- Persistent neuroinflammation from addictive substances disrupts glutamate homeostasis, synaptic pruning, extracellular matrix and plasticity across reward, stress and executive-control circuits.
- Substance-induced mechanisms include oxidative stress, pattern-recognition receptor activation, increased blood-brain barrier permeability and gut-brain axis dysregulation.
- Targeting neuroimmune pathways offers therapeutic promise but faces challenges in specificity, central-peripheral immune modulation and translating pharmacological and non-pharmacological strategies.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2026 Sep 15:1-14. doi: 10.3724/zdxbyxb-2026-0195. Online ahead of print.
ABSTRACT
Substance addiction is a chronic psychiatric disorder characterized by compulsive substance use, impaired behavioral control, and high relapse rates. Although mesolimbic dopaminergic reward system dysfunction is a key neurobiological substrate of substance addiction, it cannot fully explain persistent drug craving, addiction-related memory, or compulsive drug-seeking and drug-taking behaviors after abstinence. Repeated exposure to addictive substances can induce oxidative stress, activation of pattern-recognition receptors, increased blood-brain barrier permeability, and gut-brain axis dysregulation. These changes induce reactive microglial and astrocytic phenotypes and disrupt central-peripheral immune crosstalk. Persistent neuroinflammation induced by addictive substance exposure may alter glutamate homeostasis, complement-mediated synaptic pruning, extracellular matrix remodeling, and plasticity in reward, stress, and executive-control circuits. These alterations are thought to contribute to addiction-related memory consolidation, increased relapse risk, and comorbid psychiatric and behavioral abnormalities. This review summarizes neuroimmune regulation in the brain, central-peripheral immune interactions, and substance-specific neuroinflammatory mechanisms. It also discusses recent advances and challenges in immune-targeted pharmacological and non-pharmacological interventions.
PMID:42778520 | DOI:10.3724/zdxbyxb-2026-0195
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