For example, genetically modified Lactobacillus acidophilus (LH@LA), which co-loads lactate oxidase and catalase, effectively reduces tumor lactate levels, improves the immunosuppressive environment, and remodels the tumor microenvironment by inducing the polarization of M2 macrophages to M1 macrophages through the production of D-lactate (Mao et al., 2025). This evidence concerns the gene CAT and neoplasm.