Assessment of tissue microenvironment lactate levels has emerged as a crucial indicator of microcirculation and early organ dysfunction. Lactylation modification, closely associated with lactate concentration, represents a novel post-translational alteration targeting protein lysine residues. Post-translational modifications are chemical changes capable of modulating protein activity and functionality, serving as a rapid mechanism for enhancing proteomic diversity and influencing various life processes. While previous research primarily focused on histone lactylation, recent studies have revealed the occurrence of lactylation on non-histone proteins, exerting significant effects on gene expression and intercellular communication. Lactylation has been implicated in diverse diseases spanning embryonic development, neuronal excitability, inflammatory responses, cardiovascular conditions, tumor progression, invasion, and aging. Hence, lactylation emerges as a pivotal regulator in numerous pathological conditions. This review delves into the mechanisms underlying lactylation and disease pathogenesis, elucidates the multifaceted roles of lactylation in disease progression, and identifies novel therapeutic targets related to lactylation, offering potential avenues for future clinical interventions.
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