{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:48:42Z","timestamp":1791866922704,"version":"4.3.4"},"reference-count":167,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFA1304300"],"award-info":[{"award-number":["2022YFA1304300"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82495200"],"award-info":[{"award-number":["82495200"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82495201"],"award-info":[{"award-number":["82495201"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82404633"],"award-info":[{"award-number":["82404633"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021171","name":"Basic and Applied Basic Research Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2026A1515011144"],"award-info":[{"award-number":["2026A1515011144"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Respiratory diseases exhibit substantial heterogeneity in clinical phenotypes and underlying pathobiology that cannot be fully captured by conventional lung\u2010centred frameworks. Accumulating evidence implicates a role for the microbiome\u2013gut\u2013lung axis in respiratory disease pathogenesis. Within this bidirectional axis, gut\u2010derived microbial metabolites and structural components can modulate pulmonary immunity, whereas respiratory infection and exposures can reciprocally influence the gut microbiota. Dysregulation of the microbiome\u2013gut\u2013lung axis may influence respiratory disease susceptibility, progression, and clinical presentation. In this Review, we outline core mechanisms of gut\u2013lung crosstalk, including metabolite\u2010driven immunomodulation, pattern recognition receptor signalling and reciprocal immune\u2010ecological remodelling. We synthesize phenotype\u2010specific evidence linking the axis to major chronic inflammatory airway diseases (asthma, chronic obstructive pulmonary disease, cystic fibrosis and bronchiectasis) and acute respiratory disorders (pneumonia and sepsis\u2010associated acute respiratory distress syndrome), emphasizing mechanistic and clinical evidence. We discuss the translational promise of gut\u2013lung signatures as biomarkers and treatable traits and review current therapies with microbiome effects and emerging microbiome\u2010targeted interventions. Finally, we address key challenges and propose future research priorities to advance clinical management leveraging the gut\u2013lung axis.<\/jats:p>","DOI":"10.1002\/resp.70329","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:29:49Z","timestamp":1791865789000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Microbiome\u2013Gut\u2013Lung axis in Respiratory Diseases: From Biological Mechanisms to Clinical Translation"],"prefix":"10.1002","author":[{"given":"Yuqiong","family":"Yang","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease  Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Tang","sequence":"additional","affiliation":[{"name":"Guangdong Engineering Research Center of Precision Detection and Modulation of Human Microbiome, Biomedical Research Center School of Life Sciences, State Key Laboratory of Respiratory Disease, South China Normal University  Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7642-3921","authenticated-orcid":false,"given":"Rongchang","family":"Chen","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease  Guangzhou Guangdong Province China"},{"name":"Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Diseases, Shenzhen Key Laboratory of Respiratory Diseases Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, the First Affiliated Hospital, Southern University of Science and Technology)  Shenzhen Guangdong Province China"},{"name":"Hetao Institute of Guangzhou National Laboratory  Shenzhen Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1278-8950","authenticated-orcid":false,"given":"Zhang","family":"Wang","sequence":"additional","affiliation":[{"name":"Guangdong Engineering Research Center of Precision Detection and Modulation of Human Microbiome, Biomedical Research Center School of Life Sciences, State Key Laboratory of Respiratory Disease, South China Normal University  Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1056\/NEJMra1900475","article-title":"Update on the Pathogenesis of Chronic Obstructive Pulmonary Disease","volume":"381","author":"Agust\u00ed A.","year":"2019","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1038\/s41579-024-01048-8","article-title":"The Gut\u2013Airway Microbiome Axis in Health and Respiratory Diseases","volume":"22","author":"\u00d6z\u00e7am M.","year":"2024","journal-title":"Nature Reviews. 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