# Gut microbiota-metabolism-immunity axis: a novel perspective of traditional Chinese medicine in hepatocellular carcinoma treatment

**Authors:** Xuemei Zhang, Liming Zheng, Jia Shi, Shihan Yu, Wenlan Zheng, Hao Liu, Zhengzheng Wu, Hai Feng, Yueqiu Gao, Zhuo Yu

PMC · DOI: 10.1186/s13020-026-01357-5 · Chinese Medicine · 2026-03-24

## TL;DR

This paper explores how gut microbiota, metabolism, and immunity interact in liver cancer treatment using traditional Chinese medicine.

## Contribution

The paper introduces a novel perspective on TCM's role in HCC treatment through gut microbiota-metabolism-immunity interactions.

## Key findings

- Gut microbiota-derived metabolites significantly influence HCC immunity.
- TCM modulates the gut-liver-immune axis to treat HCC effectively.
- TCM offers a holistic approach by reprogramming tumor immunity via gut microbiota.

## Abstract

Hepatocellular carcinoma (HCC) is a highly aggressive malignancy characterized by complex metabolic dysregulation and immune evasion mechanisms, leading to poor prognosis and limited treatment efficacy. Growing evidence underscores the critical involvement of gut microbiota dysbiosis in HCC pathogenesis, wherein microbial communities and their bioactive metabolites dynamically influence the hepatic immune microenvironment and drive tumorigenesis. Emerging evidence indicates that Traditional Chinese Medicine (TCM) exerts therapeutic effects against HCC by modulating the gut-liver axis through multiple mechanisms, including remodeling gut microbial composition, regulating microbiota-derived metabolites, and fine-tuning hepatic immune responses, thus establishing a novel effective paradigm for HCC therapy. This article comprehensively reviews the intricate interactions between TCM and the gut microbiota-metabolism-immunity axis, elucidating the pivotal roles of gut microbiota and their metabolites in HCC pathogenesis and progression. Furthermore, we systematically summarize recent advances in understanding how TCM exerts anti-HCC effects through microbiota-mediated immunomodulation, with a particular focus on regulatory mechanisms involving microbial metabolites and hepatic immune responses. These findings provide valuable insights and establish a conceptual framework for future research in this burgeoning field.

The gut-liver axis is pivotal in HCC pathogenesis and therapy.Gut microbiota-derived metabolites critically regulate HCC immunity.Traditional Chinese Medicine ameliorates HCC via multitargeted modulation of the gut-liver-immune axis.Traditional Chinese Medicine reprograms tumor immunity via gut microbiota remodeling.Traditional Chinese Medicine offers a novel holistic paradigm for HCC management.

The gut-liver axis is pivotal in HCC pathogenesis and therapy.

Gut microbiota-derived metabolites critically regulate HCC immunity.

Traditional Chinese Medicine ameliorates HCC via multitargeted modulation of the gut-liver-immune axis.

Traditional Chinese Medicine reprograms tumor immunity via gut microbiota remodeling.

Traditional Chinese Medicine offers a novel holistic paradigm for HCC management.

## Linked entities

- **Diseases:** Hepatocellular carcinoma (MONDO:0007256), HCC (MONDO:0007256)

## Full-text entities

- **Diseases:** malignancy (MESH:D009369), tumorigenesis (MESH:D063646), HCC (MESH:D006528)

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13011729/full.md

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Source: https://tomesphere.com/paper/PMC13011729