Nano-omics and nanomedicine target microbial carcinogenesis: Tumor microenvironment reprograming to clinical translation.

Microbial infections are implicated in a significant fraction of human cancers, with specific bacterial, viral, and parasitic pathogens known to drive oncogenesis via chronic inflammation, genotoxic metabolites, and immune evasion. This review clarifies the major microbial players (e.g. Helicobacter pylori, HPV, HBV, Fusobacterium nucleatum, schistosomes) and their carcinogenic mechanisms, with an emphasis on how these alter the tumour microenvironment (TME). We then discuss nano-enabled strategies that target microbe-associated tumours, including targeted nano-therapies against H. pylori and F. nucleatum, nanoparticle vaccines against viral oncoproteins (e.g. HPV E6/E7), and "nano-omics" tools for tumour microbiota profiling. Next, we expand on the roles of nanomedicine in modulating the microbiota-modified immune TME (TIME): nanoparticles can reprogram tumour-associated macrophages (TAMs), activate dendritic cells, and combine with immune checkpoint inhibitors to overcome microbial immunosuppression. Mechanistic diagrams (e.g. nanoparticle-driven TAM repolarization and immunogenic cell death) illustrate these effects. Finally, we examine theranostic and smart delivery systems that integrate imaging and therapy: examples include stimuli-responsive nanocarriers releasing drugs in response to tumour acidity or enzymes, and hybrid liposome-based nanoparticles enabling simultaneous cancer imaging and treatment. Throughout, analytical commentary highlights how these nano-approaches synergize to counteract microbial carcinogenesis and reprogram the TME. This comprehensive review synthesizes the latest research (2010-2025) and offers critical interpretation of future clinical translation opportunities.