The microbiota-host metabolic axis in cervical cancer: from homeostatic disruption to mechanisms of therapy resistance.

Persistent infection with high-risk human papillomavirus (HR-HPV) is a prerequisite for cervical carcinogenesis. In this process, the vaginal microbiota, as a key component of the cervical microenvironment, plays a significant role in facilitating viral persistence and malignant transformation. Moving beyond the conventional focus on compositional shifts, this review systematically examines the dynamic remodeling of the host-microbiota co-metabolic network during the progression from health to invasive cervical cancer. It explores in depth the interactive mechanisms through which metabolites derived from a dysbiotic microbiota exacerbate epithelial barrier damage, modulate local immune evasion, and activate oncogenic signaling pathways, with particular emphasis on how co-metabolic imbalance drives therapeutic resistance. By integrating these insights, this review aims to advance the mechanistic understanding of microbial contributions to cervical cancer development and to inform novel strategies for overcoming treatment resistance through microbiota-targeted interventions.