人类肠道内的多种微生物的代谢衍生物可以通过肠肺轴参与肺部的生理活动和免疫状态。目前成熟的微生物代谢产物包括短链脂肪酸（SCFAs）、色氨酸及其衍生物、多胺（PAs）、次级胆汁酸（SBA）等。随着研究的不断深入，微生物代谢产物在肺癌的发生和治疗已逐渐被揭示。微生物衍生物可以进入循环系统调节肺癌的免疫微环境。从机制上讲，致癌代谢物会损害宿主DNA并促进肺癌的发生，而抑癌代谢物则直接影响免疫系统对抗癌细胞的恶性特性，甚至在提高肺癌免疫治疗疗效方面显示出巨大的应用潜力。考虑到沿肠肺轴的串扰，深入探索患者粪便或血清中的微生物代谢物将为肺癌诊断和治疗选择策略提供新的指导。此外，针对微生物代谢物的靶向治疗有望突破肺癌免疫治疗的瓶颈并减轻不良反应，包括粪便菌群移植、微生态制剂、代谢物合成和针对代谢途径的药物。总之，这篇综述为肠道微生物代谢物与肺癌发展之间复杂的相互作用以及通过肠肺轴的免疫治疗提供了新颖的见解和解释，这进一步证实了微生物组代谢组在肺癌治疗中可能的转化潜力.版权所有 © 2024。由 Elsevier B.V. 出版

Metabolic derivatives of numerous microorganisms inhabiting the human gut can participate in physiological activities and immune status of the lungs through the gut-lung axis. The current well-established microbial metabolites include short-chain fatty acids (SCFAs), tryptophan and its derivatives, polyamines (PAs), secondary bile acids (SBAs), etc. As the study continues to deepen, the critical function of microbial metabolites in the occurrence and treatment of lung cancer has gradually been revealed. Microbial derivates can enter the circulation system to modulate the immune microenvironment of lung cancer. Mechanistically, oncometabolites damage host DNA and promote the occurrence of lung cancer, while tumor-suppresive metabolites directly affect the immune system to combat the malignant properties of cancer cells and even show considerable application potential in improving the efficacy of lung cancer immunotherapy. Considering the crosstalk along the gut-lung axis, in-depth exploration of microbial metabolites in patients' feces or serum will provide novel guidance for lung cancer diagnosis and treatment selection strategies. In addition, targeted therapeutics on microbial metabolites are expected to overcome the bottleneck of lung cancer immunotherapy and alleviate adverse reactions, including fecal microbiota transplantation, microecological preparations, metabolite synthesis and drugs targeting metabolic pathways. In summary, this review provides novel insights and explanations on the intricate interplay between gut microbial metabolites and lung cancer development, and immunotherapy through the lens of the gut-lung axis, which further confirms the possible translational potential of the microbiome metabolome in lung cancer treatment.Copyright © 2024. Published by Elsevier B.V.