Liu Mengchen, Xu Jiaqiang, Jin Qianna, Li Yunqiao
Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Curr Drug Metab. 2023;24(8):554-567. doi: 10.2174/1389200224666230418104540.
It is well known that the response to and metabolism of the drugs entering the human body varies widely across individuals. One of the reasons is that such interpersonal differences may be related to gut microbes. On one hand, drugs or xenobiotics entering the human body may affect the composition of the gut microbiome; on the other hand, the gut microbiota may alter the absorption, distribution, metabolism and excretion (abbreviated as ADME) process of drugs or xenobiotics vice versa. However, the majority of studies focused on the interaction of general population cohorts with the gut microbiota, which is incompatible with the real clinic. For example, the gut microbiota is closely associated with the progression and treatment of irritable bowel syndrome, a common functional disorder of the gastrointestinal tract. Under the disease status, the composition of the gut microbiota is altered affecting the pharmacokinetics, efficacy and toxicity of xenobiotics. Concerning irritable bowel syndrome, a few studies reported that the xenobiotics administration process was gut microbial-mediated, while it also affected drug efficacy and toxicity. Thus, the correlation between gut microbiota and xenobiotics administration, especially the drugs administered, should be elucidated.
This review paper links differences between the gut microbiome and drug metabolism, which play a significant role in the implications for medical therapy and drug development in irritable bowel syndrome indications.
The human intestinal microbiota permeates the ADME process of orally administered drugs and has the potential to further modify the efficacy and toxicity of agents through the mediation of various enzymes, while at the same time, medications could also alter the composition and function of the human intestinal microbiota.
众所周知，进入人体的药物的反应和代谢在个体间存在很大差异。原因之一是这种个体差异可能与肠道微生物有关。一方面，进入人体的药物或外源性物质可能会影响肠道微生物群的组成；另一方面，肠道微生物群也可能反过来改变药物或外源性物质的吸收、分布、代谢和排泄（简称为ADME）过程。然而，大多数研究集中在普通人群队列与肠道微生物群的相互作用上，这与实际临床情况不符。例如，肠道微生物群与肠易激综合征（一种常见的胃肠道功能紊乱疾病）的进展和治疗密切相关。在疾病状态下，肠道微生物群的组成会发生改变，从而影响外源性物质的药代动力学、疗效和毒性。关于肠易激综合征，一些研究报告称外源性物质的给药过程是由肠道微生物介导的，同时它也会影响药物疗效和毒性。因此，应该阐明肠道微生物群与外源性物质给药，尤其是药物给药之间的相关性。
本综述文章将肠道微生物群与药物代谢之间的差异联系起来，这在肠易激综合征适应症的医学治疗和药物开发中具有重要意义。
人类肠道微生物群渗透到口服药物的ADME过程中，并有可能通过各种酶的介导进一步改变药物的疗效和毒性，同时，药物也可能改变人类肠道微生物群的组成和功能。
