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Review
. 2025 Jul 30:12:1624907.
doi: 10.3389/fmed.2025.1624907. eCollection 2025.

The intricate interactions between the lungs and gut in patients: unraveling the crosstalk mechanism

Jiale Li #  1 , Yiting Chen #  1 , Bangchuan Hu  2
Affiliations
Review

The intricate interactions between the lungs and gut in patients: unraveling the crosstalk mechanism

Jiale Li et al. Front Med (Lausanne). .

Abstract

There is a growing body of evidence indicating that the stimulation of one organ can significantly influence the functioning of another. For instance, intestinal complications are frequently observed during respiratory diseases, and conversely, pulmonary complications can arise during intestinal diseases-a phenomenon referred to as lung-gut crosstalk. Patients suffering from mechanical ventilator-induced lung injury, chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), and other pulmonary conditions have been shown to experience gastrointestinal dysfunction and related disorders. Similarly, individuals with inflammatory bowel disease (IBD) have also been found to develop pulmonary complications. However, these studies are not enough to fully explain the mechanism of lung-intestinal crosstalk, and more potential mechanisms need to be explored and further elucidated. In this paper, we summarize recent research advancements regarding lung-intestinal interactions in the context of pulmonary and intestinal diseases, analyzing the potential mechanisms of lung-intestinal crosstalk from the perspectives of respiratory mechanics, inflammation, and microbiota. Additionally, we review evidence suggesting that adipokines may play a role in lung-gut interactions, and we propose new avenues for investigating the mechanisms underlying these interactions.

Keywords: adipokines; immunity; inflammatory bowel disease; lung-gut crosstalk; microbiome; ventilator-induced lung injury.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Diagram illustrating the effects of positive pressure ventilation on the body. Arrows indicate increased intrathoracic pressure from a ventilator, leading to gastric reflux, malnutrition, venous obstruction, and increased intestinal permeability.
FIGURE 1
Interaction between mechanical ventilation and its effects on both lung and gut.
Illustration depicting the relationship between the gut microbiome, lungs, and systemic inflammatory response syndrome. Arrows indicate the translocation from the gut to the lungs and the impact of infection. Labels show increased leptin and decreased adiponectin, highlighting interactions with systemic inflammation.
FIGURE 2
The core pathways between lung inflammation and gut permeability, including dysbiosis and IBD risk.
Diagram illustrating adipokine-mediated signaling in lung-gut interactions. Adipose tissue influences leptin and adiponectin. Leptin promotes proinflammatory cytokines, increasing Th1/Th17 cells, decreasing regulatory T cells, and is linked to lung disease. Adiponectin suppresses inflammatory cytokines, decreases Th1/Th17 cells, increases regulatory T cells, and protects against intestinal inflammation. Lungs and intestines are depicted to reinforce these interactions.
FIGURE 3
Immunomodulatory roles of leptin and adiponectin in lung–gut crosstalk.
See this image and copyright information in PMC

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