Reframing Osteoarthritis Therapy Through the Gut– GUDCA – FXR – GLP1 Pathway: Opportunities and Limitations

Recent advances in immunometabolism and rheumatology have highlighted the role of gut-derived signals in modulating joint health.In particular, Yang et al. proposed that osteoarthritis (OA) may be influenced by intestinal bile acid metabolism through a mechanistic cascade involving the gut microbiota, Glycoursodeoxycholic acid (GUDCA), intestinal Farnesoid X receptor (FXR), and Glucagon-like peptide 1 (GLP-1) signaling.This emerging gut-to-joint communication axis invites new thinking about the pathogenesis and treatment of rheumatic diseases.