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Indah Dwi Lestari
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Associations of The Gut Microbiota on Respiratory Disease in Children : A Systematic Review Indah Dwi Lestari; Rifah Zafarani Soumena; Vina Zakiah Latuconsina; Octovina Toressy; Rahma Dyahnissa
The Indonesian Journal of General Medicine Vol. 42 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/jmpfne38

Abstract

Background: The gut-lung axis represents a critical pathway linking early-life gut microbiota to pediatric respiratory diseases, but comprehensive synthesis of associations, mechanisms, and therapeutic evidence is lacking. Methods: This systematic review synthesized 80 studies (RCT, etc) examining gut microbiota associations with pediatric respiratory outcomes including asthma, allergic rhinitis, respiratory tract infections (RTIs), bronchiolitis, bronchopulmonary dysplasia (BPD), and cystic fibrosis (CF) lung disease. Results: Early-life gut dysbiosis during the first 100 days—characterized by reduced Lachnospira, Veillonella , Faecalibacterium , Rothia (FLVR taxa)—consistently associated with increased asthma risk (Arrieta et al., 2015). Short-chain fatty acids (SCFAs), particularly acetate and butyrate, emerged as central immunomodulatory mediators (Yang et al., 2025). Mendelian randomization confirmed causal roles for Collinsella and Ruminococcaceae UCG014 in childhood asthma (Li et al., 2023). In CF, Bifidobacterium - dominant gut microbiota associated with 45% fewer pulmonary exacerbations (Ray et al., 2022). Probiotics reduced RTI incidence (42% vs 59% in controls) and acute asthma exacerbations (RR 0.38) but showed no benefit for primary asthma prevention. Cesarean delivery, antibiotic exposure (HR for asthma 1.21), and breastfeeding cessation were key moderators. Apparent diversity–disease contradictions resolved when considering community composition rather than diversity metrics alone. Conclusion: Gut microbiota composition in early life is causally associated with pediatric respiratory disease risk through SCFA-mediated immune modulation, with the first 100 days as a critical window. Probiotics show strain-specific efficacy for RTI prevention and asthma treatment but not primary prevention.
Co-Authors Agung Dewana Firda Ahmad Ridha Aini, Rini Qurratul Andi Haris, Andi Andika Wijaya, Andika Andri Joshua Damian Anggraeni, Yuli Puspita Anis Khoirin Hayati Ashshiddiqi W.K, Hasbi Asnar Asnar, Asnar Astuti, Lenny Aulia Brigitha Ayu Nurafni Octavia Budio, Sesra CHRISTIE, CHITRA DEWI YULIA Dela Afrilia Dewi Komala Sari Dios Sarkity Effy Wardati Maryam Elly Astuti, Elly Elvia Putri Ayu Anggraini Erma Suryani Erwan Kustriyono Eryuni Ramdhayani Fadia Anisa Fatmawati Fatmawati Fatmawati, Fatmawati Fatriansari, Asih G.W.I. Awal Habibah Hermansyah Hermansyah Ilkafah Ilkafah, Ilkafah Indah Dwi Lestari Indah Purwaningsih Indrawati, Ratih Iswandi Leo Anaris Sakti Lestari, Nia Agus Maharani, Angelina Majid, Novita Marlina Novita Merdekawati, Ana Nadia Ardiyanti Nadia Nurifayza Sufiyanti Nikmatul Maula Noviati, wiwi Nurhairunnisah, Nurhairunnisah Nurilam Harianja Octovina Toressy Pangestoeti, Wahyu Rahma Dyahnissa Ramdhayani, Eryuni Reza Ariyanto Rifah Zafarani Soumena Rihadatul Aisy Rini Qurratul Aini Rini, Wa Septiana, Yulda Dina Sholihin Sholihin Sigit Hermawan Sigit Maryanto Sintha Wahyu Arista Sri Dayanti Suhendra, Riadi Sulindra, I Gusti Made Suriansyah Murhaini Suryaningsi Suryaningsi Syafruddin Syafruddin Syafruddin Syafruddin Syafruddin Syahfitri , Aisah Aprillia Syavitri , Nadiya Ami Tarmizi Vina Zakiah latuconsina Wiwi Noviati Yosef Nono Dappa Ate Yusdita, Elana Era Zulyansah , Moch. Firnanda