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Emerging evidence suggests that the microbiota\u2013gut\u2013brain axis (MGB axis) is a crucial regulator of depressive pathophysiology, facilitating bidirectional communication between the gut microbiota and the central nervous system (CNS) through neural, immune, endocrine, and metabolic pathways. This review explores the complex mechanisms underlying MGB dysfunction in depression, including vagus nerve\u2010mediated signaling, cytokine\u2010driven neuroinflammation, and hypothalamic\u2013pituitary\u2013adrenal (HPA) axis dysregulation. Innovations in microbiota\u2010targeted interventions, ranging from probiotic engineering and precision dietary modulation to bacteriophage therapy and AI\u2010driven personalized medicine, have been critically assessed for their potential to restore MGB homeostasis. 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