Gut microbiome dysbiosis in chronic lung disease: a systematic review and meta-analysis
Abstract
Objectives Recent data suggest that the gut–lung axis plays a role in the development of lung disease. However, the potential association between the gut microbiota and chronic lung disease (CLD) remains unclear. This study aimed to investigate changes in the gut microbiome in patients with CLD. Methods We searched PubMed, Web of Science, Cochrane, Embase, China National Knowledge Infrastructure, Wanfang, and VIPC databases from inception to August 1, 2024. The inclusion criteria involved studies that reported on gut flora in patients with CLD. Two independent reviewers used standardized methods to search, screen, and code included studies. Publication bias was analyzed using Egger’s test. Changes in the gut microbiome were assessed through α-diversity, β-diversity, and changes/differences in relative abundance, and results were evaluated using a random-effects model. Results A total of 27 studies were included: 21 on chronic obstructive pulmonary disease (COPD; 1,273 patients and 6,718 healthy controls [HCs]), six on asthma (559 patients and 5,310 HCs), one on COPD and asthma combined, and one on pulmonary cystic fibrosis. Compared with HCs, α-diversity was decreased in patients with COPD (Shannon index: standard mean difference [SMD] = −0.38; 95% confidence interval [CI], −0.76 to 0.00, I2 = 72%; n=7). In COPD, Bacteroides was increased (SMD = 0.76; 95% CI, 0.00 to 1.52; I2 = 91%; n=4), while Bifidobacterium (SMD = −0.88; 95% CI, −1.39 to −0.37; I2 = 88%; n=5) and…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,273 participants or records.
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