Emerging evidence highlights the microbiota–gut–lung axis (MGLA) as a crucial regulator of respiratory health in children, influencing conditions such as asthma, pneumonia, and cystic fibrosis.

The gut–lung axis plays a significant role in childhood asthma development, with gut microbiota constituents like Lactobacillus and Bifidobacterium impacting respiratory outcomes.

Microbial interventions, including probiotics, fecal microbiota transplantation, and short-chain fatty acids (SCFAs), show promise in restoring microbial balance and reducing airway inflammation in preclinical models.

Gut microbiota-derived metabolites, especially SCFAs, are vital in modulating pulmonary immunity and maintaining immune homeostasis.

Specific microbial signatures, such as reduced Lachnospira and Faecalibacterium, have been associated with asthma, indicating potential biomarkers or therapeutic targets.

Early-life factors like delivery mode, antibiotics, and diet can cause gut dysbiosis, disrupting SCFA production and promoting inflammatory responses linked to asthma.

Dietary modulation and microbial therapeutics are emerging as personalized treatment options, offering alternatives to conventional therapies.

Phytogenic compounds are gaining attention as potential agents to reshape gut microbiota and alleviate asthma symptoms.

Further longitudinal studies and clinical trials are essential to validate the translational potential of MGLA insights and advance precision medicine in pediatric respiratory care.

Both human and animal studies provide clinical and mechanistic evidence supporting microbiota-targeted therapies, demonstrating their translational potential.

Recent multi-omics approaches are enhancing understanding of microbe–host interactions and immune dysregulation in pediatric lung diseases.

Future research should focus on developing personalized microbiota-based interventions to improve outcomes for children with asthma.