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ResearchIn-Press PreviewBone biologyMicrobiology Open Access | 10.1172/jci.insight.207933

Gut microbiota are required for reduced IGF-1 and bone growth in postnatal cystic fibrosis mice

Xiaomeng You,1 Jisun Paik,2 Stacey Meeker,3 Kevin S. Mears,2 Christopher E. Pope,4 Hillary S. Hayden,5 Kelsi Penewit,6 Adam Waalkes,6 Sruthi Sridevan,1 Stephen J. Salipante,6 Lucas R. Hoffman,4 and Julia F. Charles1

1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

Find articles by You, X. in: PubMed | Google Scholar

1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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1Department of Orthopaedic Surgery, Harvard Medical School, Boston, United States of America

2Department of Comparative Medicine, University of Washington, Seattle, United States of America

3Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, United States of America

4Department of Pediatrics, University of Washington, Seattle, United States of America

5Department of Microbiology, University of Washington, Seattle, United States of America

6Department of Laboratory Medicine and Pathology, University of Washington, Seattle, United States of America

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Published November 3, 2026 - More info

JCI Insight. https://doi.org/10.1172/jci.insight.207933.
Copyright © 2026, You et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published November 3, 2026 - Version history
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Abstract

Children with cystic fibrosis (CwCF) have impaired linear growth that correlates with poor clinical outcomes. Growth-stunted CwCF also exhibit a marked fecal dysbiosis, and lower serum levels of the gut microbiome-regulated growth factor IGF-1, relative to those without stunting. We hypothesized that the CF gut microbiome negatively impacts IGF-1 and skeletal growth in CwCF. To test this hypothesis, we compared bone phenotypes, IGF-1 and linear growth trajectories of C57BL/6 Cftrtm1Unc mutant mice (CF) to their wild-type littermates (WT) either colonized with (specific pathogen free, SPF) or without (germ-free, GF) normal microbiota. At 4 weeks of age, CF mice had reduced femur length and diminished serum IGF-1 compared to WT mice under SPF, but not GF, conditions. In contrast, by 14 weeks femur lengths and IGF-1 were similar in CF mice raised under both SPF and GF conditions. Accordingly, we observed significantly slower growth in CF mice under SPF, but not GF, conditions only from 1 to 4 weeks. CF mice also exhibited more pronounced relative taxonomic and functional dysbiosis at 4 compared with 14 weeks. These results suggest that gut microbiota play a critical role in early postnatal CF skeletal growth impairment, while microbe-independent mechanisms likely predominate in later life.

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