SYSTEMATIC REVIEW article
Front. Cell. Infect. Microbiol.
Sec. Intestinal Microbiome
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1554846
This article is part of the Research TopicMucosal Microbiota Immunomodulation of the Gut-Lung AxisView all 9 articles
Gut microbiome dysbiosis in chronic lung disease: A systematic review and metaanalysis
Provisionally accepted
- Taizhou Hospital, Wenzhou Medical University, Linhai, Zhejiang Province, China
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Objectives: Recent data suggest that the gut-lung axis plays a role in the development of lung disease. However, the potential association between the gut microbiota and chronic lung disease (CLD) remains unclear, and this study aimed to investigate changes in the gut microbiome in patients with CLD. Method: We searched PubMed, Web of Science, Cochrane, Embase, China National Knowledge Internet, Wanfang, and VIPC databases from inception to August 1, 2024. The inclusion criteria involved studies that reported the gut flora in patients with CLD. Two independent reviewers used standardized methods to search for, screen, and code included studies. Publication bias was analyzed using Egger’s test. Changes in the gut microbiome were assessed through α-diversity, β-diversity and changes/differences in relative abundance, and results were evaluated using a random effects model. Results: A total of 27 studies were included, including 21 on chronic obstructive pulmonary disease (COPD) (1273 patients with COPD) patients and 6718 healthy controls [HC]), six on asthma (559 patients with asthma and 5310 HC), among the 21 studies, one was on COPD and asthma combined, and one on pulmonary cystic fibrosis. Compared with HCs, α-diversity was decreased in patients with COPD (Shannon: standard mean difference [SMD] = -0.38; 95% confidence interval [CI], -0.76 to -0.00, I2=72%; n=7), Bacteroides was increased in patients with COPD (SMD = -0.76; 95% CI, 0.00 to 1.52; I2=91%; n=4), and Bifidobacterium (SMD = -0.88; 95% CI, -1.39 to 0.37; I2=88%; n=5) and Lactobacillus (SMD = -0.73; 95% CI, -1.00 to -0.46; I2=66%; n=5) levels were lower. We found no difference in Shannon and Simpson diversity indexes between patients with asthma and HCs. Conclusion: The gut microbiota of patients with COPD is unbalanced, and the abundance of probiotics is lower in these patients than that of healthy individuals. Further exploration of the potential mechanism of probiotics in patients with COPD may provide promising targets for the treatment of COPD.
Keywords: chronic lung disease, gut, microbiome, diversity, Dysbiosis
Received: 03 Jan 2025; Accepted: 05 Sep 2025.
Copyright: © 2025 Pan, Zhang, Qiu, Peng, Kang, Hsu and Shen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bo Shen, Taizhou Hospital, Wenzhou Medical University, Linhai, 325035, Zhejiang Province, China
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