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The respiratory tract's direct and continuous exposure to the external environment makes it particularly vulnerable to pathogens, pollutants and other injurious agents. This exposure often triggers excessive inflammatory responses and compromises the integrity of the air\u2010blood barrier, leading to impaired gas exchange, hypoxia and respiratory failure. Therefore, modulating pulmonary inflammation and enhancing barrier function are critical therapeutic objectives. The endocannabinoid system, a ubiquitous signalling network comprising cannabinoid receptors, endogenous ligands and metabolic enzymes, has emerged as a crucial modulator of these processes. This review summarizes the role of the ECS in major respiratory diseases, including asthma, pulmonary fibrosis, respiratory syncytial virus infection and acute lung injury. The evidence highlights the therapeutic potential of targeting the ECS through strategies such as receptor\u2010specific ligands and inhibitors of endocannabinoid\u2010degrading enzymes. However, the context\u2010dependent nature of ECS modulation necessitates precise intervention. Future efforts should focus on developing selective therapeutics and validating their efficacy in clinical settings, positioning the ECS as a sophisticated target for innovative respiratory disease management.<\/jats:p>","DOI":"10.1111\/bcpt.70267","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T07:52:41Z","timestamp":1782546761000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modulation of Respiratory Diseases by the Endocannabinoid System: A Therapeutic Perspective"],"prefix":"10.1111","volume":"139","author":[{"given":"Shiyuan","family":"Qin","sequence":"first","affiliation":[{"name":"College of Veterinary Medicine Jilin University  Changchun Jilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyang","family":"Shen","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine Jilin University  Changchun Jilin 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