GUT MICROBIOTA AND RECURRENT UPPER RESPIRATORY TRACT INFECTIONS: EMERGING IMPLICATIONS FOR OTOLARYNGOLOGY

Abstract

Recurrent upper respiratory tract infections (URTIs) represent a significant clinical challenge in otolaryngology, with growing evidence suggesting that intestinal microbiota may play an important role in their pathogenesis. The gut-lung axis describes bidirectional immunological, metabolic, and microbial communication between the gastrointestinal and respiratory systems. Disturbances in gut microbiota composition, known as dysbiosis, can impair mucosal immunity through altered IgA production, reduced regulatory T‑cell activity, and decreased levels of immunomodulatory metabolites such as short‑chain fatty acids. These changes may increase susceptibility to infections of the pharynx, sinuses, and middle ear, contributing to their chronic and recurrent course. Frequent antibiotic use, common in ENT practice, may further exacerbate dysbiosis, creating a potential vicious cycle of recurrent infections. Emerging therapeutic strategies - such as probiotics, prebiotics, dietary interventions, and personalized microbiome‑based approaches - offer promising but yet insufficiently validated avenues for supporting standard treatment. Further prospective clinical studies are required to better define the role of the gut-lung axis in the development and management of recurrent ENT infections and to assess the effectiveness of microbiome‑modulating therapies.