Department of Microbial Pathogenesis and Microbial Sciences Institute, Yale University School of Medicine , New Haven, CT, USA.
Gut Microbes. 2020 May 3;11(3):587-596. doi: 10.1080/19490976.2019.1667724. Epub 2019 Sep 29.
Increasing evidence suggests a role of the gut microbiota in patients' response to medicinal drugs. In our recent study, we combined genomics of human gut commensals and gnotobiotic animal experiments to quantify microbiota and host contributions to drug metabolism. Informed by experimental data, we built a physiology-based pharmacokinetic model of drug metabolism that includes intestinal compartments with microbiome drug-metabolizing activity. This model successfully predicted serum levels of metabolites of three different drugs, quantified microbial contribution to systemic drug metabolite exposure, and simulated the effect of different parameters on host and microbiota drug metabolism. In this addendum, we expand these simulations to assess the effect of microbiota on the systemic drug and metabolite levels under conditions of altered host physiology, microbiota drug-metabolizing activity or physico-chemical properties of drugs. This work illustrates how and under which circumstances the gut microbiome may influence drug pharmacokinetics, and discusses broader implications of expanded pharmacokinetic models.
越来越多的证据表明肠道微生物群在患者对药物的反应中起着重要作用。在我们最近的研究中,我们将人类肠道共生菌的基因组学和无菌动物实验相结合,定量分析了微生物群和宿主对药物代谢的贡献。根据实验数据,我们构建了一个基于生理学的药物代谢药代动力学模型,其中包括具有微生物药物代谢活性的肠道隔室。该模型成功预测了三种不同药物的代谢物的血清水平,量化了微生物对全身药物代谢物暴露的贡献,并模拟了不同参数对宿主和微生物药物代谢的影响。在本附录中,我们扩展了这些模拟,以评估在宿主生理学改变、微生物药物代谢活性或药物物理化学性质的条件下,微生物群对全身药物和代谢物水平的影响。这项工作说明了肠道微生物组如何以及在何种情况下可能影响药物的药代动力学,并讨论了扩展药代动力学模型的更广泛意义。