Chronic obstructive pulmonary disease: in-depth analysis of microbiota association and innovative prevention and treatment approaches from the gut-lung axis perspective

Abstract

The pathogenesis of chronic obstructive pulmonary disease (COPD) is complex and affects multiple systems. This article focuses on COPD and elaborates on the roles of the lung and gut microbiota as well as preventive and therapeutic strategies. Innovatively, this article reveals the impact of the connection between the lung and gut microbiota via the gut-lung axis on COPD, clarifies the association between changes in the lung microbiota and clinical features, enriches the understanding of the correlation between gut dysbiosis and COPD, breaks through the limitations of single-organ research, and opens up a completely new path for uncovering the underlying pathogenesis of COPD. In terms of prevention and treatment, gut microbiota-targeted therapies (fecal microbiota transplantation, probiotics and prebiotics) provide new ideas and evidence. Research on dietary factors (vitamins, dietary fiber) helps with precise nutritional interventions and highlights the significance of dietary adjustments. The multi-target actions of natural compounds integrate traditional and modern medicine and lay the foundation for the development of new approaches, which is of great significance and value for COPD research, clinical translation, and the improvement of patient health.

Keywords: chronic obstructive pulmonary disease; fecal microbiota transplantation; gut-lung axis; microbiota; nutritional therapy; prevention and treatment.

Figure 1

Possible link between gut-lung axis and COPD. The gut-lung axis is believed to operate bidirectionally and this intricate interplay is facilitated by a complex network involving hypoxia, inflammation, oxidative stress, microbiota dysbiosis, and epithelial barrier dysfunction. (Created with Biorender.com).

Figure 2

Potential treatment options for COPD based on gut-lung axis: FMT, Probiotics, Diet, and Naturopathy (Created with Biorender.com). FMT can reshape the structure of the gut microbiota, improve airway inflammation and emphysema in COPD mice, and in particular, the lipopolysaccharide of P. goldsteinii exerts an anti-inflammatory effect by acting as an antagonist of the toll-like receptor 4 signaling pathway; Probiotic strains can relieve respiratory symptoms, reduce lung inflammation and improve lung function through various mechanisms such as regulating the balance of cytokines, increasing the level of short-chain fatty acids, and affecting the immune signaling pathway; Dietary factors play a significant role in COPD, especially the intake of antioxidant nutrients, and they mainly affect the progression of COPD through the mechanisms of inflammation regulation (such as ω-3 fatty acids and flavonoids regulating the inflammatory response) and oxidative stress (such as vitamin C and vitamin E scavenging free radicals); Active compounds derived from Chinese herbal medicines and other natural sources can regulate the gut microbiota, enhance the gut barrier, inhibit inflammation-related signaling pathways, and improve oxidative stress to alleviate the symptoms of COPD.