Alessia Bartolacci

Osteoarthritis (OA) is a chronic and progressive joint disease involving the articular cartilage, synovium, subchondral bone, and ligaments, ultimately leading to pain, dysfunction, and, in advanced stages, joint destruction. Several factors contribute to the development and progression of OA, including genetic predisposition, biomechanical stress, metabolic imbalance, and chronic low-grade inflammation. Recently, a novel factor has emerged: the gut microbiome. Gut dysbiosis, defined as an alteration in gut microbiota homeostasis, can disrupt immune, metabolic, and inflammatory pathways, promoting systemic inflammation and accelerating degenerative changes in joint tissues. Conversely, restoration of a balanced gut microbiota may play a protective role and represent a promising avenue for innovative therapeutic strategies. The aim of this review is to analyse the relationship between gut dysbiosis and osteoarthritis, and to discuss potential therapeutic approaches targeting the microbiome to prevent disease progression.

Background/Objectives: The recent discovery of the importance of gut microbiota has enhanced our understanding of several issues related to energy metabolism, immune systems, and post-exercise recovery, which could have an impact on sports performance. Probiotics are used as sports supplements and have recently been proposed to be effective in reducing the incidence of gastrointestinal and respiratory infections during training and competition. This scoping review aimed to evaluate the gut microbiota composition of competitive cyclists and investigate the effect of probiotic administration in this sports population. Methods: A literature review was conducted using the following databases: PubMed/Medline, Web of Science, and Scopus, and all studies until 1 November 2025 were considered. After dual-reviewer screening, data were charted to identify the composition of gut microbiota and the effects of probiotics on these types of athletes. Results: After all the study identification phases, eleven studies were selected. Seven studies evaluated the composition of the gut microbiota, while four randomized controlled trials evaluated probiotic intake. The results indicate an abundance of Prevotella distinct for this type of athlete, which could facilitate the metabolism of glucose and short-chain fatty acids. Among the four main areas of improvement identified in relation to probiotics, a 16-week multi-strain supplementation protocol showed improved aerobic performance and exertion rate in amateur cyclists. Conclusions: Despite the limited number of studies, certain microbiota traits could be identified in competitive cyclists, which may correspond to their high metabolic rate. Although further strain standardized studies are needed on professional cyclists, the data could indicate that certain probiotic supplementation may be an effective addition for competitive cyclists.

Homocysteine, a sulfur-containing amino acid, is an intermediate product during the metabolism of methionine, a vital amino acid. An elevated concentration of homocysteine in the plasma, named hyperhomocysteinemia, has been significantly related to the onset of several diseases, including diabetes, multiple sclerosis, osteoporosis, cancer, and neurodegenerative disorders such as dementia, Alzheimer’s and Parkinson’s diseases. An interaction between metabolic pathways of homocysteine and gut microbiota has been reported, and specific microbial signatures have been found in individuals experiencing hyperhomocysteinemia. Furthermore, some evidence suggests that gut microbial modulation may exert an influence on homocysteine levels and related disease progression. Conventional approaches for managing hyperhomocysteinemia typically involve dietary interventions alongside the administration of supplements such as B vitamins and betaine. The present review aims to synthesize recent advancements in understanding interventions targeted at mitigating hyperhomocysteinemia, with a particular emphasis on the role of gut microbiota in these strategies. The emerging therapeutic potential of gut microbiota has been reported for several diseases. Indeed, a better understanding of the complex interaction between microbial species and homocysteine metabolism may help in finding novel therapeutic strategies to counteract hyperhomocysteinemia.

In recent years, there has been an alarming increase in the incidence of inflammatory bowel disease (IBD), which includes both Crohn's disease (CD) and ulcerative colitis (UC), particularly in Western countries. This chronic condition is intricately linked to the composition and health of the gut microbiota (GM) — a complex community of microorganisms residing in the gastrointestinal (GI) tract. Despite extensive research, the underlying pathogenesis of IBD remains poorly understood, making it a wide area of investigation. This review aims to provide a comprehensive exploration of the complex relationship between GM and the onset and progression of IBD. A key focus is the nucleotide-binding oligomerization domain-containing protein 2 (NOD2) pathway, which plays a crucial role in the immune response to gut bacteria and may influence susceptibility to IBD. Through a review of the current literature, an attempt was made to understand how a gut microbiome (GM) imbalance – dysbiosis – can trigger the inflammatory processes associated with IBD. Moreover, this review highlights the crucial role of vitamin D (VitD), a fat-soluble vitamin that is often deficient in individuals affected by IBD. Research suggests that VitD deficiency may impair the immune system and disrupt GM health, contributing to disease severity. Additionally, a growing body of evidence indicates that VitD metabolism is involved in NOD2 regulation. VitD supplementation could potentially act as a therapeutic strategy for managing IBD, alleviating symptoms and enhancing the overall gut health. This study aims to improve our understanding of the connection between gut bacteria, the immune system, and nutrition, ultimately paving the way for more effective prevention and treatment strategies for IBD.

This narrative review provides an overview of the various diagnostic tools used to assess cartilage health, with a focus on early detection, nutrition intervention, and management of osteoarthritis. Early detection of cartilage damage is crucial for effective patient management. Traditional diagnostic tools like radiography and conventional magnetic resonance imaging (MRI) sequences are more suited to detecting late-stage structural changes. This paper highlights advanced imaging techniques, including sodium MRI, T2 mapping, T1ρ imaging, and delayed gadolinium-enhanced MRI of cartilage, which provide valuable biochemical information about cartilage composition, particularly the glycosaminoglycan content and its potential links to nutrition-related factors influencing cartilage health. Cartilage degradation is often linked with inflammation and measurable via markers like CRP and IL-6 which, although not specific to cartilage breakdown, offer insights into the inflammation affecting cartilage. In addition to imaging techniques, biochemical markers, such as collagen breakdown products and aggrecan fragments, which reflect metabolic changes in cartilage, are discussed. Emerging tools like optical coherence tomography and hybrid positron emission tomography–magnetic resonance imaging (PET-MRI) are also explored, offering high-resolution imaging and combined metabolic and structural insights, respectively. Finally, wearable technology and biosensors for real-time monitoring of osteoarthritis progression, as well as the role of artificial intelligence in enhancing diagnostic accuracy through pattern recognition in imaging data are addressed. While these advanced diagnostic tools hold great potential for early detection and monitoring of osteoarthritis, challenges remain in clinical translation, including validation in larger populations and integration into existing clinical workflows and personalized treatment strategies for cartilage-related diseases.

Type 2 diabetes (T2D) is a chronic metabolic disorder with a heterogeneous etiology encompassing societal and behavioral risk factors in addition to genetic and environmental susceptibility. The cardiovascular consequences of diabetes account for more than two-thirds of mortality among people with T2D. Not only does T2D shorten life expectancy, but it also lowers quality of life and is associated with extremely high health expenditures since diabetic complications raise both direct and indirect healthcare costs. An increasing body of research indicates a connection between T2D and gut microbial traits, as numerous alterations in the intestinal microorganisms have been noted in pre-diabetic and diabetic individuals. These include pro-inflammatory bacterial patterns, increased intestinal permeability, endotoxemia, and hyperglycemia-favoring conditions, such as the alteration of glucagon-like peptide-1 (GLP-1) secretion. Restoring microbial homeostasis can be very beneficial for preventing and co-treating T2D and improving antidiabetic therapy outcomes. This review summarizes the characteristics of a “diabetic” microbiota and the metabolites produced by microbial species that can worsen or ameliorate T2D risk and progression, suggesting gut microbiota-targeted strategies to restore eubiosis and regulate blood glucose. Nutritional supplementation, diet, and physical exercise are known to play important roles in T2D, and here their effects on the gut microbiota are discussed, suggesting non-pharmacological approaches that can greatly help in diabetes management and highlighting the importance of tailoring treatments to individual needs.

Background: Vitamin D can influence athletic performance and infection risk. This study aimed to investigate vitamin D status, hematochemical factors, anthropometric and performance parameters, and dietary habits in runners (n = 23) and sedentary healthy individuals (non-runners, n = 22) during the autumn season. Methods: Both groups had their serum 25-Hydroxyvitamin D (ng/mL) levels, blood and performance parameters, and dietary habits measured. Results: Serum 25-Hydroxyvitamin D levels were significantly lower in non-runners (runners: males 30.0 ± 5.6, females 31.2 ± 5.2 vs. non-runners: males, 22.8 ± 6.5, females 24.7 ± 6.5 ng/mL, p < 0.001). White blood cells, monocyte, and neutrophil levels were higher in non-runners for both males and females. Among the subjects, 23 had optimal vitamin D levels (>29 ng/mL), while 22 had insufficient/deficient levels (p = 0.053). Maximal isometric force and jump height were equal in both groups, but VO₂max was higher in runners. Linear regression analysis identified monocyte count as the only predictor of vitamin D levels for both males (y = −24.452 x + 40.520; R² = 0.200; p = 0.015) and females (y = −33.409 x + 45.240; R² = 0.368; p = 0.003). Conclusions: This study highlights significant differences in vitamin D status between runners and non-runners, with runners exhibiting higher serum 25-Hydroxyvitamin D levels, although this finding is likely due to the increased sun exposure that runners receive. It also provides valuable insights into the vitamin D status of healthy young sedentary individuals and runners, enhancing the understanding of how physical activity influences vitamin D levels.

Background: Age-related loss of skeletal muscle strength and mass is linked to adverse postoperative outcomes in older individuals with sarcopenia. Half of patients suffer from severe associated osteoarthritis requiring orthopedic interventions. Mitigating the onset and progression of sarcopenia before surgery is essential to improve the prognosis and reduce surgical complications. The aim of this research was to innovatively explore whether the preoperative period could be the appropriate timeframe to empower surgical resilience, through prehabilitation and dietary supplementation, in older sarcopenic patients undergoing knee arthroplasty. Methods: The current literature concerning the effectiveness of prehabilitation and dietary supplementation before knee arthroplasty in sarcopenic older individuals was reviewed, following the SANRA criteria, between December 2023 and February 2024. The study inclusion criteria were as follows: (1) prehabilitation and/or dietary supplementation interventions; (2) human participants aged 65 years and older; (3) relevant outcome reporting (functional status, postoperative complications, and patient-reported outcomes); and (4) articles written in English The extracted information included study characteristics, demographics, intervention details, outcomes, and the main findings. Results: Merged prehabilitation and dietary supplementation strategies extrapolated from the current literature and involving strength, resistance, balance, and flexibility training, as well as essential amino acids, iron, vitamin D, adenosine triphosphate, and glucosamine sulphate supplementation, could improve the functional capacity, ability to withstand the upcoming surgical stressors, and postoperative outcomes in older people undergoing knee arthroplasty. Conclusions: Addressing complex links between knee osteoarthritis and sarcopenia in older individuals undergoing knee arthroplasty requires a multidimensional approach. Prehabilitation emerges as a crucial preliminary step, allowing the optimization of surgical outcomes. Nutraceutical integration, included in a comprehensive care plan, could have a synergic effect in achieving prehabilitation goals. Those interventions are essential for surgical resilience, in terms of muscle function preservation, recovery acceleration, and overall quality of life enhancement. Intensive collaboration among specialists could advance knowledge and the sharable consensus concerning the critical and evolutive field of perioperative care.

Background: Breast cancer (BC) is the second-leading cause of cancer-related death worldwide. This study aimed to investigate the effects of a 12-week home-based lifestyle intervention (based on nutrition and exercise) on gut microbial composition in twenty BC survivors of the MoviS clinical trial (protocol: NCT 04818359).Methods: Gut microbiota analysis through 16S rRNA gene sequencing, anthropometrics, Mediterranean Diet (MD) adherence, and cardiometabolic parameters were evaluated before (Pre) and after (Post) the lifestyle intervention (LI).Results: Beneficial effects of the LI were observed on MD adherence, and cardiometabolic parameters (pre vs post). A robust reduction of Proteobacteria was observed after LI, which is able to reshape the gut microbiota by modulating microorganisms capable of decreasing inflammation and others involved in improving the lipid and glycemic assets of the host. A significant negative correlation between fasting glucose and Clostridia_vadinBB60 (r = -0.62), insulin and homeostatic model assessment (HOMA) index and Butyricicoccus genera (r = -0.72 and -0.66, respectively), and HDL cholesterol and Escherichia/Shigella (r = -0.59) have been reported. Moreover, positive correlations were found between MD adherence and Lachnospiraceae_ND3007 (r = 0.50), Faecalibacterium (r = 0.38) and Butyricimonas (r = 0.39).Conclusion: These data suggest that adopting a healthy lifestyle, may contribute to ameliorate several biological parameters that could be involved in the prevention of cancer relapses through the modulation of gut microbiota.

A decline in muscle mass and function represents one of the most problematic changes associated with aging, and has dramatic effects on autonomy and quality of life. Several factors contribute to the inexorable process of sarcopenia, such as mitochondrial and autophagy dysfunction, and the lack of regeneration capacity of satellite cells. The physiologic decline in muscle mass and in motoneuron functionality associated with aging is exacerbated by the sedentary lifestyle that accompanies elderly people. Regular physical activity is beneficial to most people, but the elderly need well-designed and carefully administered training programs that improve muscle mass and, consequently, both functional ability and quality of life. Aging also causes alteration in the gut microbiota composition associated with sarcopenia, and some advances in research have elucidated that interventions via the gut microbiota–muscle axis have the potential to ameliorate the sarcopenic phenotype. Several mechanisms are involved in vitamin D muscle atrophy protection, as demonstrated by the decreased muscular function related to vitamin D deficiency. Malnutrition, chronic inflammation, vitamin deficiencies, and an imbalance in the muscle–gut axis are just a few of the factors that can lead to sarcopenia. Supplementing the diet with antioxidants, polyunsaturated fatty acids, vitamins, probiotics, prebiotics, proteins, kefir, and short-chain fatty acids could be potential nutritional therapies against sarcopenia. Finally, a personalized integrated strategy to counteract sarcopenia and maintain the health of skeletal muscles is suggested in this review.