Impact of gut microbiota on drug metabolism: an update for safe and effective use of drugs

다국어 초록 (Multilingual Abstract)

The intestinal mucosa and liver have long beenconsidered as the main sites of drug metabolism, and thecontribution of gut microbiota to drug metabolism has beenunder-estimated. However, it is now generally acceptedthat the gut microbiota plays an important role in drugmetabolism prior to drug absorption or during enterohepaticcirculation via various microbial enzymatic reactionsin the intestine. Moreover, some drugs are metabolized bygut microbiota to specific metabolite(s) that cannot beformed in the liver. More importantly, the metabolism ofdrugs by gut microbiota prior to absorption can alter thesystemic bioavailability of certain drugs. Therefore,understanding drug metabolism by gut microbiota is criticalfor explaining changes in the pharmacokinetics ofdrugs, which may cause significant alterations in drug-inducedpharmacodynamics and toxicities. In this review, wedescribe recent progress with regard to the role of metabolismby gut microbiota in some drug-induced alterationsof either pharmacological or toxicological effects toemphasize the clinical importance of gut microbiota forsafe and effective use of drugs.

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