Lactate and <italic>Akkermansia muciniphila</italic>: Emerging Roles in Inflammatory Bowel Disease and Colorectal Cancer.

BACKGROUND: Lactate levels are significantly elevated in the tissues of patients with inflammatory bowel disease (IBD) and colorectal cancer (CRC). In IBD, lactate promotes anti-inflammatory repair by inducing M2 macrophage polarization, whereas abnormal lactate levels in the CRC tumor microenvironment contribute to tumor initiation and progression through acidification, immune reprogramming, and activation of pro-angiogenic pathways. Akkermansia muciniphila (Akk) exhibits a distinct preference for lactate as a nutritional substrate, and its abundance increases significantly in the murine gut following lactate administration. As an important intestinal symbiont, Akk shows potential in the prevention and treatment of both IBD and CRC.

KEY MESSAGES: We hypothesize that targeting lactate metabolism and leveraging the active components of Akk may provide novel strategies for the prevention and therapy of IBD and CRC.

SUMMARY: This review aims to summarize the relationship among lactate, Akk, and inflammation-associated CRC, thereby offering new perspectives and approaches for the clinical management of CRC.