{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:06:24Z","timestamp":1789992384326,"version":"4.0.1"},"reference-count":78,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014907","name":"Lingnan Normal University","doi-asserted-by":"publisher","award":["ZL22018"],"award-info":[{"award-number":["ZL22018"]}],"id":[{"id":"10.13039\/501100014907","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014907","name":"Lingnan Normal University","doi-asserted-by":"publisher","award":["2026JSJY29"],"award-info":[{"award-number":["2026JSJY29"]}],"id":[{"id":"10.13039\/501100014907","id-type":"DOI","asserted-by":"publisher"}]},{"award":["ZL22018"],"award-info":[{"award-number":["ZL22018"]}],"id":[{"id":"https:\/\/ror.org\/01h6ecw13","id-type":"ROR","asserted-by":"publisher"}]},{"award":["2026JSJY29"],"award-info":[{"award-number":["2026JSJY29"]}],"id":[{"id":"https:\/\/ror.org\/01h6ecw13","id-type":"ROR","asserted-by":"publisher"}]},{"name":"2024 Guangdong Provincial Education Science Planning Project","award":["2024GXJK330"],"award-info":[{"award-number":["2024GXJK330"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>The intestinal barrier (IB) is a critical interface that maintains internal homeostasis. Its functional compromise\u2014termed intestinal hyperpermeability\u2014permits luminal antigens such as lipopolysaccharide to enter the circulation, triggering metabolic endotoxemia and low-grade systemic inflammation that underpin both intestinal and extra-intestinal diseases. This narrative review was based on a comprehensive literature search of PubMed, Web of Science, and Scopus databases up to July 2026, using keywords related to exercise, intestinal barrier, tight junction proteins, inflammation, oxidative stress, gut microbiota, and short-chain fatty acids. The synthesis indicates that regular moderate-intensity continuous training (30\u201360 min\/session, 3\u20135 sessions\/week) enhances barrier integrity through upregulation of tight junction proteins, suppression of TLR4\/NF-\u03baB-driven inflammation, activation of Nrf2-mediated antioxidant defenses, and beneficial remodeling of gut microbiota composition and short-chain fatty acid production. Exercise also induces peripheral\u2013gut crosstalk mediated by myokines and vagal cholinergic signaling. The relationship between exercise volume and barrier function follows a J-shaped dose\u2013response curve, with moderate exercise conferring protection while excessive high-intensity or prolonged exercise transiently increases permeability via splanchnic hypoperfusion and hypoxia-induced epithelial stress. Exercise shows preliminary therapeutic potential as an adjunctive intervention in inflammatory bowel disease, irritable bowel syndrome, and metabolic-associated fatty liver disease, with systemic benefits extending through the gut\u2013liver and gut\u2013brain axes. However, clinical translation remains limited by small sample sizes, short follow-up periods, and heterogeneous protocols. Future research should prioritize large-scale randomized controlled trials, precision exercise prescriptions, and synergistic exercise\u2013probiotic co-interventions to establish definitive clinical guidelines.<\/jats:p>","DOI":"10.3390\/biology15181672","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:25:43Z","timestamp":1789986343000},"page":"1672","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exercise and Intestinal Barrier Integrity: Molecular Mechanisms and Therapeutic Potential in Gut Health and Disease"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4316-2456","authenticated-orcid":false,"given":"Wenqian","family":"Yang","sequence":"first","affiliation":[{"name":"Institute of Exercise and Health, Lingnan Normal University, Zhanjiang 524048, China"},{"name":"School of Sports Science, Lingnan Normal University, Zhanjiang 524048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqian","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute of Exercise and Health, Lingnan Normal University, Zhanjiang 524048, China"},{"name":"School of Sports Science, Lingnan Normal University, Zhanjiang 524048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitao","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Exercise and Health, Lingnan Normal University, Zhanjiang 524048, China"},{"name":"School of Sports Science, Lingnan Normal University, Zhanjiang 524048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang","family":"Yang","sequence":"additional","affiliation":[{"name":"Institute of Exercise and Health, Lingnan Normal University, Zhanjiang 524048, China"},{"name":"School of Sports Science, Lingnan Normal University, Zhanjiang 524048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1136\/gutjnl-2019-318427","article-title":"Leaky gut: Mechanisms, measurement and clinical implications in humans","volume":"68","author":"Camilleri","year":"2019","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1038\/nri2653","article-title":"Intestinal mucosal barrier function in health and disease","volume":"9","author":"Turner","year":"2009","journal-title":"Nat. Rev. Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1080\/17474124.2017.1343143","article-title":"The intestinal barrier: A fundamental role in health and disease","volume":"11","author":"Vancamelbeke","year":"2017","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1007\/s00018-012-1070-x","article-title":"Regulation of intestinal epithelial permeability by tight junctions","volume":"70","author":"Suzuki","year":"2013","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1038\/nri3738","article-title":"Regional specialization within the intestinal immune system","volume":"14","author":"Mowat","year":"2014","journal-title":"Nat. Rev. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1038\/nature18847","article-title":"The microbiome and innate immunity","volume":"535","author":"Thaiss","year":"2016","journal-title":"Nature"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1016\/j.cell.2016.05.041","article-title":"From dietary fiber to host physiology: Short-chain fatty acids as key bacterial metabolites","volume":"165","author":"Koh","year":"2016","journal-title":"Cell"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bischoff, S.C., Barbara, G., Buurman, W., Ockhuizen, T., Schulzke, J.D., Serino, M., Tilg, H., Watson, A., and Wells, J.M. (2014). Intestinal permeability\u2014A new target for disease prevention and therapy. BMC Gastroenterol., 14.","DOI":"10.1186\/s12876-014-0189-7"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s12276-018-0126-x","article-title":"Mechanisms regulating intestinal barrier integrity and its pathological implications","volume":"50","author":"Chelakkot","year":"2018","journal-title":"Exp. Mol. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1038\/nrmicro3344","article-title":"The gut microbiota, bacterial metabolites and colorectal cancer","volume":"12","author":"Louis","year":"2014","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.2337\/db06-1491","article-title":"Metabolic endotoxemia initiates obesity and insulin resistance","volume":"56","author":"Cani","year":"2007","journal-title":"Diabetes"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Kelly, J.R., Kennedy, P.J., Cryan, J.F., Dinan, T.G., Clarke, G., and Hyland, N.P. (2015). Breaking down the barriers: The gut microbiome, intestinal permeability and stress-related psychiatric disorders. Front. Cell. Neurosci., 9.","DOI":"10.3389\/fncel.2015.00392"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Jones, K., Kimble, R., Baker, K., and Tew, G.A. (2022). Effects of structured exercise programmes on physiological and psychological outcomes in adults with inflammatory bowel disease (IBD): A systematic review and meta-analysis. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0278480"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1093\/advances\/nmz061","article-title":"Negative effects of a high-fat diet on intestinal permeability: A review","volume":"11","author":"Rohr","year":"2020","journal-title":"Adv. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Alsinani, Y., Rostamkhani, F., and Shirvani, H. (2026). Exercise and the gut microbiome: From mechanisms to clinical applications. Nutrients, 18.","DOI":"10.3390\/nu18101565"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3831972","DOI":"10.1155\/2017\/3831972","article-title":"Exercise modifies the gut microbiota with positive health effects","volume":"2017","author":"Monda","year":"2017","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Clauss, M., G\u00e9rard, P., Mosca, A., and Leclerc, M. (2021). Interplay between exercise and gut microbiome in the context of human health and performance. Front. Nutr., 8.","DOI":"10.3389\/fnut.2021.637010"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.cell.2014.10.029","article-title":"Integrative biology of exercise","volume":"159","author":"Hawley","year":"2014","journal-title":"Cell"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"van Wijck, K., Lenaerts, K., van Loon, L.J., Peters, W.H., Buurman, W.A., and Dejong, C.H. (2011). Exercise-induced splanchnic hypoperfusion results in gut dysfunction in healthy men. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0022366"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s13578-020-00413-3","article-title":"New insights into the cellular activities of Fndc5\/Irisin and its signaling pathways","volume":"10","author":"Rabiee","year":"2020","journal-title":"Cell Biosci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1136\/bjsports-2012-091585","article-title":"Exercise regulation of intestinal tight junction proteins","volume":"48","author":"Zuhl","year":"2014","journal-title":"Br. J. Sports Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1038\/nri3041","article-title":"The anti-inflammatory effects of exercise: Mechanisms and implications for the prevention and treatment of disease","volume":"11","author":"Gleeson","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_23","first-page":"446","article-title":"Resveratrol attenuated high intensity exercise training-induced inflammation and ferroptosis via Nrf2\/FTH1\/GPX4 pathway in intestine of mice","volume":"53","author":"Xu","year":"2023","journal-title":"Turk. J. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1136\/gutjnl-2013-306541","article-title":"Exercise and associated dietary extremes impact on gut microbial diversity","volume":"63","author":"Clarke","year":"2014","journal-title":"Gut"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1080\/19490976.2015.1134082","article-title":"Formation of short chain fatty acids by the gut microbiota and their impact on human metabolism","volume":"7","author":"Morrison","year":"2016","journal-title":"Gut Microbes"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1038\/nrendo.2012.49","article-title":"Muscles, exercise and obesity: Skeletal muscle as a secretory organ","volume":"8","author":"Pedersen","year":"2012","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/nature10777","article-title":"A PGC1-\u03b1-dependent myokine that drives brown-fat-like development of white fat and thermogenesis","volume":"481","author":"Wu","year":"2012","journal-title":"Nature"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"130857","DOI":"10.1016\/j.ijbiomac.2024.130857","article-title":"Irisin delays the onset of type 1 diabetes in NOD mice by enhancing intestinal barrier","volume":"265","author":"Sun","year":"2024","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1038\/nature01321","article-title":"The inflammatory reflex","volume":"420","author":"Tracey","year":"2002","journal-title":"Nature"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s40279-020-01348-y","article-title":"The effects of exercise on indirect markers of gut damage and permeability: A systematic review and meta-analysis","volume":"51","author":"Chantler","year":"2021","journal-title":"Sports Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1249\/JES.0000000000000096","article-title":"Exercise is a novel promoter of intestinal health and microbial diversity","volume":"45","author":"Campbell","year":"2017","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Dmytriv, T.R., Storey, K.B., and Lushchak, V.I. (2024). Intestinal barrier permeability: The influence of gut microbiota, nutrition, and exercise. Front. Physiol., 15.","DOI":"10.3389\/fphys.2024.1380713"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1152\/japplphysiol.00536.2015","article-title":"Intestinal epithelial barrier function and tight junction proteins with heat and exercise","volume":"120","author":"Dokladny","year":"2016","journal-title":"J. Appl. Physiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1038\/nrm.2016.80","article-title":"Tight junctions: From simple barriers to multifunctional molecular gates","volume":"17","author":"Zihni","year":"2016","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Nay, K., Smiles, W.J., Kaiser, J., McAloon, L.M., Loh, K., Galic, S., Oakhill, J.S., Gundlach, A.L., and Scott, J.W. (2021). Molecular mechanisms underlying the beneficial effects of exercise on brain function and neurological disorders. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22084052"},{"key":"ref_36","first-page":"5297","article-title":"Exercise training reverses impaired intestinal epithelial barrier function in diet-induced obese mice","volume":"590","author":"Ghosh","year":"2012","journal-title":"J. Physiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3","DOI":"10.23736\/S0026-4806.18.05589-1","article-title":"Effects of chronic exercise on gut microbiota and intestinal barrier in human with type 2 diabetes","volume":"110","author":"Pasini","year":"2019","journal-title":"Minerva Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.brainresbull.2022.07.007","article-title":"Mechanism of CNS regulation by irisin, a multifunctional protein","volume":"188","author":"Qi","year":"2022","journal-title":"Brain Res. Bull."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"G512","DOI":"10.1152\/ajpgi.00232.2020","article-title":"Exercise and intestinal permeability: Another form of exercise-induced hormesis?","volume":"319","author":"Keirns","year":"2020","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.jare.2024.10.031","article-title":"Exerkine irisin mitigates cognitive impairment by suppressing gut-brain axis-mediated inflammation","volume":"75","author":"Zhang","year":"2025","journal-title":"J. Adv. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"G155","DOI":"10.1152\/ajpgi.00066.2012","article-title":"Physiology and pathophysiology of splanchnic hypoperfusion and intestinal injury during exercise: Strategies for evaluation and prevention","volume":"303","author":"Lenaerts","year":"2012","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1038\/s41374-019-0232-y","article-title":"The beneficial effects of physical exercise in the brain and related pathophysiological mechanisms in neurodegenerative diseases","volume":"99","author":"Liu","year":"2019","journal-title":"Lab. Investig."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.bbrc.2022.09.075","article-title":"Aerobic exercise improves intestinal mucosal barrier dysfunction through TLR4\/MyD88\/NF-\u03baB signaling pathway in diabetic rats","volume":"634","author":"Li","year":"2022","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.bbi.2013.11.013","article-title":"The effects of moderate exercise on chronic stress-induced intestinal barrier dysfunction and antimicrobial defense","volume":"39","author":"Luo","year":"2014","journal-title":"Brain Behav. Immun."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.bbi.2009.02.011","article-title":"Acute exercise mobilises CD8+ T lymphocytes exhibiting an effector-memory phenotype","volume":"23","author":"Campbell","year":"2009","journal-title":"Brain Behav. Immun."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"17950","DOI":"10.1038\/s41598-020-74837-9","article-title":"Alterations in the mucosal immune system by a chronic exhausting exercise in Wistar rats","volume":"10","author":"Castell","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/apt.14157","article-title":"Systematic review: Exercise-induced gastrointestinal syndrome\u2014Implications for health and intestinal disease","volume":"46","author":"Costa","year":"2017","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Khan, M.Z., Li, S., Ullah, A., Wang, Y., Liu, J., Chen, X., Zhang, H., Wu, D., Yang, J., and Wang, C. (2026). Therapeutic agents targeting the Nrf2 signaling pathway to combat oxidative stress and intestinal inflammation in veterinary and translational medicine. Vet. Sci., 13.","DOI":"10.3390\/vetsci13010025"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Vargas-Mendoza, N., Morales-Gonz\u00e1lez, \u00c1., Madrigal-Santill\u00e1n, E., Madrigal-Bujaidar, E., \u00c1lvarez-Gonz\u00e1lez, I., Garc\u00eda-Melo, L.F., Anguiano-Robledo, L., Fregoso-Aguilar, T., and Morales-Gonzalez, J.A. (2019). Antioxidant and adaptative response mediated by Nrf2 during physical exercise. Antioxidants, 8.","DOI":"10.3390\/antiox8060196"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Li, R.L., Zhang, T.N., Cheng, Z., Yao, C., Meng, X., and Ma, T. (2025). Advancements of physical exercise and intestinal microbiota and their potential mechanisms. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1595118"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1249\/JES.0000000000000183","article-title":"Exercise and the gut microbiome: A review of the evidence, potential mechanisms, and implications for human health","volume":"47","author":"Mailing","year":"2019","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12967-025-07492-1","article-title":"Exercise intensity-mediated regulation of gut epithelial cells and immune function in gut microbiota dysbiosis","volume":"24","author":"Hoseini","year":"2026","journal-title":"J. Transl. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1053\/j.gastro.2025.01.224","article-title":"Exercise, the gut microbiome and gastrointestinal diseases: Therapeutic impact and molecular mechanisms","volume":"169","author":"Hawley","year":"2025","journal-title":"Gastroenterology"},{"key":"ref_54","first-page":"428","article-title":"The interplay between gut microbiome and physical exercise in athletes","volume":"27","author":"Quaresma","year":"2024","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1249\/MSS.0000000000001495","article-title":"Exercise alters gut microbiota composition and function in lean and obese humans","volume":"50","author":"Allen","year":"2018","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1038\/s42255-020-0188-7","article-title":"Short-chain fatty acids as potential regulators of skeletal muscle metabolism and function","volume":"2","author":"Frampton","year":"2020","journal-title":"Nat. Metab."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1038\/s41380-022-01819-w","article-title":"The role of exercise in the treatment of depression: Biological underpinnings and clinical outcomes","volume":"28","author":"Ross","year":"2023","journal-title":"Mol. Psychiatry"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s00702-020-02143-9","article-title":"Antidepressant-like and pro-neurogenic effects of physical exercise: The putative role of FNDC5\/irisin pathway","volume":"127","author":"Siteneski","year":"2020","journal-title":"J. Neural Transm."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1002\/hep.24001","article-title":"Evolution of inflammation in nonalcoholic fatty liver disease: The multiple parallel hits hypothesis","volume":"52","author":"Tilg","year":"2010","journal-title":"Hepatology"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Muguerza-Rodr\u00edguez, L., Mier, A., Ponce-Gonz\u00e1lez, J.G., Pino-Ortega, J., and Guti\u00e9rrez-Hell\u00edn, J. (2025). Systematic review on the importance of gut microbiota in the regulation of type 2 diabetes through physical activity and exercise. Curr. Issues Mol. Biol., 47.","DOI":"10.3390\/cimb47070505"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Kasimu, A., Huang, Y., Wang, D., Jiang, Y., Liu, Y., Song, Y., Zhang, Y., Chen, X., and Li, B. (2026). Exercise pretreatment intervention alleviates intestinal dysbiosis and improves intestinal dysfunction in stroke rats. BMC Gastroenterol., 26.","DOI":"10.1186\/s12876-025-04554-y"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Bianco, A., Patti, A., Buscemi, S., Bellafiore, M., Palma, A., Ferrara, A., Di Gaudio, F., and Cibella, F. (2024). Beyond nutritional treatment: Effects of fitwalking on physical capacity and intestinal barrier integrity in BMI-stratified IBS patients. Nutrients, 16.","DOI":"10.3390\/nu16234181"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Saponaro, F., Bertolini, A., Baragatti, R., Galfo, L., Chiellini, G., Saba, A., and D\u2019Urso, G. (2024). Myokines and microbiota: New perspectives in the endocrine muscle-gut axis. Nutrients, 16.","DOI":"10.3390\/nu16234032"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"102610","DOI":"10.1016\/j.jtherbio.2020.102610","article-title":"The magnitude of physical exercise-induced hyperthermia is associated with changes in the intestinal permeability and expression of tight junction genes in rats","volume":"91","author":"Fuscaldi","year":"2020","journal-title":"J. Therm. Biol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1159\/000371795","article-title":"The impact of a ten-week physical exercise program on health-related quality of life in patients with inflammatory bowel disease","volume":"91","author":"Klare","year":"2015","journal-title":"Digestion"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1159\/000342169","article-title":"Exercise, intestinal barrier dysfunction and probiotic supplementation","volume":"59","author":"Lamprecht","year":"2012","journal-title":"Med. Sport Sci."},{"key":"ref_67","first-page":"106835","article-title":"Exploring the gut-exercise link: A systematic review of gastrointestinal disorders in physical activity","volume":"31","author":"Saeed","year":"2025","journal-title":"World J. Gastroenterol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1038\/ajg.2010.480","article-title":"Physical activity improves symptoms in irritable bowel syndrome: A randomized controlled trial","volume":"106","author":"Johannesson","year":"2011","journal-title":"Am. J. Gastroenterol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.jsams.2024.07.003","article-title":"Physical activity, sedentary behavior and microbiome: A systematic review and meta-analysis","volume":"27","author":"Ortega","year":"2024","journal-title":"J. Sci. Med. Sport"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jad.2017.02.006","article-title":"A systematic review of yoga for major depressive disorder","volume":"213","author":"Cramer","year":"2017","journal-title":"J. Affect. Disord."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"6212","DOI":"10.1038\/s41598-024-51470-4","article-title":"Effect of different exercise modalities on nonalcoholic fatty liver disease: A systematic review and network meta-analysis","volume":"14","author":"Xue","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"36","DOI":"10.5114\/pg.2025.148473","article-title":"Structured exercise in patients with inflammatory bowel disease: A literature review","volume":"20","author":"Achtenberg","year":"2025","journal-title":"Gastroenterol. Rev.\/Prz. Gastroenterol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2404141","DOI":"10.1080\/19490976.2024.2404141","article-title":"A new perspective in intestinal microecology: Lifting the veil of exercise regulation of cardiometabolic diseases","volume":"16","author":"Gao","year":"2024","journal-title":"Gut Microbes"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"10779","DOI":"10.1007\/s12035-025-04938-x","article-title":"Six weeks of moderate-intensity treadmill exercise improves intestinal barrier and intestinal inflammation in Parkinson\u2019s disease mice","volume":"62","author":"Li","year":"2025","journal-title":"Mol. Neurobiol."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Tero-Vescan, A., Moldovan, R., Munteanu, A., Popa, C., Olah, P., and Todoran, N. (2026). Kynurenine pathway metabolites as mediators of exercise-induced mood enhancement, fatigue resistance, and neuroprotection. Int. J. Mol. Sci., 27.","DOI":"10.3390\/ijms27010129"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s12970-016-0155-6","article-title":"Exercise-induced stress behavior, gut-microbiota-brain axis and diet: A systematic review for athletes","volume":"13","author":"Clark","year":"2016","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Liu, Y., Fu, X., Zhao, X., Cui, R., and Yang, W. (2024). The role of exercise-related FNDC5\/irisin in depression. Front. Pharmacol., 15.","DOI":"10.3389\/fphar.2024.1461995"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"e9211","DOI":"10.1590\/1414-431x20209211","article-title":"Alanyl-glutamine protects the intestinal barrier function in trained rats against the impact of acute exhaustive exercise","volume":"53","author":"Freitas","year":"2020","journal-title":"Braz. J. Med. Biol. Res."}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/15\/18\/1672\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:14:01Z","timestamp":1789989241000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/15\/18\/1672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":78,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["biology15181672"],"URL":"https:\/\/doi.org\/10.3390\/biology15181672","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]}}}