[Role of gut-derived immune cells and the gut-lung axis in acute respiratory distress syndrome].

Acute respiratory distress syndrome (ARDS) is a critical illness with high incidence and mortality in the intensive care unit (ICU). Recent studies have demonstrated that the "gut-lung axis", a bidirectional regulatory network between the gut and the lungs, plays a pivotal role in the pathophysiology of ARDS. This review focuses on the "homing" mechanisms underlying the directed migration of gut-derived immune cells, particularly ILC2s, ILC3s, and γδ T17 cells, from the gut to the lungs. It also discusses the critical mediating role of the "gut-lymph-lung" pathway in gut-derived lung injury. Furthermore, this article summarizes interventional strategies targeting the gut-lung axis, including modulation of the gut microbiota (probiotics and fecal microbiota transplantation), supplementation with metabolites (such as short-chain fatty acids), and novel nanoparticle-based drug delivery systems. A deeper understanding of this immunoregulatory network will provide new insights and therapeutic targets for precision treatment and clinical translation of ARDS.