INTERRELATIONSHIP BETWEEN MICRONUTRIENT STATUS AND GUT MICROBIOTA IN CHILDREN WITH COMMUNITY-ACQUIRED PNEUMONIA AND ITS IMPACT ON DISEASE SEVERITY

Abstract

Community-acquired pneumonia (CAP) remains one of the leading causes of hospitalization and mortality in children worldwide. This review explores the complex bidirectional relationship between micronutrient status (particularly zinc, vitamin D, iron, and vitamin A) and gut microbiota composition in pediatric patients with CAP, and examines how this interplay influences disease severity. The gut-lung axis serves as the central mechanism through which microbial metabolites (especially short-chain fatty acids) and micronutrient-dependent immune pathways modulate pulmonary inflammation, epithelial barrier integrity, and host defense. Micronutrient deficiencies alter microbial diversity, reduce colonization resistance, and promote dysbiosis, while dysbiotic microbiota exacerbates nutrient malabsorption and systemic inflammation, creating a vicious cycle that worsens clinical outcomes such as prolonged hypoxia, elevated inflammatory markers, and increased complication rates. Understanding these interactions opens new avenues for integrated nutritional and microbiota-targeted interventions to reduce severity and improve prognosis in children with CAP. This paper synthesizes current evidence on the molecular and clinical dimensions of this relationship and highlights future directions for precision medicine approaches.