New insights into Alzheimer’s pathogenesis involve microbial and protein regulatory mechanisms. A National Institute on Aging grant supports Lighthouse Pharmaceuticals’ trial of LHP588, a lysine-gingipain inhibitor targeting Porphyromonas gingivalis infections linked to neuroinflammation and cognitive decline in Alzheimer’s patients. Additionally, midkine protein was shown to attenuate amyloid-β fibril formation, suggesting a protective role that may inform future therapeutic strategies.