Gut microbiome interactions with drug metabolism, efficacy, and toxicity
Open accessAbstract
The gut microbiota has both direct and indirect effects on drug and xenobiotic metabolisms, and this can have consequences for both efficacy and toxicity. Indeed, microbiome-driven drug metabolism is essential for the activation of certain prodrugs, for example, azo drugs such as prontosil and neoprontosil resulting in the release of sulfanilamide. In addition to providing a major source of reductive metabolizing capability, the gut microbiota provides a suite of additional reactions including acetylation, deacylation, decarboxylation, dehydroxylation, demethylation, dehalogenation, and importantly, in the context of certain types of drug-related toxicity, conjugates hydrolysis reactions. In addition to direct effects, the gut microbiota can affect drug metabolism and toxicity indirectly via, for example, the modulation of host drug metabolism and disposition and competition of bacterial-derived metabolites for xenobiotic metabolism pathways. Also, of course, the therapeutic drugs themselves can have effects, both intended and unwanted, which can impact the health and composition of the gut microbiota with unforeseen consequences.
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The gut microbiota can have both direct and indirect effects on the metabolism of drugs, with consequences for both efficacy and toxicity.
“The gut microbiota can have both direct and indirect effects on the metabolism of drugs, with consequences for both efficacy and toxicity.60, 61”
From Emerging issues in probiotic safety: 2023 perspectives (2023) · cites this paper as [60]
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- Authors
- Wilson, I. D., & Nicholson, J. K.
- Affiliations
- Imperial College London (GB)
- Corresponding author
- Wilson, Ian D.
- Venue
- Translational Research
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 179
- Pages
- 204-222
- ISSN
- 1878-1810 (ISSN-L)
- 1931-5244
- PMC
- PMC5718288
- OpenAlex
- W2517182458
- Cited by
- 656
- References
- 141
- Citations by year
- 2026: 81 · 2025: 74 · 2024: 66 · 2023: 71 · 2022: 70 · 2021: 91 · 2020: 75 · 2019: 63 · 2018: 42 · 2017: 20 · 2016: 1
- FWCI
- 7.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Translational research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Spiral (Imperial College London) (submittedVersion, cc-by-nc-nd)
- Funders
- Wellcome Trust (104933)
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Keywords
- gut microbiota, drug metabolism, xenobiotic metabolism, drug efficacy, drug toxicity, prodrug activation, sulfanilamide, Prontosil, reductive metabolism, conjugate hydrolysis, bacterial metabolites
- MeSH terms
- Gastrointestinal Microbiome, Bacteria, Pharmaceutical Preparations, Humans, Xenobiotics, Treatment Outcome, Drug-Related Side Effects and Adverse Reactions
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