00:00Opening this new episode of Fermenti, I would like to start with a pre-consideration that
00:13I find fundamental, and that is that the bones of our body are not static.
00:18The tissue that structurally composes the bones, over the course of our life, goes against
00:24a continuous remanagement, and this within a physiological process that takes the name
00:31of bone remodeling.
00:34Recent studies show that the bacteria of the so-called intestinal bacterial flora would have
00:41an important role also in the physiological process of bone remodeling, first of all
00:48through some of their specific metabolites that would work in that sector, but then
00:54also by interacting with the immune system, favoring the intestinal absorption of calcium,
01:01increasing the peripheral action of vitamin D on the bone, and still modulating the action
01:09and the biodisposability of circulating estrogens.
01:12Just think, for example, of the loss of mineral density of the bone, and therefore the increased
01:20possibility of osteoporosis, which is usually associated with the postmenopausal period,
01:26when the levels of the estrogens collapse.
01:30The sudden drop in estrogen levels, and of estradiol in particular, has a pro-inflammatory effect
01:36in the woman's body, in the sense that the estrogen deficit is able to activate
01:48both at the level of the endometrium, i.e. of the uterine structures, as well as at the systemic level,
01:54it is able to activate a whole series of immune-competent cells, among which above all
01:59the T lymphocytes, which activated in turn cause, through the release of growth factors
02:08and pro-inflammatory cytokines, a whole series of damage, both local and systemic,
02:14among which also, and above all, I would say, the loss of bone tissue, therefore osteoporosis.
02:21In fact, it must be said that the lymphocytic activation of which I spoke previously
02:27requires, in addition to the estrogen deficit, also the presence of an antigen that, as it were,
02:33initiates the inflammatory process that will lead, in the final analysis, to osteoporosis.
02:37And, according to those recent studies of which I spoke previously, the intestinal microbiota
02:43would represent precisely the source of the antigen that initiates the inflammatory mechanism.
02:50I would also like to add that the intestinal wall is equipped with a rich supply of estrogen receptors,
02:58which, in fact, if something happens in the post-menopausal phase,
03:05would determine an alteration of the wall structure, therefore increasing the intestinal permeability,
03:12which allows bacteria to go beyond, therefore to go from the internal intestinal canal
03:18towards the perintestinal spaces, where these bacteria meet the cells of the immune system
03:25and this meeting causes the intestinal bacteria, by functioning as antigens, to trigger the inflammatory reaction.
03:34These are new dynamics that emerge, dynamics that are, among other things, confirmed by observations,
03:42also quite numerous, from which it is observed that an adequate probiotic therapy
03:48is able to reduce, in some way, the damage or, in any case, slow down the process of the loss of mineral material
03:58inside the bone, therefore it is able to slow down the processes of osteoporosis.
04:02And among the probiotics that seem to have a very positive effect in this sense,
04:07there are some bifidobacteria and some lactobacilli, among which, above all, the paracaseae and the plantarum,
04:15there are some clusters of plantarum and paracaseae.
04:18How do these probiotics work at the intestinal level?
04:22They work, basically, by producing some of their specific metabolites,
04:28among which, above all, the short-chain fatty acids, but there are also other substances
04:34that are represented by the E. coli and then there are also the esopolysaccharides.
04:40Now, it has been seen that the short-chain fatty acids produced by these bacteria
04:45are able to increase the production of osteoprotegine,
04:50a protein that has the ability to inhibit the development and growth of osteoclasts,
04:57which are those cells that, in the bone, in some way promote the reabsorption of the bone
05:03and therefore favor the discourse of osteoporosis, so that, inhibiting these cells,
05:08the process of osteoporosis is somehow slowed down.
05:12E. coli, on the other hand, inhibits the production of inflammatory factors,
05:16such as TNF-alpha or Interleukin-6, and can increase the expression of osteoprotegine.
05:25The esopolysaccharides, finally, mainly inhibit the production of inflammatory factors.
05:33The impact of probiotics on bone health in recent years has gone so far
05:38that it has led to the development of the so-called osteomicrobiology,
05:43a term coined to define the strategic relationship between bone and intestinal microbiota.
06:02you
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