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The human gut contains hundreds of trillions of microbes, including at least 1,000 known bacteria. Over the past decade or so, changes in the gut microbiome have been found to be associated with obesity, diabetes, liver disease, neurodegenerative diseases and even cancer. The gut microbiome is also affected by a variety of factors, such as eating habits, intestinal peristalsis, defecation, and medication.

A new study published at the 2019 European Digestive Disease Week Conference brought new evidence: 18 commonly used drugs affect the composition and metabolism of the gut microbiome.

This study is from the University of Groningen and Maastricht University (Maastricht University) team. By performing macrogenomic sequencing on 1883 stool samples from the general population, patients with inflammatory bowel disease, irritable bowel syndrome, and healthy controls, the researchers analyzed the microbial composition and metabolic characteristics of the drug, combined with drug use.Further assessment of the effects of 41 commonly used drugs on gut microbiome composition, metabolic function and drug resistance, including separate and combined drug use.

The researchers observed that nearly half of the drugs (18 species) are associated with changes in gut microbiome composition or metabolic function. These changes may increase health risks such as intestinal infections and obesity.

There are four types of drugs that have the greatest impact on the gut microbiome:

• Proton Pump Inhibitor( PPI): Common stomach medicine for the treatment of dyspepsia, peptic ulcer, gastric reflux, eradication of Helicobacter pylori.

• Metformin: a classic first-line medication for type 2 diabetes.

• Antibiotics: For the treatment of bacterial infections.

• Poop laxatives: for the treatment and prevention of constipation.

For example, in people taking PPI, the number of intestinal bacteria in the upper digestive tract is significantly increased, and the fatty acid content in their metabolites is also increased. In patients taking metformin, the number of potentially harmful bacteria, Escherichia coli (selective serotonin reuptake inhibitors) antidepressant drugs, associated with an increase in the number of potentially harmful bacteria Eubacterium ramulus. Methanogenic bacteria

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Although the content published at this meeting has not yet announced all the specific drugs, the interaction between gut microbiome and drugs has received more and more research attention.

In cancer immunotherapy, the influence of intestinal microbial diversity and composition on drug response is one of the research hotspots. The American Association for Cancer Research (AACR)2019, a study by the MD Anderson Cancer Center, Parker Cancer Immunotherapy Institute and its team It has been found that adjusting the daily diet through the effects on the intestinal flora may improve the efficacy of checkpoint inhibitors. In June of this year, a heavy research published by Nature also found that levodopa, which has been used in the treatment of Parkinson’s disease for more than half a century, was actually digested by the intestinal flora!

The first author of the study, Dr. Arnau Vich Vila of the University of Groningen, said, “We already know that the effectiveness and side effects of certain drugs are affected by the composition of the gut bacteria, and that the gut microbiota Relevant to health status. Understanding the effects of drug use on the gut microbiome is critical. Our research suggests that the role of the gut microbiome should also be considered when developing a treatment plan.Some side effects associated with medication are also expected to be explained by further studies of the gut microbiome.

References:

[1] OP334 – IMPACT OF 41 COMMONLY USED DRUGS ON THE COMPOSITION, METABOLIC FUNCTION AND RESISTOME OF THE GUT MICROBIOME. Retrieved Oct 23, 2019, from http://www. Professionalabstracts.com/ueg2019/iplanner/#/grid/1571788800

[2] Half of all commonly used drugs profoundly affecting the gut microbiome, warn experts. Retrieved Oct 23, 2019, from https://www.eurekalert.org/pub_releases/ 2019-10/sh-hoa101519.php

[3] Cani PD, et al., (2019). Human gut microbiome: hopes, threats and promises. Gut, 10.1136/gutjnl-2018-316723
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