• Serum lactate levels correlate with tumor grade and poor prognosis in ovarian cancer patients, suggesting lactate as a prognostic biomarker.
• Lactate induces M2 polarization of macrophages, which promotes ovarian cancer cell proliferation and migration via CCL18 and Gpr132 signaling.
• Mechanistically, lactate upregulates CCL18 expression through histone H3K18 lactylation, revealing a novel epigenetic regulatory pathway.
• Targeting lactate or the lactate-CCL18 axis may offer new therapeutic strategies for ovarian cancer treatment.