. The study utilized genetic variants as instrumental variables (IVs) from a large genome-wide association study (GWAS) on gut microbiota and another GWAS on scoliosis to conduct the analysis.

 

Who was studied?
The study population consisted of participants from two major datasets. The gut microbiome data were obtained from the MiBioGen consortium, which included 16S rRNA gene sequencing profiles of 18,340 individuals from 24 cohorts, with the majority (n=13,266) of European ancestry. The scoliosis data were sourced from the FinnGen consortium R5, encompassing 1168 scoliosis cases and 164,682 controls, primarily of Finnish descent. These large-scale GWAS datasets provided the genetic variants used in the MR analysis.

 

What were the most important findings?

The key findings of the study were the identification of specific gut microbiome taxa that either increased or decreased the risk of scoliosis.  These results were confirmed by sensitivity analyses, which showed no significant heterogeneity or pleiotropy, indicating the robustness of the findings:

Protective Bacteria Taxa:  Bilophila (OR = 0.61), Eubacterium (eligens group) (OR = 0.47), Prevotella9 (OR = 0.69), Ruminococcus2 (OR = 0.54)

Bacteria Taxa Increasing Scoliosis Risk: Mollicutes RF9 (OR = 1.48),  Catenibacterium (OR = 1.60), Coprococcus2 (OR = 2.14),  Eubacterium (ventriosum group) (OR = 1.69), Lachnospiraceae (FCS020 group) (OR = 1.59), Ruminiclostridium6 (OR = 1.47), Ruminococcaceae UCG009 (OR = 1.39)

 

What are the greatest implications of this study?

The implications of this study are multifaceted and significant for the understanding and treatment of scoliosis:

Insight into Pathogenesis: The study provides new insights into the potential role of gut microbiota in the pathogenesis of scoliosis, suggesting that alterations in specific bacterial taxa may influence spinal health and development.

Potential for Biomarkers: Identifying gut microbiome compositions that are protective against or increase the risk of scoliosis could lead to the development of novel biomarkers for early detection and risk assessment.

Therapeutic Interventions:Understanding the causal relationship between gut microbiota and scoliosis opens up potential avenues for therapeutic interventions. Modifying gut microbiota through diet, probiotics, or other means could become a strategy for preventing or managing scoliosis.

Future Research Directions:The findings encourage further research using more sophisticated MR techniques and larger, more diverse datasets to confirm these results and explore the underlying molecular mechanisms. This could enhance the precision of causal estimates and expand the applicability of findings across different populations.

 

Association between calcium-phosphorus balance and adolescent idiopathic scoliosis: A meta-analysis
October 16, 2019

This systematic review and meta-analysis examined the association between calcium-phosphorus balance and adolescent idiopathic scoliosis (AIS), revealing that AIS patients had lower serum levels of vitamin D and calcium. The study suggests vitamin D deficiency might influence AIS pathogenesis by affecting bone metabolism.

What was studied?

The study investigated the association between calcium-phosphorus balance and adolescent idiopathic scoliosis (AIS) through a systematic review and meta-analysis of case-control and cross-sectional studies.

 

Who was studied?

The meta-analysis included a total of 646 AIS cases and 791 controls, comprising adolescents from various countries, with a focus on sex and menstruation status for subgroup analysis.

 

What were the most important findings?

AIS patients had significantly lower serum levels of vitamin D compared to controls [MD = −6.74, 95% CI (−9.47, −4.00)].

AIS patients also had lower calcium levels [SMD= −0.77, 95% CI (−1.51, −0.02)].

There was no statistical difference in phosphorus levels [SMD=0.5, 95% CI (−0.46, 0.57)] or parathyroid hormone levels [SMD = −0.11, 95% CI (−0.54, −0.31)].

Vitamin D levels were not affected by gender or menstruation status in AIS patients.

 

What are the greatest implications of this study?

The findings suggest that vitamin D deficiency may play a role in the pathogenesis of AIS by disrupting calcium-phosphorus metabolism, thus affecting bone health. This highlights the potential importance of screening for vitamin D levels in AIS patients and considering vitamin D supplementation as part of AIS management strategies. Further research is needed to fully understand the mechanisms involved and explore additional factors contributing to AIS.

 

Idiopathic

"Idiopathic" is a term used in medicine to describe a disease or condition that arises spontaneously or for which the cause is unknown.

References

  1. Causal effects of gut microbiota on scoliosis: A bidirectional two-sample mendelian randomization study.. Lai B, Jiang H, Gao Y, Zhou X.. (Heliyon. ( Oct 27. 2023))
  2. Causal effects of gut microbiota on scoliosis: A bidirectional two-sample mendelian randomization study.. Lai B, Jiang H, Gao Y, Zhou X.. (Heliyon. ( Oct 27. 2023))
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