Exercise and immune system as modulators of intestinal microbiome: implications for the gut-muscle axis hypothesis.

Exercise is a possible modulator of intestinal microbiome composition, since some investigations have shown that it is associated with increased biodiversity and representation of taxa with beneficial metabolic functions. Conversely, training to exhaustion can be associated with dysbiosis of the intestinal microbiome, promoting inflammation and negative metabolic consequences. Gut microbiota can, in turn, influence the pathophysiology of several distant organs, including the skeletal muscle. A gut-muscle axis may in fact regulate muscle protein deposition and muscle function. In older individuals, this axis may be involved in the pathogenesis of muscle wasting disorders through multiple mechanisms, involving transduction of pro-anabolic stimuli from dietary nutrients, modulation of inflammation and insulin sensitivity. The immune system plays a fundamental role in these processes, being influenced by microbiome composition and at the same time contributing to shape microbial communities. In this review, we summarize the most recent literature acquisitions in this field, disentangling the complex relationships between exercise, microbiome, immune system and skeletal muscle function and proposing an interpretative framework that will need verification in future studies.