Following this, a two-step mediation analysis was conducted to construct a protein-protein-metabolic regulatory network.<h4>Results</h4>The study identified that the LAT-IL23R metabolic axis mediates CRS through γ-glutamyltyrosine and trans-4-hydroxyproline.<h4>Conclusion</h4>This study systematically reveals, for the first time, the promoting role of the LAT-IL23R-amino acid metabolic network in CRS, providing a theoretical basis for the development of targeted combination therapies.<h4>Level of evidence</h4>Level 3 (causal inference from cohort-derived genetic data). This evidence concerns the gene IL23R and congenital rubella syndrome.