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  4. Vol 8, Issue 2, 2026

The Gut-Lung Axis in Chronic Obstructive Pulmonary Disease: Mechanistic Evidence and Traditional Chinese Medicine Interventions

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DOI: 10.23977/medcm.2026.080201 | Downloads: 0 | Views: 13

Author(s)

Zang Xinyi 1, Wang Qiang 2

Affiliation(s)

1 Tianjin University of Traditional Chinese Medicine, Tianjin, China
2 Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China

Corresponding Author

Wang Qiang

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung disorder accompanied by systemic immune, metabolic and mucosal dysfunction. We reviewed clinical and experimental evidence for the gut-lung axis and assessed how traditional Chinese medicine (TCM) interventions map onto defined biological nodes. Human studies consistently identify altered microbial functions and metabolites, whereas taxonomic signals vary with geography, diet, medication and disease state. Transfer, dietary, depletion and rescue experiments support a causal contribution of gut communities to experimental lung injury. Candidate mediators include short-chain fatty acids, epithelial barrier integrity, regulation of neutrophil extracellular trap formation involving GPR43, Th17/regulatory T-cell balance, NLRP3 signalling, tryptophan metabolites and trimethylamine N-oxide. Evidence for the reverse lung-to-gut route is weaker and is confounded by hypoxaemia, infection-associated inappetence and treatment exposure. Several TCM formulations engage these nodes in preclinical models, while early randomised studies link clinical outcomes to microbiome or metabolome changes. However, parallel biomarker shifts do not establish mediation, and no study yet connects treatment, mediator and clinical outcome within a prespecified causal model. Translation therefore requires hypothesis-driven trials stratified by TCM pattern and baseline microbial-metabolic state, with serial multi-compartment sampling and formal mediation analysis.

KEYWORDS

Chronic Obstructive Pulmonary Disease; Gut-Lung Axis; Gut Microbiota, Short-Chain Fatty Acids; Traditional Chinese Medicine; Clinical Mediation

CITE THIS PAPER

Zang Xinyi, Wang Qiang. The Gut-Lung Axis in Chronic Obstructive Pulmonary Disease: Mechanistic Evidence and Traditional Chinese Medicine Interventions. MEDS Chinese Medicine (2026). Vol. 8, No. 2, 1-9. DOI: http://dx.doi.org/10.23977/medcm.2026.080201.

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