Function and mechanism of lactylation in health and diseases: a comprehensive review

Lactylation, the post-translational modification of proteins by lactate, has emerged as a novel and dynamic regulatory mechanism in cellular metabolism and signaling. The lactylation proteome represents a frontier in the study of cellular regulation, offering new insights into the complex interplay between metabolism and signaling pathways. It not only plays a pivotal role in regulating cell fate, cell signaling, gene expression, and cellular metabolism, but also exhibits unique and profound biological implications in inflammation, immune regulation, construction of the tumor microenvironment, and maintenance of cardiovascular and cerebrovascular functions. Therefore, researchers have shown interest in this novel post-translational modification of proteins and anticipate that in-depth studies will lead to breakthroughs in understanding the progression of various diseases and the development of therapeutic approaches. In this review, we aimed to summarize the discovery of lactylation, elucidate its functional roles and molecular mechanisms in diseases such as cancer, cardiovascular diseases, and neurological disorders, and discuss their translational and future research prospects. By integrating these insights, we aim to provide researchers with a holistic perspective, ultimately advancing our understanding of lactylation.