Probiotics in asthma: immunoregulatory mechanisms and emerging opportunities for respiratory delivery-a narrative review.

BACKGROUND AND

OBJECTIVE

Asthma is a complex heterogeneous respiratory disease influenced by various factors such as genetics, immunity, and environment. Probiotics and related microbial preparations can be used in the prevention and treatment of asthma. This review aims to clarify the role and mechanism of microbial preparations in the treatment of asthma through respiratory administration, as well as the theoretical basis as delivery carriers. This may provide new insights for the prevention and treatment of asthma.

METHODS

This study employed the narrative review method and searched for articles published on PubMed between January 2007 and February 2026. The search terms included asthma, probiotics, airway microbiota, respiratory administration and nanoparticles. The inclusion criteria covered relevant original research, reviews, and guidelines, while editorials and articles lacking full text were excluded.

KEY CONTENT AND FINDINGS: Alterations in airway microbiota are closely associated with the occurrence of asthma. Animal studies have demonstrated that oral intake of probiotics can effectively alleviate asthma symptoms, but their clinical application remains controversial. The main reasons include differences in study populations, asthma phenotypes, probiotic strains, dosages and treatment courses. The therapeutic effects and mechanisms of probiotic respiratory administration for asthma have been confirmed in animal experiments. Probiotics as delivery vehicles for respiratory administration in the treatment of asthma are theoretically feasible.

CONCLUSIONS

Probiotics respiratory administration represents a potentially promising strategy to treat asthma. Probiotics as delivery vehicles can also be used to deliver anti-asthma drugs. However, current evidence is predominantly preclinical, and further studies are needed to optimize delivery, ensure safety and product standardization, and confirm clinical efficacy before routine clinical application.