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This intricate microbiotagut microbial metabolite (GMM)ICI interaction, mediated in part by BA receptors including FXR and TGR5 expressed on immune cells, highlights the expansive role of BAs in shaping immunotherapeutic outcomes ( Therapeutic strategies leveraging this microbiotaBAICI axis are actively under investigation and have shown encouraging results in both preclinical and early clinical settings ( Akkermansia muciniphila has been demonstrated to improve PD-1 blockade efficacy by modulating BA composition and enhancing T cell infiltration in MAFLD-HCC models (151)) are being tested as adjuncts to immunotherapy ( Bifidobacterium CBM588 have shown clinical benefit in RCTs for patients receiving ICI therapy (149)

A gluten-restricted diet may reduce anti-thyroid antibodies in patients with concurrent celiac disease or gluten sensitivity (Cayres et al

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