Impacts of the Human Gut Microbiome on Therapeutics

The human microbiome contains a vast source of genetic and biochemical variation, and its impacts on therapeutic responses are just beginning to be understood. This expanded understanding is especially important because the human microbiome differs far more among different people than does the human...

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Bibliographic Details
Published in:Annual review of pharmacology and toxicology 2018-01, Vol.58 (1), p.253-270
Main Authors: Vázquez-Baeza, Yoshiki, Callewaert, Chris, Debelius, Justine, Hyde, Embriette, Marotz, Clarisse, Morton, James T, Swafford, Austin, Vrbanac, Alison, Dorrestein, Pieter C, Knight, Rob
Format: Article
Language:English
Subjects:
Animals
Anti-Inflammatory Agents, Non-Steroidal - pharmacology
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Antineoplastic Agents - pharmacology
Antineoplastic Agents - therapeutic use
Cardiac Glycosides - pharmacology
Cardiac Glycosides - therapeutic use
Gastrointestinal Microbiome - drug effects
Gastrointestinal Microbiome - physiology
Humans
metabolome
microbial ecology
microbiome
Microbiota - drug effects
Microbiota - physiology
personalized medicine
precision medicine
Signal Transduction - drug effects
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Summary:The human microbiome contains a vast source of genetic and biochemical variation, and its impacts on therapeutic responses are just beginning to be understood. This expanded understanding is especially important because the human microbiome differs far more among different people than does the human genome, and it is also dramatically easier to change. Here, we describe some of the major factors driving differences in the human microbiome among individuals and populations. We then describe some of the many ways in which gut microbes modify the action of specific chemotherapeutic agents, including nonsteroidal anti-inflammatory drugs and cardiac glycosides, and outline the potential of fecal microbiota transplant as a therapeutic. Intriguingly, microbes also alter how hosts respond to therapeutic agents through various pathways acting at distal sites. Finally, we discuss some of the computational and practical issues surrounding use of the microbiome to stratify individuals for drug response, and we envision a future where the microbiome will be modified to increase everyone's potential to benefit from therapy.
ISSN:0362-1642
1545-4304
DOI:10.1146/annurev-pharmtox-042017-031849