Lung cancer (LC) remains the leading cause of cancer-related mortality worldwide, and resistance to therapy continues to pose a major clinical challenge. Increasing evidence highlights the relevance of the gut–lung axis in immune response modulation, tumor progression, and treatment outcomes. Within this inter-organ network, bacterial extracellular vesicles (bEVs), nanosized particles containing proteins, nucleic acids, and metabolites, serve as important mediators of host–microbiota communication, influencing immune regulation, metabolic pathways, and tumor biology. This review explores EV-mediated mechanisms involved in LC pathogenesis, including immune modulation, epigenetic regulation, and microbial metabolite signaling. The mechanistic influence of environmental and dietary factors on bEV composition and function is further explored, and emerging translational applications, ranging from diagnostic biomarker development to drug delivery strategies and modulation of immunotherapy responses, are discussed. Moreover, ongoing clinical trials testing microbiota-based strategies in non-small cell lung cancer (NSCLC) are summarized, offering potential new perspectives for personalized cancer management.
肺癌仍是全球癌症相关死亡的主要原因，治疗耐药性仍是临床面临的主要挑战。越来越多的证据表明，肠-肺轴在免疫应答调节、肿瘤进展及治疗结局中具有重要作用。在这一器官间网络中，细菌胞外囊泡作为宿主-微生物群通讯的关键介质，通过其携带的蛋白质、核酸和代谢物等纳米级颗粒成分，影响着免疫调节、代谢通路及肿瘤生物学行为。本综述探讨了胞外囊泡参与肺癌发病的机制，包括免疫调节、表观遗传调控及微生物代谢物信号传导。进一步分析了环境与饮食因素对细菌胞外囊泡组成和功能的机制性影响，并讨论了从诊断标志物开发到药物递送策略及免疫治疗应答调节等新兴转化应用。此外，本文总结了当前正在进行的针对非小细胞肺癌的微生物群相关临床试验，为个体化癌症管理提供了潜在新视角。
From Microbiota to Cancer: Role of Extracellular Vesicles in Gut–Lung Axis
肿瘤(癌症)患者之家