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Gastroenterology

Gut-lung axis in viral respiratory infections

By Dr Genelle Healey

Gastroenterology
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This article is based on scientific information

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About this article

Author

Dr Genelle Healey, PhD

Postdoctoral Researcher

Postdoctoral Research Fellow in the Department of Pediatrics at the University of British Columbia, Vancouver, Canada.

She has an expertise in the gut microbiome modulating effects of diet, particularly fiber, in immune mediated diseases.

See the author
Created 23 November 2021
Updated 25 November 2021

Interestingly, microbiota at both tissue sites appear to be perturbed during respiratory infections, reinforcing the theory that all mucosal sites are interconnected and that the gut-lung axis is bidirectional.1

Gut bacteria, their fragments, as well as SCFAs may translocate across the intestinal barrier and travel along the mesenteric lymphatic system to reach the systemic circulation and modulate immune cells in the lung.11 During Influenza respiratory infections, lung microbiota and immune functions are altered, and a gut microbiota dysbiosis is also observed which may explain the commonly associated gastroenteritis-like symptoms (Fig 7A).10

FIGURE 7: Gut-lung axis during viral respiratory infection (A) and model of microbiota modulation using probiotics (B).

Adapted from Dumas A et al, 20182

Probiotics may be helpful to recover a healthy status (microbiota homeostasis, infection control, modulation of immune responses) via gut microbiota metabolites (SCFAs…) or host-derived products.

infographic

There are likely several causes of this gut dysbiosis including loss of appetite (leading to reduced food and calorie intake), as well as inflammatory cytokine release. This may have local consequences: intestinal inflammation, disruption of gut barrier, decreased production of antimicrobial peptides (AMPs), a drop in SCFAs, potentially leading to secondary enteric infections.10

Gut barrier alteration promotes bacterial translocation as well as endotoxin release into the blood, leading to systemic inflammation, lung damage aggravation and increased risk of secondary bacterial infections.10 The reduced SCFA production by the gut microbiota also contributes to the reduced antibacterial immunity seen in the lungs.10 This highlights the vital role that the gut microbiota plays in the lung’s defenses against respiratory infections.

infographic

Modulation of the gut microbiota using strategies such as probiotics may help reduce susceptibility to respiratory infections via the gut-lung axis, or they may be helpful in recovering from infection and reaching a healthy status (Fig 7B). Several studies in mice have shown that specific probiotics administered prior to influenza infection led to the reduced accumulation of immune cells in the infected lungs. These probiotics also enhanced viral clearance, improved overall health and reduced alterations in the gut microbiota.12,13

Sources

1 Taylor SL, Wesselingh S, Rogers GB. Host-microbiome interactions in acute and chronic respiratory infections. Cell Microbiol. 2016 May;18(5):652-62. 

2 Dumas A, Bernard L, Poquet Y, et al. The role of the lung microbiota and the gut-lung axis in respiratory infectious diseases. Cell Microbiol. 2018 Dec;20(12):e12966. 

10 Sencio V, Machado MG, Trottein F. The lung-gut axis during viral respiratory infections: the impact of gut dysbiosis on secondary disease outcomes. Mucosal Immunol. 2021 Mar;14(2):296-304.

11 Bingula R, Filaire M, Radosevic-Robin N, et al. Desired Turbulence? Gut-Lung Axis, Immunity, and Lung Cancer. J Oncol. 2017;2017:5035371.

12 Park MK, Ngo V, Kwon YM, et al. Lactobacillus plantarum DK119 as a probiotic confers protection against influenza virus by modulating innate immunity. PLoS One. 2013 Oct 4;8(10):e75368. 

13 Belkacem N, Serafini N, Wheeler R, et al. Lactobacillus paracasei feeding improves immune control of influenza infection in mice. PLoS One. 2017 Sep 20;12(9):e0184976. 

Tags
Gut microbiota Lung Dysbiosis Immunity Immune response Respiratory infections Winter lung infection Virus Viral Diversity

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    Focus
    Microbiota, a diplomatic immunity?
    • Introduction
      • Understanding the complex interplay between the microbiota and immunity is only just beginning
    • Intestinal Immunity
      • The infant's gut at the heart of immunity
      • Factors influencing microbiota development and maturation of the immune system early in life
      • The impact of western diet on the mucus layer
      • Dampening gastrointestinal inflammation through nutrition
    • Gut microbiota influences respiratory immunity
      • The gut microbiota is involved in the lung’s defense against viral respiratory infections
      • Gut-lung axis in viral respiratory infections
      • The hygiene hypothesis and the COVID-19 pandemic
      • Targeting the gut microbiota to optimize vaccine efficacy?
    • Role of the microbiota in skin immunity and atopic dermatitis
      • Expert interview: Pr. Brigitte Dréno
    • Conclusion
      • What to take away? Intestinal Immunity
      • What to take away? Respiratory immunity
      • What to take away? Skin immunity
    Created 23 November 2021
    Updated 25 November 2021

    About this article

    To know more about this topic.

    Content type

    Dossier detail

    Author

    Dr Genelle Healey, PhD

    Postdoctoral Researcher

    Postdoctoral Research Fellow in the Department of Pediatrics at the University of British Columbia, Vancouver, Canada.

    She has an expertise in the gut microbiome modulating effects of diet, particularly fiber, in immune mediated diseases.

    See the author
    The gut microbiota is involved in the lung’s defense against viral respiratory infections
    The hygiene hypothesis and the COVID-19 pandemic
    Focus

    Microbiota, a diplomatic immunity?

    Introduction

    Understanding the complex interplay between the microbiota and immunity is only just beginning

    Intestinal Immunity

    The infant's gut at the heart of immunity Factors influencing microbiota development and maturation of the immune system early in life The impact of western diet on the mucus layer Dampening gastrointestinal inflammation through nutrition

    Gut microbiota influences respiratory immunity

    The gut microbiota is involved in the lung’s defense against viral respiratory infections Gut-lung axis in viral respiratory infections The hygiene hypothesis and the COVID-19 pandemic Targeting the gut microbiota to optimize vaccine efficacy?

    Role of the microbiota in skin immunity and atopic dermatitis

    Expert interview: Pr. Brigitte Dréno

    Conclusion

    What to take away? Intestinal Immunity What to take away? Respiratory immunity What to take away? Skin immunity

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