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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Biol Chem. Dec 5, 2025; 16(4): 112221
Published online Dec 5, 2025. doi: 10.4331/wjbc.v16.i4.112221
Published online Dec 5, 2025. doi: 10.4331/wjbc.v16.i4.112221
Gut microbiome and chemotherapy-induced cardiotoxicity: A systematic review of evidence and emerging therapies
Razan Abdulaal, Imad Afara, Ehab Al Mashtoub, Alaa Tarchichi, Karim Hassan, Jana Abou Fakher, Sethrida Salhab, Issam Fassih, Mohamad Tlais, Department of Cardiology, University of Balamand, Beirut 1100, Beyrouth, Lebanon
Ali Harajli, Department of Cardiology, Lebanese American University, Beirut 1100, Beyrouth, Lebanon
Ali Afara, Department of Cardiology, Saint Georges University of Beirut, Beirut 1100, Beyrouth, Lebanon
Author contributions: Abdulaal R and Tlais M contributed to the conceptualization, design, and execution of this study; Afara I, Harajli A, Al Mashtoub E, and Afara A conducted the systematic search and initial data extraction; Tarchichi A, Hassan K, and Fassih I performed analysis and interpretation; Salhab S, Fakher JA drafted the manuscript; all authors critically reviewed and approved the final version for submission.
Conflict-of-interest statement: All authors declare that there are no conflicts of interest related to this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohamad Tlais, Department of Cardiology, University of Balamand, Dekweneh, Beirut, Beirut 1100, Beyrouth, Lebanon. mmtlaiss22@gmail.com
Received: July 21, 2025
Revised: August 3, 2025
Accepted: October 21, 2025
Published online: December 5, 2025
Processing time: 136 Days and 10.6 Hours
Revised: August 3, 2025
Accepted: October 21, 2025
Published online: December 5, 2025
Processing time: 136 Days and 10.6 Hours
Core Tip
Core Tip: This systematic review highlights the emerging role of the gut microbiome in chemotherapy-induced cardiotoxicity, focusing on how dysbiosis disrupts microbial metabolite balance, particularly short-chain fatty acids and trimethylamine-N-oxide, to drive inflammation, oxidative stress, and cardiac damage. The review synthesizes mechanistic insights and evaluates microbiome-targeted interventions such as probiotics, prebiotics, and fecal microbiota transplantation. It emphasizes the gut-heart axis as a novel therapeutic target in cardio-oncology and underscores the need for standardized clinical trials to translate these findings into personalized medicine.