Work

The Importance of Liver‐Lung Communication in Pulmonary Vascular Diseases

Year: 2026

Type: article

Abstract: In normal health, the liver and lungs enjoy a close anatomic, physiologic, and functional relationship. In the context of pulmonary vascular disease, however, there is accumulating evidence that the interplay between the gut microbiome, hepatic system, and pulmonary vasculature (so-called "gut-liver-lung" axis) plays an important role in driving disease pathogenesis and determining clinical outcomes. Despite recognizing the importance of the gut-liver-lung axis in pulmonary vascular disease however, little is known about the clinical characteristics, circulating factors, and physiologic pathways that mediate this important axis of communication. In this clinical and translationally focused review, we provide an overview of liver-lung communication in normal physiology, and contrast this with gut-liver-lung derangements in pulmonary arterial hypertension, portopulmonary hypertension, and hepatopulmonary syndrome. We conclude with identifying key gaps in knowledge that will need to be addressed in order to manipulate the gut-liver-lung axis to prevent worsening pulmonary vascular disease, develop novel therapeutics, and improve patient outcomes.

Source: Comprehensive physiology

DOI: 10.1002/cph4.70140

Authors: Navneet Singh, Hilary M. DuBrock, Sasha Z. Prisco, Zhiyu Dai, Qi Zheng, Michael B. Fallon, Thenappan Thenappan, Corey E. Ventetuolo, Arun Jose

Institutions: Brown University, Mayo Clinic, University of Minnesota, Washington University in St. Louis, University of Arizona College of Medicine- Phoenix, University of Cincinnati

Language: English

Topic: Pulmonary Hypertension Research and Treatments

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funders: American Heart Association, United Therapeutics Corporation, Regeneron Pharmaceuticals, National Institutes of Health, National Heart, Lung, and Blood Institute

Awards: G2299159794, G3159339289, G5467377882, Modulating the Gut Microbiome to Augment Right Ventricular Function in Pulmonary Hypertension Due to Lung Disease, G6621846098, G6663055105, G6941143991, G7326697280, G8095831075, G8346946882, Modulating the Microbiome to Enhance Right Ventricular Function in Pulmonary Arterial Hypertension, G9000005517, G9000075860, Role of Endothelial SOX17 Deficiency in the Pathogenesis of Pulmonary Hypertension, Brown Respiratory Research Training Program, Pulmonary Artery Endothelial Cell Endotypes and the Role of Anoikis Resistance in Pulmonary Hypertension, General Capillary to Arterial Endothelial Cell Transition in Pulmonary ArterialHypertension, Biomarker Discovery in Portopulmonary Hypertension, Fatty acid-binding proteins sustain endothelial glycolysis and arterial programming in pulmonary arterial hypertension, Novel alveolar mechanisms of hypoxemia in hepatopulmonary syndrome

OpenAlex ID: W7147720438

FWCI: 8.759

Cites: 85

Cited by: 2

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