Gut Check: Future of Drugs May Rest with Your Microbes

Over the past century, tremendous advances have been made in
understanding how the human body responds to medications.
Scientists have picked apart how the body processes drugs, and
how environmental factors and genes contribute to variation in
individual responses.

But there is another critical player that is not so well
understood: The
microbes that live in our guts
, two researchers
write in the June 8 issue of the journal Science.

“The trillions of microbes associated with the
human body
 are a key part of a comprehensive view of
pharmacology,” write Henry Haiser and Peter Turnbaugh of Harvard
University.

A better understanding of just how these organisms affect human
metabolism and their effects on our health will likely open the
door to new treatments and ways of diagnosing health problems,
they write.

Gut microbes can influence how a compound is processed in a
number of ways. For example, they contribute enzymes (proteins
that spark reactions) that human cells don’t make on their own.
The relationship is a two-way street, however. Consuming certain
compounds, particularly antibiotics, can alter the composition of
a person’s gut microbe community, also called a
microbiome
. [ Gallery:
Belly Button Bacteria
]

Research has given examples of how gut bugs may directly alter
the effects of drugs. For instance, a common resident of human
guts, Eggerthella lenta, can carry out a reaction that
almost completely inactivates the
cardiovascular drug digoxin
.

There is also evidence they can affect the metabolization of
drugs indirectly. And they can be associated with disease; the
activity of certain gut microbes is associated with
atherosclerosis or hardening of the arteries, which can cause
heart attacks. Research in mice has shown that suppressing this
microbial activity can prevent the associated atherosclerosis,
they write.

Haiser and Turnbaugh propose that by understanding these
interactions, it is possible to improve the effects of
medications. For example, bacterial enzymes can interact with a
cancer drug, irinotecan, to cause severe diarrhea, so researchers
combined the drug with a compound that inhibited the enzymes and
so alleviated the negative side effect in mice, they write. 

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