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This narrative review synthesizes mechanistic, clinical, and translational evidence to delineate molecular pathways of microbiome-targeted interventions, evaluates clinical outcomes in IBS and IBD, and proposes a unified framework linking gastrointestinal modulation to systemic health. A structured literature search across PubMed\/MEDLINE, Scopus, Web of Science, and Google Scholar (2012\u20132024) identified approximately 68 eligible sources, appraised using Cochrane Risk of Bias 2.0 and AMSTAR-2. Five principal molecular pathways were identified: competitive pathogen exclusion, epithelial barrier reinforcement, immune modulation, short-chain fatty acid (SCFA) production, and neurotransmitter signaling. Clinically, dietary strategies, biological agents (probiotics, prebiotics, synbiotics, postbiotics, and fecal microbiota transplantation [FMT]), advanced modalities (rifaximin, psychobiotics, bacteriophage therapy), and lifestyle interventions collectively engage these pathways. The same mechanisms underpin emerging applications in metabolic, autoimmune, neurological, and cardiovascular disease. We propose a three-tier model progressing from molecular mechanisms through gastrointestinal outcomes to systemic benefits, with precision medicine and standardized trial designs as prerequisites for therapeutic translation.<\/jats:p>","DOI":"10.1556\/030.2026.03015","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T12:28:20Z","timestamp":1786105700000},"update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["From Dysbiosis to systemic health: Microbiome modulation as a unified therapeutic framework"],"prefix":"10.1556","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6407-598X","authenticated-orcid":true,"given":"Neena Kumar","family":"Dhiman","sequence":"first","affiliation":[{"name":"Department of Zoology, Gargi College, University of Delhi, Delhi 110049, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0796-5238","authenticated-orcid":true,"given":"S Rehan","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Zoology, Hiralal Mazumdar Memorial College for Women, West Bengal State University, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"issue":"11","key":"B1","series-title":"Biochem J","doi-asserted-by":"publisher","first-page":"1823","DOI":"10.1042\/BCJ20160510","article-title":"Introduction to the human gut microbiota","volume":"474","author":"Thursby E","year":"2017","unstructured":"Thursby E, Juge N. 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