Everyone knows that side effects can occur when taking medications. Generally the benefits tend to outweigh them. What has now been discovered is that the drugs probably interact with the gut microbiome , that is, with all that population of bacteria that lives in the gut.
In a study recently published in Nature, scientists have discovered that numerous species of bacteria that live in the human intestine can interact and accumulate various types of medications such as antidepressants, pain relievers, and heart drugs , among others. “This requires that we start treating the microbiome as one of our organs,” says one of the study’s authors, bioinformatician Peer Bork, from the European Molecular Biology Laboratory (EMBL) in Germany.
Scientists already knew that bacteria in the human microbiome have the ability to chemically modify the drugs with which they come into contact within the body, a phenomenon called biotransformation. The novelty is that these bacteria end up unexpectedly accumulating chemicals without modifying them.
According to the researchers, bioaccumulated drugs can not only alter bacterial behavior and metabolic processes, but affect the distribution and balance of bacterial populations. In other words, the drugs would likely have unknown effects on the gut microbiome and its overall makeup if the results obtained were replicated in real human patients, which has yet to be done. The experiment has worked with more than twenty human intestinal bacteria and with 15 drugs.
“There are likely to be very personal differences between individuals, depending on the composition of their gut microbiota ,” says Kiran Patil, research director of the MRC Toxicology Unit at the University of Cambridge. “We saw differences even between different strains of the same species of bacteria.”
In addition to the effect that drugs can have on our gut microbiome, researchers have raised a second point that is not trivial and that is that if gut bacteria sequester certain chemical amounts, the drugs could be less effective . After all, when the doses of the drugs are prescribed, it is not taken into account that the bacteria are going to sequester a part.
And, finally and derived from the above, it is possible that the same phenomenon of drug sequestration also introduces or affects side effects in patients.
More research is needed to understand the real significance of this bacterial build-up problem. “The next steps will be to advance this basic molecular research and investigate how an individual’s gut bacteria are related to different individual responses to drugs such as antidepressants: differences in response, required drug dose, and side effects, such as antidepressants. weight gain, “says Patil.
“If we can characterize how people respond based on the makeup of their microbiome, drug treatments could be individualized.”
Fuente: Klünemann, M., Andrejev, S., Blasche, S. et al. Bioaccumulation of therapeutic drugs by human gut bacteria. Nature (2021). https://doi.org/10.1038/s41586-021-03891-8
