Understanding gut dysbiosis for hepatocellular carcinoma diagnosis and treatment.

Gut dysbiosis has been implicated in the pathogenesis of hepatocellular carcinoma (HCC) arising from diverse etiological factors. Microbe-associated molecular patterns (MAMPs), microbial metabolites, and fungi are capable of modulating the metabolic pathways and immune composition of the HCC microenvironment. The gut microbiome holds potential as a novel tool for early diagnosis and evaluation of the outcome response, especially to immune checkpoint inhibitors (ICIs). Targeted manipulation of the gut microbiome through diets, antibiotics, probiotics, fecal microbiota transplantation (FMT), and nano-delivery systems may augment therapeutic efficacy in the management of HCC. The gut microbiome can play a crucial role in hepatocellular carcinoma (HCC) progression through the enterohepatic circulation, primarily acting via metabolic reprogramming and alterations in the hepatic immune microenvironment triggered by microbe-associated molecular patterns (MAMPs), metabolites, and fungi. In addition, the gut microbiome shows potential as a biomarker for early HCC diagnosis and for assessing the efficacy of immunotherapy in unresectable HCC. This review examines how gut microbiota dysbiosis, with varied functional profiles, contributes to HCCs of different etiologies. We discuss therapeutic strategies to modulate the gut microbiome including diets, antibiotics, probiotics, fecal microbiota transplantation, and nano-delivery systems, and underscore their potential as an adjunctive treatment modality for HCC. [ABSTRACT FROM AUTHOR]