Immunotherapeutic Innovations in Alzheimer’s Disease: A BibliometricLandscape of Global Research Trends and Evolution

Background: Immunotherapy has emerged as a promising strategy for Alzheimer’s disease by targeting pathological proteins like amyloid-β. Despite increasing research, systematic assessments of this field remain scarce. Bibliometric analysis offers a quantitative approach to map trends, identify collaborations, and reveal hotspots such as antibody therapies and immune modulation mechanisms in neurodegenerative studies. Objective: This study aimed to perform a bibliometric analysis assessing the therapeutic efficacy and recent advancements in immunotherapy for Alzheimer's disease (AD), with an emphasis on emerging trends and key challenges. Methods: This study systematically retrieved 5,585 articles from the Science Citation Index Expanded (SCIE) within the Web of Science Core Collection (WoSCC) from 2005 to March 2025. Multi-dimensional analyses were performed on countries, institutions, authors, and keyword cooccurrence patterns using advanced visualization tools such as VOSviewer, CiteSpace, and R software. Results and Discussion: The United States and China constitute the predominant proportion of research output, with amyloid-beta (Aβ)-targeted therapies (like aducanumab, lecanemab, donanemab) and tau immunomodulation serving as the principal research foci. Emerging research frontiers encompass neuroinflammatory regulation mechanisms (like NOD-like receptor protein 3 (NLRP3) inflammasome) alongside innovative approaches, including gut-microbiota axis modulation and extracellular vesicle-based strategies. Although these therapeutic interventions have exhibited potential in amyloid burden reduction and cognitive decline mitigation, Amyloid-Related Imaging Abnormalities (ARIA) persist as critical safety challenges demanding rigorous investigation. Conclusion: Immunotherapy demonstrates disease-modifying potential in early-stage AD; however, it requires carefully optimized dosing regimens, precise biomarker-guided patient stratification, and integrated combinatorial strategies targeting Aβ, tau, and neuroinflammation. Future research should prioritize establishing robust translational models and promoting interdisciplinary collaboration to address preclinical-clinical translation gaps effectively