Victoria Frankell

Are We On Our Way To Personalized Medicine? Scientists Dive Into the Impact of the Gut Microbiome On Drug Response

Jul 29, 2019

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The next time you have a headache, try thinking about what might be causing it before you grab a glass of water and a couple of aspirin. Your headache or backache might be occurring from stress, tight muscles, or sleep deprivation: all signs that you might benefit from a couple minutes of deep breathing and targeted stretches that might relieve your symptoms in the same length of time it takes for the medicine to kick in.

In truth, you may even be one of the people who experiences the warnings on the back of your bottle. Have you ever picked up a seemingly innocent package of Ibuprofen, just to turn it over and read all the potential side effects? If you thought your headache was bad, imagine taking it and instead of receiving pain relief - you end up with nausea, diarrhea, skin irritation, or even severe liver damage. You might be like most of the people that take it and feel better afterwards, but you might be one of the few who immediately regrets it due to a whole slew of adverse reactions.

When it comes to manufacturing medicine, scientists follow complex processes in hopes of creating safe and effective drugs that can help thousands, if not millions, of people each day. Although many of these medicines have been painstakingly studied, adverse reactions are still continually reported. Though the warnings may seem to be clear, it is more than a little difficult to determine who will actually experiences these side-effects. For most, it’s trial and error: take the drug and see what happens. While many drug trials show that most people may respond to a drug in a similar manner, that is not the case for everyone. In fact, some people may experience strangely unique and dangerous reactions. Scientists have summed up this discrepancy as variations in individuals’ genetic makeup – a statement that pretty much means, people are different - which of course, we at Viome know all too well.

Although many factors do drive how we metabolize drugs, scientists are diving deeper into how our gut microbiome may be contributing to our responses. With new research continuously unmasking the complex relationship between our food and our gut microbiome, scientists are beginning to theorize there may be more going on with our drug metabolism, too. The microorganisms that thrive in our GI system may be impacting how drugs are broken down, triggering changes in how these drugs react in our body. This field of research, called “pharmacomicrobiomics,” seeks to understand how individuals respond differently to drugs and determine potential efficacy and side-effect changes based on interactions with our gut microbiota.

This is why many scientists believe pharmacomicrobiomics may be responsible for the wide variety of responses to drugs. It may be that the side effects many of us experience are occurring from changes in our gut ecosystem in response to those drugs. Some studies have found that various microbes have the ability to take certain non-antibiotic drugs and break them down into toxic byproducts. You can imagine the first set of scientists trying to help people with their daily aches and pains didn’t expect to see the microbes in our bodies converting seemingly safe drugs into dangerous metabolites. In some cases, however, that’s exactly what they’re doing.

It doesn’t stop there, either. Some microbes can alter our immune response or even interfere with how drugs are absorbed in our body, minimizing their benefits. For example, if you or someone you know had an organ transplant, you might be familiar with the necessity of immunosuppressants that prevent someone’s body from rejecting their new organ. A common immunosuppressant, tacrolimus, has notoriously been shown to require varying prescription strengths among different people. It turns out that if your gut microbiome has a high concentration of Faecalibacterium prausnitzii, you might have to increase your dose of tacrolimus to prevent an immune response. What was even more surprising is that this same bacteria has been shown to exhibit anti-inflammatory benefits in our GI system, something scientists previously thought would be helpful to people on immunosuppressants. Surprise!

We already know that diet and environmental factors can play a significant part to the kind of diversity we find in our gut microbes, but some studies have shown that use of medications can cause even more significant changes.

 It’s been established that antibiotic treatments are often prescribed with the intention of helping people cure infections from pathogenic bacteria. Unfortunately, antibiotics aren’t usually known for discriminating the bad from the good, and heavy doses of antibiotics can wreak havoc on your microbiome by killing off many of the beneficial bacteria as well. This has been well-documented and these days doctors are a little more hesitant to prescribe wide-spectrum antibiotics that can wipe out the majority of microbes in your gut unnecessarily. Interestingly, when scientists examined whether or not the use of medications that were non-antibiotic drugs had harmful effects on gut microbes, they found that they too could harm entire populations of microbes that thrive within our gut. For example,  that Tylenol could destroy your gut microbepopulation and reshape your entire gut ecosystem. Studies with Nonsteroidal Anti-inflammatory Drugs or NSAIDs, like aspirin and ibuprofen, revealed that although many of these drugs are activated and used in the liver, when they pass through our digestive system, their metabolized byproducts can become re-activated by certain bacteria and can harm your gut microbiome.

This could have monumental implications. Each day we are learning of new illnesses and conditions that seem to stem from our gut microbiome health. Could it be that the medications you’re on might be factoring into your disease status?

 Thanks to scientists, we know how drugs interact with humans; there are whole textbooks, drug encyclopedias, and pharmaceutical databases professionals can access. One of the difficult aspects of determining drug interactions with our gut microbiome is that specialists lack these kinds of tools to help assess people’s risk. That’s why scientists across the globe have committed to building a platform that can systematically track drug interactions with gut microbes and even potentially their resulting metabolites. Over the next decade, we may see monumental strides towards narrowing down the complex relationships our drug therapies have with our gut microbiome. We might even see some of our go-to drugs being taken down from our drug store shelves and replaced with more targeted pharmaceuticals that don’t harm our gut ecosystem. 

What’s even more exciting is that the drug industry is finally starting to come to terms with what Viome has been saying all along: there is no such thing as a one-size-fits-all guide to nutrition or health. Why would on Earth would we think it’s any different with the drugs we consume?


*The information on the Viome website is provided for informational purposes only and with the understanding that Viome is not engaged in rendering medical advice or recommendations. Viome is providing this educational information to share the exciting developments being reported in the scientific literature about the human microbiome and your health. Viome products are not intended to diagnose, treat, or prevent any disease.


https://science.sciencemag.org/content/363/6427/eaat9931

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Are We On Our Way To Personalized Medicine? Scientists Dive Into the Impact of the Gut Microbiome On Drug Response

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