Pr. Elens (Belgium winner 2020): Gut microbiome & immunosuppresive pharmacotherapy
To celebrate #WorldMicrobiomeDay, Biocodex Microbiota Institute is handing the floor to national grant winners.
About this article
Pr. Elens Laure
Professor at the Louvain Drug Research Institute, department of integrated pharmacometrics, pharmacogenomics and pharmacokinetics, Catholic University of Louvain, Brussels, Belgium.
Prof. Laure Elens is a biomedical scientist investigating the importance of host factors, among which the gut microbiota, for explaining variation in the pharmacokinetics of drugs through experimental researches, clinical association studies and pharmacometric modelling.
What has the national grant allowed to discover in your microbiota research area?
The grant allowed us to investigate the relationship between the human gut microbiota composition and some pharmacokinetic (PK) markers of mycophenolic acid (MPA), an immunosuppressive drug largely used in solid organ transplantation, in a cohort of 100 stable renal transplant patients. A first screening analysis at the genus level revealed that 7 taxa were significantly correlated with the drug exposure as characterised by the MPA area under the concentration curve (AUC). Among these 7 genera, 4 showed a consistent difference in the low exposure group when compared to the medium & high exposure groups, which differences remained significant when correcting for false discovery rate. This correlation between MPA exposure and microbiota composition highlights a potential interaction. It suggests that either MPA impacts on the flora composition or, inversely, that the gut microbiota affects the drug enterohepatic recycling or, most probably, a combination of both.
What are the consequences for the patient?
The need of controlling immunosuppression is critical in transplanted patients to avoid inadequate exposure that can lead to inappropriate drug response, i.e. graft rejection or adverse drug reaction. As a chronic medication, identifying and understanding the factors affecting immunosuppressive drug PK are capital to master unanticipated deviations from therapeutic control. Our study constitutes a first step to the demonstration that the microbiota might contribute to the unexplained abnormalities reported in clinics and might further help the clinician to anticipate any potential PK deviance thereby, facilitating clinical management.
In your point of view, what is the biggest breakthrough related to microbiota these last years?
The importance of Gut microbiota in human metabolic health, disease and pharmacotherapy but also the fact that they can produce neurotransmitters. It makes me thinking that, in a certain way, they are able to control us (and e.g. the response I am giving to your question 😊).
Do you think there is a growing interest on microbiota recently?
Do you have a tip for taking care of our microbiota?
Avoid antibiotics and processed food as much as possible
What is for you the most fascinating bacteria?
I find every single bacterium amazing in its own style but if I had to pick one: Penicillium notatum as we all know what consequences it had on microbiology with the discovery of penicillin by Sir A. Fleming