Wan Yating, Zuo Tao
Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, P. R. China.
Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China.
Gastroenterol Rep (Oxf). 2022 Apr 8;10:goac009. doi: 10.1093/gastro/goac009. eCollection 2022.
The gut microbiota is considered a key 'metabolic organ'. Its metabolic activities play essential roles complementary to the host metabolic functions. The interplays between gut microbes and commonly used non-antibiotic drugs have garnered substantial attention over the years. Drugs can reshape the gut microorganism communities and, vice versa, the diverse gut microbes can affect drug efficacy by altering the bioavailability and bioactivity of drugs. The metabolism of drugs by gut microbial action or by microbiota-host cometabolism can transform the drugs into various metabolites. Secondary metabolites produced from the gut microbial metabolism of drugs contribute to both the therapeutic benefits and the side effects. In view of the significant effect of the gut microbiota on drug efficiency and clinical outcomes, it is pivotal to explore the interactions between drugs and gut microbiota underlying medical treatments. In this review, we describe and summarize the complex bidirectional interplays between gut microbes and drugs. We also illustrate the gut-microbiota profile altered by non-antibiotic drugs, the impacts and consequences of microbial alteration, and the biochemical mechanism of microbes impacting drug effectiveness. Understanding how the gut microbes interact with drugs and influence the therapeutic efficacy will help in discovering diverse novel avenues of regulating the gut microbes to improve the therapeutic effects and clinical outcomes of a drug in precision.
肠道微生物群被认为是一个关键的“代谢器官”。其代谢活动在补充宿主代谢功能方面发挥着重要作用。多年来，肠道微生物与常用非抗生素药物之间的相互作用备受关注。药物可以重塑肠道微生物群落，反之，多样的肠道微生物可以通过改变药物的生物利用度和生物活性来影响药物疗效。肠道微生物作用或微生物-宿主共代谢对药物的代谢可将药物转化为各种代谢产物。药物肠道微生物代谢产生的次级代谢产物既有助于治疗效果，也会导致副作用。鉴于肠道微生物群对药物疗效和临床结果的显著影响，探索药物与肠道微生物群在医学治疗中的相互作用至关重要。在这篇综述中，我们描述并总结了肠道微生物与药物之间复杂的双向相互作用。我们还阐述了非抗生素药物改变后的肠道微生物群特征、微生物改变的影响和后果，以及微生物影响药物疗效的生化机制。了解肠道微生物如何与药物相互作用并影响治疗效果，将有助于发现多种调节肠道微生物的新途径，以精准提高药物的治疗效果和临床结果。
