Microbiota 11 - December 2020
the impact of some drugs on the composition of the microbiota and, consequently, on its functions, has been reported for a number of years. The best known of such drugs are antibiotics but proton-pump inhibitors and metformin are also implicated. Conversely, what impact does the microbiota exert on drugs? The role of gut microbiota in drug metabolism, which has been observed and characterised more recently, could explain the difference in efficacy from person to person of some drugs, based on the composition of their microbiota. The microbiota, as a veritable enzymeproducing factory, may exert a positive influence by modifying inactive precursors or, conversely, exert a negative impact by disrupting interactions between the drug and its receptor. When administered orally, which is the most common route, or parenterally, where metabolites reach the gut via bile secretions, the microbiota could affect all drugs.
In this issue, Professor Balskus uses several examples to outline how the gut microbiota is involved in the metabolism of some drugs and the consequences on their efficacy. She also describes the studies underway to identify which drugs are likely to act on the metabolic activity of the microbiota vis-à-vis certain medicines. Finally, she discusses the importance of considering the metabolic role of the microbiota when developing new drugs.
Another area where the microbiota is also implicated is respiratory infections. Recent studies seem to show a decrease in certain butyrate-producing bacterial species in patients with SARS-CoV-2 (preliminary results). In addition, 7-20% of people with SARS-CoV-2 experience diarrhoea thus also having an impact on the gut.
Professor Trottein tackles the “gut-lung” axis and discusses changes to the intestinal microbiota observed during viral respiratory infections as well as the consequences of such dysbiosis. He also explains the crucial role played by the microbiota in combating respiratory infections and the potential benefit of its modulation for their prevention.
Enjoy your reading.