摘要The host-microbe co-metabolism system,generating diverse exogenous and endogenous bio-active molecules that influence the host's immune and metabolic functions,plays a crucial role in the pathogenesis of atherosclerosis.Recent studies have elucidated the interaction between natural medicines and this co-metabolism system.Upon oral administration,natural medicine ingredients can undergo transformation by gut microbiota,potentially enhancing their bioavailability or anti-atherogenic efficacy.Furthermore,natural medicines can exert anti-atherogenic effects via modulation of endogenous host-microbe co-metabolism.This re-view presents an updated understanding of the dual association between natural medicines and host-microbe co-metabolites.It explores the critical function of microbial exogenous metabolites derived from natural medicines and uncovers the mechanisms underlying natur-al medicines' intervention on key nodes of endogenous host-microbe co-metabolism.These insights may offer new perspectives for cardiovascular disease(CVD)treatment and guide fu-ture drug discovery efforts.