High-altitude exposure, characterized by hypobaric hypoxia, cold, and intense radiation, profoundly remodels the gut microbiota, triggering a cascade of physiological and pathological changes that extend far beyond the gastrointestinal tract. As millions travel to or reside in regions above 2500 meters, understanding this gut-centric axis has become critical for managing health risks. Hypoxia disrupts the delicate balance of the gut ecosystem, leading to dysbiosis, impaired barrier function, and increased intestinal permeability. This allows bacterial translocation and systemic inflammation, which underpin conditions like acute and chronic mountain sickness. Crucially, the gut microbiome acts as a dynamic environmental sensor; its altered production of metabolites—particularly short-chain fatty acids (SCFAs) and bile acids—directly influences host energy metabolism, immune responses, and acclimatization capacity. These changes are increasingly implicated in a spectrum of diseases, from metabolic disorders to colorectal cancer, positioning the gut as a central mediator of high-altitude health. This review synthesizes evidence from human and animal studies to elucidate how high-altitude stress reshapes the microbial landscape, explores the mechanisms linking microbiota to disease, and evaluates emerging microbiome-based interventions for promoting resilience.

Recent decades have witnessed unprecedented scientific growth driven by the convergence of clinical medicine, life sciences, information technology, materials science, and quantum computing. Landmark achievements such as the Human Genome Project, CRISPR-Cas9 gene editing, and multi-omics technologies have provided deep insights into human biology. Meanwhile, artificial intelligence, wearable devices, big data analytics, and the Internet of Medical Things have revolutionized medical data processing, clinical decision-making, and remote patient monitoring. These advances are accelerating drug development, digitalizing public health systems, and transforming medical diagnosis from experience-based practice to AI-augmented precision detection. Personalized medicine now benefits millions of cancer patients, while regenerative medicine offers new solutions for tissue and organ repair. Against this backdrop, the inaugural issue of MedScience is launched as the new identity of the Chinese Academy of Engineering medical journal. Originally established as Frontiers of Medicine in China in 2007 and renamed Frontiers of Medicine in 2011, the journal has achieved indexing in Scopus, PubMed/Medline, and SCI-E. The name MedScience embodies a commitment to both medical service and scientific rigor. The journal will focus on emerging fields including cell and gene therapy, AI-driven drug discovery, organoids, precision medicine, and environmental health, aiming to serve as a dynamic international platform that transcends disciplinary boundaries and contributes to global human health advancement.

Cancer immunotherapy has changed the treatment landscape, yet many tumors still evade immune attack by hiding antigens, blocking T cell entry, and building an immunosuppressive tumor microenvironment (TME).