ACHE and Alzheimer disease: Although there is no direct evidence in clinical trials that the effects on MGBA of current medications for AD (acetylcholinesterase inhibitors or N-methyl-D-aspartate (NMDA) antagonists) have been studied (La Rosa et al., 2018), the latest study provides evidence that donepezil affects GM via amino acid pathways and sugar metabolism (Jo et al., 2022).