title: The Impact of the Gut Microbiota on Drug Metabolism and Clinical Outcome.
abstract: The significance of the gut microbiota as a determinant of drug pharmacokinetics and accordingly therapeutic response is of increasing importance with the advent of modern medicines characterised by low solubility and/or permeability, or modified-release. These physicochemical properties and release kinetics prolong drug residence times within the gastrointestinal tract, wherein biotransformation by commensal microbes can occur. As the evidence base in support of this supplementary metabolic "organ" expands, novel opportunities to engineer the microbiota for clinical benefit have emerged. This review provides an overview of microbe-mediated alteration of drug pharmacokinetics, with particular emphasis on studies demonstrating proof of conceptin vivo. Additionally, recent advances in modulating the microbiota to improve clinical response to therapeutics are explored.
authors.affiliation: APC Microbiome Institute, University College Cork, Cork, Ireland; School of Pharmacy, University College Cork, Cork, Ireland.
authors.forename: Elaine F
authors.initials: EF
authors.lastname: Enright
authors.affiliation: APC Microbiome Institute, University College Cork, Cork, Ireland; School of Pharmacy, University College Cork, Cork, Ireland; School of Microbiology, University College Cork, Cork, Ireland.
authors.forename: Cormac G M
authors.initials: CG
authors.lastname: Gahan
authors.affiliation: APC Microbiome Institute, University College Cork, Cork, Ireland; School of Biochemistry & Cell Biology, University College Cork, Cork, Ireland.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Joyce
authors.affiliation: APC Microbiome Institute, University College Cork, Cork, Ireland; School of Pharmacy, University College Cork, Cork, Ireland.
authors.forename: Brendan T
authors.initials: BT
authors.lastname: Griffin
mesh_terms: D000069196:Gastrointestinal Microbiome / Q000502:physiology*; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D064307:Microbiota / Q000502:physiology; D010599:Pharmacokinetics
keywords: drug metabolism; gastrointestinal; microbiome; microbiota; pharmacokinetics