[Mechanisms of exercise-induced improvement in drug addiction via gut microbiota].

Drug addiction not only involves dysfunction of the central reward system but is also accompanied by gut microbial dysbiosis. Drug abuse-associated microbial alterations primarily manifest in community composition, diversity, and metabolic function, and exhibit substance specificity. Studies have shown that the gut microbiota and its metabolites can, in turn, influence drug reward and drug-seeking behavior. Exercise, as a non-pharmacological intervention, facilitates abstinence and rehabilitation in individuals with addiction. Appropriate and sustained exercise may promote the enrichment of certain short-chain fatty acid (SCFA)-producing taxa and improve microbial metabolic function, with these effects influenced by factors such as exercise intensity and intervention duration. Exercise may ameliorate drug addiction by modulating the gut microbiota through the following principal pathways: regulating the gut microbiota and improving intestinal barrier function to reduce endotoxin translocation and modulate peripheral and central immune responses, thereby attenuating neuroinflammation; reshaping microbial metabolic function, with signaling involving SCFAs, glucagon-like peptide-1, peptide YY, and tryptophan metabolism contributing to the functional regulation of reward circuits such as the ventral tegmental area-nucleus accumbens pathway, thereby attenuating aberrant reward responses to drugs and drug-associated cues; and modulating microbiota-related neurotrophic, neuroplastic, and neurotransmitter signaling to influence prefrontal cortical and hippocampal function, promote the recovery of cognitive functions such as working memory and inhibitory control, and alleviate negative emotions including anxiety and depression. This review systematically synthesizes the interrelationships between drug abuse and gut microbial dysbiosis, exercise-induced adaptive microbial changes, and the potential mechanisms by which these changes contribute to addiction intervention. It also discusses current research limitations and future directions, including causal verification, multi-omics integration, and individualized exercise prescription, with the aim of providing a reference for mechanistic research on exercise-based drug rehabilitation and for optimizing intervention strategies.