A review of current evidence and perspectives on the mechanisms and clinical significance of hypoxia-induced remodeling of the gastric microbiota-metabolism axis.

Hypoxia, as a critical environmental factor, significantly influences the gastric microbiota. The microbiota-metabolism axis profoundly influences host health and disease through its effects on microbial composition and metabolic processes. This review examines how gastric hypoxia affects microbial populations in distinct ways and how these metabolic changes may contribute to gastric disorders. Integrating recent insights from molecular biology and metabolomics, we elucidate the mechanisms underlying microbial dysbiosis in hypoxic environments and their impact on downstream signaling pathways. These findings implicate this axis in the pathogenesis of gastritis, gastric ulcers, and gastric cancer. Finally, we discuss key considerations for future clinical implementation, acknowledging that the current evidence base remains largely observational and indirect. Moreover, we offer a novel perspective on the interplay between hypoxia, bacteria, and metabolism within the gastric niche.