Authors
Financing
No funding declared
30/06/2025
Alcohol use disorder and gut microbiota: a narrative review
abstract
Alcohol use disorder (AUD) affects millions of people worldwide and can lead to serious physical and social consequences. The human gut harbors a complex and diverse community of microorganisms that modulate the immune system, metabolic responses, and the nervous system, thereby influencing brain function and behavior. It has been demonstrated that imbalances in this microbial ecosystem— in both abundance and diversity—are associated with various psychiatric disorders. In particular, intestinal dysbiosis, involving alterations in the composition of bacteria, viruses, yeasts, archaea, and fungi, is well documented in patients with AUD. Recent research has highlighted not only the impact of alcohol on the gut microbiome but also the fundamental role of the microbiota and the gut-brain axis in the onset and persistence of AUD. This article presents a comprehensive review of the bidirectional interaction between alcohol consumption and the gut microbiota, addressing the effects of alcohol on microbial composition, changes in intestinal microbial metabolites following alcohol intake, and the influence of these metabolites on drinking behavior. Additionally, the mechanisms of gut-mediated neuroinflammation that contribute to and result from AUD are examined, including disruption of the intestinal barrier, Toll-like receptor signaling, and activation of glial and immune cells. Finally, current evidence on therapies targeting the gut microbiota for the treatment of AUD is analyzed, and the implications of these findings for understanding the pathophysiology of the disorder, as well as prospects for future research, are discussed.
Keywords:
Alcohol, gut microbiota.