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The vast genetic and metabolic potential of the gut microbiome underpins its ubiquity in nearly every aspect of human biology, including health maintenance, development, aging, and disease. The advent of new sequencing technologies and culture-independent methods has allowed researchers to move beyond correlative studies toward mechanistic explorations to shed light on microbiome\u2013host interactions. Evidence has unveiled the bidirectional communication between the gut microbiome and the central nervous system, referred to as the \u201cmicrobiota\u2013gut\u2013brain axis\u201d. The microbiota\u2013gut\u2013brain axis represents an important regulator of glial functions, making it an actionable target to ameliorate the development and progression of neurodegenerative diseases. In this review, we discuss the mechanisms of the microbiota\u2013gut\u2013brain axis in neurodegenerative diseases. As the gut microbiome provides essential cues to microglia, astrocytes, and oligodendrocytes, we examine the communications between gut microbiota and these glial cells during healthy states and neurodegenerative diseases. Subsequently, we discuss the mechanisms of the microbiota\u2013gut\u2013brain axis in neurodegenerative diseases using a metabolite-centric approach, while also examining the role of gut microbiota-related neurotransmitters and gut hormones. Next, we examine the potential of targeting the intestinal barrier, blood\u2013brain barrier, meninges, and peripheral immune system to counteract glial dysfunction in neurodegeneration. Finally, we conclude by assessing the pre-clinical and clinical evidence of probiotics, prebiotics, and fecal microbiota transplantation in neurodegenerative diseases. A thorough comprehension of the microbiota\u2013gut\u2013brain axis will foster the development of effective therapeutic interventions for the management of neurodegenerative diseases.<\/jats:p>","DOI":"10.1038\/s41392-024-01743-1","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T20:25:22Z","timestamp":1708028722000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1232,"title":["Microbiota\u2013gut\u2013brain axis and its therapeutic applications in neurodegenerative diseases"],"prefix":"10.1038","volume":"9","author":[{"given":"Jian Sheng","family":"Loh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen Qi","family":"Mak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li Kar Stella","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chu Xin","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Hao","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiau Hueh","family":"Yeow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jhi Biau","family":"Foo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Sze","family":"Ong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chee Wun","family":"How","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kooi Yeong","family":"Khaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,16]]},"reference":[{"key":"1743_CR1","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1038\/s41579-022-00833-7","volume":"21","author":"G Caballero-Flores","year":"2023","unstructured":"Caballero-Flores, G., Pickard, J. 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