Anwar Firoz, Al-Abbasi Fahad A, Al-Bar Omar A, Verma Amita, Kumar Vikas
Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, 21589, Jeddah, Saudi Arabia.
Bioorganic and Medicinal Chemistry Research Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, Uttar Pradesh, India.
Inflammopharmacology. 2025 Jan;33(1):49-68. doi: 10.1007/s10787-024-01593-x. Epub 2024 Nov 2.
The intricate Gut microbiome is evolving as an important system and is hypothesized to be a "metabolic organ" within the host. Alterations in Gut microbiota and inflammation associated with several diseases play a crucial role in drug transformation through microbiota-host co-metabolism, modified pharmacokinetic and pharmacodynamics profiles, and may result in the formation of toxic metabolites with interference in drug response. In recent studies, a large number of drugs are reported that are co-metabolized by the host and the Gut microbial enzymes. we summarize the direct and indirect involvement of Gut microbiome promotion or inhibition of cardiovascular diseases, mechanisms on bioavailability, and therapeutic outcomes of cardiovascular drugs, particularly pharmacokinetics and pharmacodynamics profiles in light of AUC, T, C, and bioavailability and drug transportation via immune cells, inter-individual variations in intestinal microbial taxonomy, influence of drugs on diversity and richness of microflora, high lightening limitations and significance of in personalized medicine. Recent advances in target-drug delivery by nanoparticles with limitations and challenges in application are discussed. The cross-talk between Gut microbiota and cardiovascular drugs signifies a better understanding and rationale for targeting the Gut microbiota to improve the therapeutic outcome for cardiovascular diseases, with present-day limitations.
复杂的肠道微生物群正逐渐演变成一个重要的系统，并且被假定为宿主体内的一个“代谢器官”。肠道微生物群的改变以及与多种疾病相关的炎症，通过微生物群-宿主共代谢、改变的药代动力学和药效学特征，在药物转化中起着关键作用，并且可能导致有毒代谢物的形成，从而干扰药物反应。在最近的研究中，报道了大量由宿主和肠道微生物酶共同代谢的药物。我们总结了肠道微生物群促进或抑制心血管疾病的直接和间接参与情况、生物利用度的机制以及心血管药物的治疗结果，特别是根据曲线下面积（AUC）、达峰时间（T）、血药浓度（C）和生物利用度以及通过免疫细胞的药物转运，探讨药代动力学和药效学特征、肠道微生物分类的个体间差异、药物对微生物群落多样性和丰富度的影响，强调在个性化医疗中的局限性和意义。还讨论了纳米颗粒靶向给药的最新进展及其应用中的局限性和挑战。肠道微生物群与心血管药物之间的相互作用表明，尽管存在当前的局限性，但对于靶向肠道微生物群以改善心血管疾病的治疗效果有了更好的理解和理论依据。
