A 100 trillion bacteria, consisting of more than 1000 species, reside within your guts. While the presence of a 100 trillion bacteria inside you may sound somewhat unsettling, it should be known that they play a very important role within your body. These bacteria play a crucial part in the digestion of various substances that our body alone cannot digest - such as the dietary fibers you see within various plant foods. In addition they take part in the synthesis of vitamins and many more essential materials. In other words, they are important partners that our body can’t live without.
Well, it turns out that they do more than just helping our bodies’ digest and acquire materials, Gut bacteria have also shown to determine how our body reacts to certain drugs.
Researchers Michael Zimmerman, Maria Kogadeeva, Rebekka Wegmann and Andrew L. Goodman of Yale University have found out that the genetic composition of an individual’s microbiota within their digestive tract/guts plays a major role in how people’s bodies respond to various medications.
Every person possesses a different microbiome within their guts - that is, everyone possesses a unique variety and ratio of different types of gut bacteria. While person 1 might possess a large number of bacteria A in their intestines, person 2 might have much more bacteria B in comparison less bacteria A. Depending on the gut ecosystem, a human’s guts can foster growth for certain groups of bacteria also called an enterotype, which specialize in carrying out different processes and breaking down different materials - for example, members of the enterotype Prevotella are known to metabolize carbohydrates whereas those of the enterotype Bacteroides specialize in breaking down proteins and amino acids. The enterotypes of an individual is most likely dictated by long term diet behavior. The primary consumption of a particular substance may foster the growth of a certain enterotype; e.g. consuming a lot of carbohydrates would likely mean prevotella would become the dominant enterotype.
The researchers collected chemical evidence on how different types of gut bacteria affect the usage of medications. They did this by collecting 76 different species of bacteria to represent the human microbiome, and exposed them to various drug solutions made of 271 oral drugs within test tubes. After incubating the bacteria for 12 hours, the researchers found out that up to 176 out of the 271 drug solutions had been altered by at least one species of bacteria. The bacteria had metabolized the drug solution, reducing the concentration level of the drug within the test tubes. Each bacterial species was shown to have affected from 11 to 95 drugs. These alterations would come in 3 types; the activation of the drug, inactivation of the drug, and even toxification. Muscle pain reducers like sulfasalazine were often seen being activated further by the bacteria, whereas the antiviral drug brivudine was shown to take part in the production of harmful substances.
Next, the researchers collected samples of feces from 28 participants and once again tested the interactions between the microbiota within the samples and various drugs. Results showed a variety of interactions between drugs and microbiotas once again.
The researchers moved on studying which portions of the bacterial DNA were creating such interactions. They achieved this by taking portions from the DNA of the bacterial strains being tested and then inserting them into the genome of E. Coli cells. From this they were able to identify the DNA segments modifying the drugs, and take a closer look at how they cause the modifications.
The significance of this research lies in the detailing of a new factor when producing and administering new drugs. Pharmaceutical companies have to consider the various different microbiomes present in each indiv idual. No two are the same, and thus they must attempt to spend more time finding a solution that is mostly effective for a large range of people or alternatively try to classify their drugs for multiple specific cases. Although it may sound less cost efficient for companies to invest in drugs that would only be consumed by few, both strategies have shown to reap comparable amount of revenue, as those with special, rare cases are willing to pay more to fix their conditions. It may sound unfair for those that may have to pay more due to their unique situation, but then again it is by no means a reason to not take such medications and “endure the pain,” which may be dangerous. Doctors must consider the microbiota of their patients before issuing them certain medications in order to make sure that there will be no side effects that come from interactions between the gut bacteria of their patients and the drugs. By taking samples of their patients’ feces, they will analyze and predict the possible reactions. Either way, careful research into the presence of gut bacterial like that done by the scientists at Yale will act as a guide for pharmaceutical companies and others in the medical field in the usage of medicines, and help in the provision of many more effective drugs for each individual in the future. It’s also safe to assume that you will need to hand out a sample of your feces more often whenever you need to take medications, whether or not you like it. After all, it is for the better.
Works Cited
Temming, M. (2019, July 9). Gut bacteria may change the way many drugs work in the body. Retrieved from https://www.sciencenews.org/article/gut-bacteria-may-change-way-many-drugs-work-body
Zimmermann, M., Zimmermann-Kogadeeva, M., Wegmann, R., & Goodman, A. L. (2019). Mapping human microbiome drug metabolism by gut bacteria and their genes. Nature, 570(7762), 462–467. doi: 10.1038/s41586-019-1291-3
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