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Beyond tumorintrinsic effects, lactylation also modulates immune cell function directly, for example, H3K18la upregulates the immunosuppressive molecule B7H3 in CD8 + T cells, inducing T cell exhaustion (78, 79)

Through -glucuronidase activity, gut microbes deconjugate bound androgens, increasing circulating free testosterone levels ( Clinically, PCOS patients exhibit reduced gut microbial -diversity, an elevated Bacteroidetes-to-Firmicutes ratio, and decreased abundance of beneficial bacteria such as Akkermansia muciniphila

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doi: 10.1128/mSphere.00914-19 [DOI] [PMC free article] [PubMed] [Google Scholar] 44.Abuabara K, Azfar RS, Shin DB, Neimann AL, Troxel AB, Gelfand JM