Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by cognitive decline and progressive neuronal damage. Recent research has highlighted the significant roles of the gut microbiota and microRNAs (miRNAs) in the pathogenesis of AD. This review explores the intricate interaction between gut microbiota and miRNAs, emphasizing their combined impact on Alzheimer’s progression. First, we discuss the bidirectional communication within the gut-brain axis and how gut dysbiosis contributes to neuroinflammation and neurodegeneration in AD. Changes in gut microbiota composition in Alzheimer’s patients have been linked to inflammation, which exacerbates disease progression. Next, we delve into the biology of miRNAs, focusing on their roles in gene regulation, neurodevelopment, and neurodegeneration. Dysregulated miRNAs are implicated in AD pathogenesis, influencing key processes like inflammation, tau pathology, and amyloid deposition. We then examine how the gut microbiota modulates miRNA expression, particularly in the brain, potentially altering neuroinflammatory responses and synaptic plasticity. The interplay between gut microbiota and miRNAs also affects blood–brain barrier integrity, further contributing to Alzheimer’s pathology. Lastly, we explore therapeutic strategies targeting this gut microbiota-miRNA axis, including probiotics, prebiotics, and dietary interventions, aiming to modulate miRNA expression and improve AD outcomes. While promising, challenges remain in fully elucidating these interactions and translating them into effective therapies. This review highlights the importance of understanding the gut microbiota-miRNA relationship in AD, offering potential pathways for novel therapeutic approaches aimed at mitigating the disease’s progression.

阿尔茨海默病 （AD） 是一种神经退行性疾病，其特征是认知能力下降和进行性神经元损伤。最近的研究强调了肠道菌群和 microRNA （miRNA） 在 AD 发病机制中的重要作用。本综述探讨了肠道菌群与 miRNAs 之间错综复杂的相互作用，强调了它们对阿尔茨海默病进展的综合影响。首先，我们讨论了肠-脑轴内的双向通信，以及肠道菌群失调如何导致 AD 的神经炎症和神经退化。阿尔茨海默病患者肠道微生物群组成的变化与炎症有关，炎症会加剧疾病进展。接下来，我们深入研究 miRNA 的生物学，重点关注它们在基因调控、神经发育和神经退行性变中的作用。失调的 miRNA 与 AD 发病机制有关，影响炎症、tau 病理学和淀粉样蛋白沉积等关键过程。然后，我们检查肠道微生物群如何调节 miRNA 表达，尤其是在大脑中，从而可能改变神经炎症反应和突触可塑性。肠道微生物群和 miRNA 之间的相互作用也会影响血脑屏障的完整性，进一步导致阿尔茨海默病的病理学。最后，我们探索了针对该肠道微生物群-miRNA 轴的治疗策略，包括益生菌、益生元和饮食干预，旨在调节 miRNA 表达并改善 AD 结果。虽然前景广阔，但在充分阐明这些相互作用并将其转化为有效的疗法方面仍然存在挑战。本综述强调了了解 AD 中肠道微生物群-miRNA 关系的重要性，为旨在减轻疾病进展的新型治疗方法提供了潜在途径。