Received by the Editorial Office: 12.06.2026
Accepted for publication: 19.06.2026
Published online: 30.06.2026
UDC: 616.24-007.17-053.32/.34:579.67
DOI: 10.26212/2227-1937.2026.11.10.002
THE GUT–LUNG AXIS IN BRONCHOPULMONARY DYSPLASIA: MICROBIOLOGICAL CHARACTERIZATION OF THE GUT MICROBIOTA IN PRETERM INFANTS FROM ALMATY
Abilbayeva A.A.¹, Idrissova G.M.², Yelubaeva D.B.³, Koloskova Y.A.⁴,
Ramazanova B.A.⁴, Mustafina K.K.⁴, Bunyaeva D.V.⁴
¹Department of General Immunology named after A.A. Shortanbaev
Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
²Clinical and diagnostic laboratory, “City Rheumatology Center” of the Almaty Public Health Center,
Almaty, Kazakhstan
³Center for Perinatology and Pediatric Cardiac Surgery, Almaty, Kazakhstan
⁴Department of Microbiology, Virology of Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Introduction. Bronchopulmonary dysplasia (BPD) remains one of the leading causes of chronic respiratory morbidity in preterm infants. Growing evidence supports the involvement of the gut–lung axis in the pathogenesis of respiratory diseases; however, data on the association between gut microbiota and BPD remain limited.
Purpose of study: to evaluate the utility of conventional culture-based microbiological assessment of the gut microbiota as a clinically accessible approach for identifying microbial signatures associated with the development of bronchopulmonary dysplasia in preterm infants.
Materials and Methods. A total of 62 preterm infants admitted to neonatal intensive care and neonatal pathology units of perinatal centers in Almaty, Kazakhstan, were enrolled in the study. The BPD group included 37 infants diagnosed with bronchopulmonary dysplasia, while the comparison group comprised 25 infants without BPD. Culture-based analysis of the gut microbiota was performed to assess total microbial load and the abundance of major intestinal microbial taxa, including bifidobacteria, lactobacilli, clostridia, enterococci, bacteroides, Escherichia coli, and staphylococci. Alpha diversity (Shannon, Simpson, and Chao1 indices), beta diversity (Bray–Curtis dissimilarity and non-metric multidimensional scaling), correlation analysis, logistic regression, and microbial network analysis were conducted. Network centrality measures and hub taxa were also identified.
Results. Infants who developed BPD had a lower gestational age and more severe respiratory distress syndrome than those without BPD. Lower gestational age remained the strongest independent predictor of BPD development (adjusted OR = 0.62; 95% CI: 0.46–0.83; p = 0.002). Taxonomic analysis revealed no statistically significant differences in the prevalence of most studied microbial taxa between groups. A trend toward a higher detection rate of non-hemolytic flora was observed in infants with BPD (48.6% vs. 24.0%; p = 0.065). Quantitative analysis of microbial load among positive samples also showed no significant between-group differences (all p > 0.05). Similarly, alpha- and beta-diversity analyses did not demonstrate significant separation of microbial communities according to BPD status. However, network analysis revealed a more interconnected and centralized microbial community structure in infants with BPD, with Bacteroides spp., Enterococcus spp., and Staphylococcus epidermidis serving as key hub taxa.
Discussion. The findings indicate that, in this cohort, BPD was driven primarily by clinical factors related to prematurity and the severity of respiratory support rather than by isolated taxon-specific changes in gut microbiota. The absence of significant differences in alpha and beta diversity does not exclude the relevance of the gut–lung axis, as network analysis revealed reorganization of microbial interactions and a more centralized microbial community architecture in infants with BPD.
Conclusions. No substantial differences in the taxonomic composition or diversity of the gut microbiota were identified between preterm infants with and without bronchopulmonary dysplasia. These findings suggest that BPD development is primarily associated with clinical factors related to prematurity, whereas gut microbiota alterations are relatively subtle and are reflected mainly in the organization of microbial interaction networks. Further studies using high-resolution molecular microbiome profiling and larger cohorts are warranted to clarify the role of the gut microbiota in the pathogenesis of BPD.
Keywords: bronchopulmonary dysplasia; preterm infants; gut microbiota; gut–lung axis; dysbiosis; microbiome.
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