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. 2025 Aug 8;16:1630828. doi: 10.3389/fmicb.2025.1630828

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Copyright © 2025 Yue, Fan, Shan and Chen.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Diagram illustrating the connection between the oral microbiome and MetS phenotypes. Oral pathogens interact with T cells, influencing the oral-gut axis. This can lead to inflammation, compromising the gut barrier and causing systemic inflammation. Metabolites include SCFAs increasing FFAs, BCAAs affecting mTOR/S6K1/IRS-1 pathways contribute to insulin resistance. Reduced nitrate-reducing bacteria lead to lowered NO levels, thus promoting hypertension. In the end, systematic inflammation can mediate insulin resistance and the latter worsens hypertension. — The oral microbiome influences systemic inflammation, insulin resistance, and hypertension through the oral-gut axis via various microbial metabolites and specific bacterial taxa. Upper portion of the figure: The illustration depicts how oral microbiome-derived immune cells and oral pathogens affect the gut via the oral-gut axis, shifting it from a healthy state to a dysbiotic, pro-inflammatory condition. This process disrupts gut barrier integrity, mediating systemic inflammation. Lower portion of the figure: The diagram highlights the role of oral microbial metabolites and specialized nitrate-reducing bacteria in modulating insulin resistance and hypertension through key signaling pathways, FFAs, and NO levels. Additionally, crosstalk between systemic inflammation and insulin resistance is illustrated. Visual guide: Black arrows: Represent progressive relationships; Red arrows: Indicate changes in metabolites; Blue arrows: Show pathway modifications; Blue background: Highlights MetS mechanisms and phenotypes discussed in this study; Pink background: Indicates microbiome-related metabolites; Yellow background: Marks relevant signaling pathways. Abbreviations: FFAs, free fatty acids; CCR9, CC-chemokine receptor 9; SCFAs, short-chain fatty acids; BCAAs, branched-chain amino acids; mTOR, mammalian target of rapamycin; S6K1, ribosomal protein S6 kinase1; IRS-1, insulin receptor substrate 1; NO, nitric oxide. Created in BioRender. Yue, Z. (2025) https://BioRender.com/0e0vmmc.