Du Jiajia, Guan Yan, Zhang Erlei
Hepatic Surgery Center, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
Hubei Key Laboratory of Hepato-Pancreato-Biliary Diseases, Wuhan, China.
Hepatol Int. 2025 Apr 14. doi: 10.1007/s12072-025-10822-6.
The gut microbiota plays a role in triggering innate immunity and regulating the immune microenvironment (IME) of hepatocellular carcinoma (HCC) by acting on various signaling receptors and transcription factors through its metabolites and related molecules. Furthermore, there is an increasing recognition of the gut microbiota as a potential therapeutic target for HCC, given its ability to modulate the efficacy of immune checkpoint inhibitors (ICIs).
This review will discuss the mechanisms of gut microbiota in modulating immunotherapy of HCC, the predictive value of efficacy, and the therapeutic strategies for modulating the gut microbiota in detail.
We conducted a systematic literature search in PubMed, Embase, Scopus, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Chinese databases for articles involving the influence of gut microbiota on HCC immunotherapy.
The mechanisms underlying the effect of gut microbiota on HCC immunotherapy include gut-liver axis, tumor immune microenvironment (TIME), and antibodies. Patients who benefit from ICIs exhibit a higher abundance of gut microbiota. Antibiotics, fecal microbiota transplantation (FMT), probiotics, and prebiotics are effective methods to regulate gut microbiota.
The strong connection between the liver and gut will provide numerous opportunities for the development of microbiome-based diagnostics, treatments, or prevention strategies for HCC patients.
肠道微生物群通过其代谢产物和相关分子作用于各种信号受体和转录因子，在触发先天性免疫和调节肝细胞癌（HCC）的免疫微环境（IME）中发挥作用。此外，鉴于肠道微生物群能够调节免疫检查点抑制剂（ICIs）的疗效，其作为HCC潜在治疗靶点的认识也日益增加。
本综述将详细讨论肠道微生物群调节HCC免疫治疗的机制、疗效预测价值以及调节肠道微生物群的治疗策略。
我们在PubMed、Embase、Scopus、Cochrane图书馆、中国国家知识基础设施和万方中文数据库中进行了系统的文献检索，以查找涉及肠道微生物群对HCC免疫治疗影响的文章。
肠道微生物群对HCC免疫治疗产生影响的潜在机制包括肠-肝轴、肿瘤免疫微环境（TIME）和抗体。从ICIs中获益的患者肠道微生物群丰度较高。抗生素、粪便微生物群移植（FMT）、益生菌和益生元是调节肠道微生物群的有效方法。
肝脏与肠道之间的紧密联系将为开发基于微生物群的HCC患者诊断、治疗或预防策略提供众多机会。
