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The gut microbiota is a clear risk factor. In AD, microbiota imbalances drive immune system activation, disrupt protective barriers, and alter neuromodulatory signaling. Additionally, gut microbiota dysbiosis has been identified as a risk factor for AD. Recent research indicates that dysbiosis of the microbiota in AD is linked to immune activation, barrier dysfunction, and neuromodulatory signaling. Studies of AD pathology reveal that short-chain fatty acids, indole derivatives, and bile acids can have both protective and harmful effects. New strategies, such as probiotics, dietary changes, and fecal microbiota transplantation, may influence disease progression in AD. However, conflicting methods, unaccountable motives, and ethical concerns surrounding microbiome interventions pose significant hurdles. To translate findings related to the gut-brain axis into effective solutions, we need standardized multi-omics approaches, personalized therapies, and oversight from regulatory authorities. Ultimately, leveraging insights from the gut microbiome holds great promise for transforming how we diagnose, prevent, and treat AD.<\/jats:p>","DOI":"10.1186\/s13041-025-01263-1","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T12:26:24Z","timestamp":1764159984000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Molecular mechanisms of gut microbiota dysbiosis and metabolites in Alzheimer\u2019s disease pathogenesis: implications for precision therapeutics"],"prefix":"10.1186","volume":"18","author":[{"given":"Yashar","family":"Vaziri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaleh Bagheri Hamzyan","family":"Olia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cigir Biray","family":"Avci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Nourazarian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"1263_CR1","doi-asserted-by":"publisher","first-page":"e70329","DOI":"10.1111\/cns.70329","volume":"31","author":"J Su","year":"2025","unstructured":"Su J, Zhao L, Fu R, Tang Z. 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