This review examines how microbiome-derived metabolites (short-chain fatty acids, bile acids, indoles, lipopolysaccharides) modulate immune cells via epigenetic remodeling, mitochondrial reprogramming, and mTOR/AMPK signaling, and how these interactions shape cardiometabolic disease outcomes.
Microbiome-immune crosstalk influences inflammatory programs linked to obesity, type 2 diabetes, metabolic dysfunction-associated steatotic liver disease (MASLD), and cardiovascular disease; emerging therapeutic strategies include personalized nutrition, precision probiotics, microbial consortium transplantation, and metabolite-based postbiotics.
As a narrative review, no original experimental data are presented; causal relationships between specific microbiome signals and human disease outcomes remain largely inferential from cited studies.
Clinicians managing cardiometabolic disease should watch this space: microbiome-targeted strategies (probiotics, postbiotics, dietary modulation) are moving toward precision applications, though robust clinical trial evidence is still emerging.
