Gut microbiota: what is its place in pharmacology?

ABSTRACT

Introduction: In each section of the human gastrointestinal (GI) tract we may find bacteria that are adapted to local conditions and fulfill an important role in the proper functioning of the body. The gut microorganisms are crucial in human physiology in areas as diverse as the brain and the immune system functions. Therefore, there is a close relationship between the intestinal microbiota, its metabolic activity, and health of the host.

Areas covered: In this review, we explore the host–microbiome interactions and characterize the role they may play in drug metabolism and toxicity. The study is based on pertinent papers that were retrieved by a selective search using relevant keywords in PubMed and ScienceDirect databases.

Expert opinion: Increasing unhealthy eating habits, stress, antibiotic therapy, unfavorable environmental factors, and genetic predisposition contribute to imbalances in the composition and function of the GI tract microbes and the initiation and progression of disease processes. Restoration of the balanced gut microbiota composition is possible by oral administration of probiotics.

KEYWORDS:

• Gut microbiota
• drug toxicity
• drug efficacy
• drug metabolism
• pharmacology

Article highlights

• The largest number of bacteria and their diversity is observed in the digestive tract of animals and humans – the assessment is that it is the intestines that constitute the most complex and dense bacterial ecosystem from all the known so far.

• Research conducted on gnotobiotic animals indicates a very important role of the microbiome in the host’s physiology.

• Maintaining gastrointestinal homeostasis is extremely complicated. On the one hand, the human body derives several benefits, and in many aspects is even dependent on the occurrence of the correct bacterial flora. On the other hand, commensal bacteria do not differ significantly from pathogenic bacteria, and components such as lipopolysaccharides, peptidoglycan or lipoteichoic acids are also recognized by specific host’s receptors.

• It would be useful to develop specific strategies for modifying the intestinal microbiome, to prevent the development of metabolic diseases as well as improve drug metabolism and as a consequence their efficacy.

• Oral administration of probiotics may change the gut microbiota composition.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The paper was supported by the Medical University of Lodz (502-03/1-156-04/502-14-361-18 to AT and 503/1-156-04/503-11-001 to JF).