肠道菌群对药物代谢影响的研究进展

肠道菌群是寄居在肠道的种类繁多、数量庞大的微生物群落,对药物等外来化合物的代谢至关重要,近年来肠道菌群作为机体"隐形器官"被广泛关注。通过查阅国内外相关文献,该文对机体中肠道菌群的分类、功能及其对中药化学成分和化学药物代谢的影响进行了分析、归纳和总结。了解肠道菌群对药物代谢的影响,明确药物转化过程,对于指导临床合理用药、个体化用药、毒理学评估及推动药物发现和研发具有重要意义,为后期研究高原环境下肠道菌群对药物代谢的影响提供理论指导。     

肠道菌群与药物代谢

肠道菌群具有强大的代谢能力,被认为是人体后天获得的重要"代谢器官",在宿主消化、营养吸收、代谢、免疫等各方面发挥重要作用。肠道菌群参与外源药物等的体内代谢过程及内源糖类、蛋白质、脂肪等的代谢平衡,从而影响药物的体内处置过程、药效-毒性反应以及机体生理、病理状态。     

肠道菌群介导高原低氧对药物代谢的调节

高原低氧显著影响药物代谢动力学特征及药物代谢酶和转运体的活性和表达。肠道菌群是影响药物体内代谢的重要因素,可通过直接或间接作用影响药物代谢,改变药物的生物利用度、生物活性或毒性,进一步影响药物的疗效和安全性。高原低氧环境中肠道菌群的结构和多样性发生显著改变,在高原低氧条件下药物代谢的调节中可能发挥关键作用。本文旨在综述高原低氧对肠道菌群的影响及肠道菌群对药物代谢的影响,探讨肠道菌群介导的高原低氧对药物代谢的调节作用及相关机制。     

常见药物毒性相关的肠道菌群研究进展

肠道菌群在物质信息传递、代谢等方面发挥重要作用,随着生物技术的进步,人们对肠道菌群与宿主健康的关系有了进一步的认识。近年来的研究发现,肠道菌群与某些药物毒性存在相关性。本文总结了药物肝毒性、肾毒性、神经毒性和生殖及幼龄毒性相关的肠道菌群研究成果,以期为药物毒理研究提供参考。     

肠道菌群在高血压及其药物治疗中的作用研究进展

高血压是全球最常见的慢性疾病之一,在人群中发病率较高并趋于年轻化,严重影响人类健康。其中,药物治疗是高血压的重要治疗策略,一定程度提高了我国高血压的控制率,但总体仍处于较低水平。近年来,大量文献报道了肠道菌群与高血压存在密切关系,与抗高血压药物效果反应也存在显著相关性。本文综述了肠道菌群与高血压疾病机制的研究,并探讨了肠道菌群与常用一线降压药物治疗效果的关系,为改善高血压治疗提供理论依据。     

肠道菌群调控肥胖症脂质代谢机制的研究进展

肥胖是全球性健康问题,与多种代谢疾病相关。肠道菌群的特定改变是肥胖和肥胖相关的代谢疾病的重要特征之一。近年来,肠道菌群在肥胖及相关代谢疾病中的作用受到了越来越多的关注,被认为是肥胖潜在的治疗靶点。肠道菌群的组成丰富,其参与宿主脂质代谢机制复杂。本文介绍了肥胖发生发展过程中的代表性菌种,概述了肠道微生物调控宿主脂质代谢的潜在机制的研究进展,以期为基于肠道菌群为靶点的治疗手段和药物研发提供思路。     

肠道菌群调控骨代谢及中药应用研究进展

肠道菌群是定植在人体内复杂而庞大的微生物群落,肠道菌群及其代谢物短链脂肪酸在参与人体代谢、抵御外来致病菌以及调节免疫机制等方面发挥重要作用。近年来,不少研究发现肠道菌群与骨骼代谢密切相关。肠道菌群可通过营养吸收、短链脂肪酸生成、调节机体免疫、影响机体代谢等多种途径调控骨代谢,影响骨量变化。本文综述了肠道菌群影响骨代谢中骨量变化的潜在途径及作用机制,以及中药干预肠道菌群调控骨代谢的相关进展,以期为骨代谢相关疾病骨质疏松症的防治提供新思路。     

肠道菌群代谢产物与宿主疾病

研究发现人体中的肠道菌群在各种疾病的发生和发展中扮演着重要的角色,被认为是人体的“第9大系统”“第2基因组”。肠道菌群及其代谢产物直接影响着人体的健康。本文综述肠道菌群代谢产物与糖尿病、高血脂、免疫系统、结肠癌及心血管疾病的相关性及其潜在的作用机制。     

Potential Implications of Gut Microbiota in Drug Pharmacokinetics and Bioavailability

Gut microbial communities are capable of enzymatically transforming pharmaceutical compounds into active, inactive, and toxic metabolites, thus potentially affecting the pharmacokinetics and bioavailability of orally administered medications. Our understanding of the impact and clinical relevance of how gut microbial communities can directly and indirectly affect drug metabolism and, ultimately, clinical outcomes, is limited. Interindividual variability of gut microbial composition may partially explain differences observed in drug efficacy and toxicity in certain patient populations. This review provides an overview of how gut microbial communities can potentially contribute to individual drug response. This review focuses on the current landscape of clinical and preclinical research that defines the microbiome contribution on medication response with the goal of improving medication efficacy and decreasing medication toxicity.     

药物微生物组学:肠道微生物与个体化用药

药物的安全性与有效性是临床治疗中的关键问题,大量研究表明,人体微生物与药物的疗效、不良反应等显著相关。随着人类微生物组计划的实施,药物微生物组学成为当前生命科学和医学的研究热点。药物微生物组学是药物基因组学的重要扩展和补充,致力于研究药物与微生物之间的相互作用及其与药物效应之间的关系。药物微生物组学研究尚处于起步阶段,其发展将为个体化医学和精准医疗提供必要参考。简介药物微生物组学的发展,并对肠道菌群与个体化用药的国内外研究现状进行综述。     

肠道菌群对某些疾病及药物疗效与毒性的影响

经过长期的协同进化,肠道菌群与宿主间形成了密切的共生关系,并对宿主的多种生理功能起着重要作用。在相关疾病的治疗过程中,药物对肠道菌群的影响以及肠道菌群对药物和疾病的影响相互交织,并有可能改变药物在体内的药动学过程及药效。综述药物、肠道菌群以及疾病三者间的相互作用与联系,提出利用药物调节肠道菌群以治疗相关疾病的思路,为现有药物的新药理作用的发现和以肠道菌群为作用靶点的新型药物的研发提供有益信息。     

Gut microbiota modulates drug pharmacokinetics

Abstract

Gut microbiota, one of the determinants of pharmacokinetics, has long been underestimated. It is now generally accepted that the gut microbiota plays an important role in drug metabolism during enterohepatic circulation either before drug absorption or through various microbial enzymatic reactions in the gut. In addition, some drugs are metabolized by the intestinal microbiota to specific metabolites that cannot be formed in the liver. More importantly, metabolizing drugs through the gut microbiota prior to absorption can alter the systemic bioavailability of certain drugs. Therefore, understanding intestinal flora-mediated drug metabolism is critical to interpreting changes in drug pharmacokinetics. Here, we summarize the effects of gut microbiota on drug pharmacokinetics, and propose that the influence of intestinal flora on pharmacokinetics should be organically related to the therapeutic effects and side effects of drugs. More importantly, we could rationally perform the strategy of intestinal microflora-mediated metabolism to design drugs.     

Structure-based Drug Metabolism Predictions for Drug Design

Significant progress has been made in structure-based drug design by pharmaceutical companies at different stages of drug discovery such as identifying new hits, enhancing molecule binding affinity in hit-to-lead, and reducing toxicities in lead optimization. Drug metabolism is a major consideration for modifying drug clearance and also a primary source for drug metabolite-induced toxicity. With major cytochrome P450 structures identified and characterized recently, structure-based drug metabolism prediction becomes increasingly attractive. In silico methods based on molecular and quantum mechanics such as docking, molecular dynamics and ab initio chemical reactivity calculations bring us closer to understand drug metabolism and predict drug–drug interactions. In this study, we review important progress in drug metabolism and common in silico techniques adopted to predict drug regioselectivity, stereoselectivity, reactive metabolites, induction, inhibition and mechanism-based inactivation, as well as their implementation in hit-to-lead drug discovery.     

Gut microbiota and lipid metabolism alterations in mice induced by oral cadmium telluride quantum dots

The potential toxicity of cadmium-containing quantum dots (QDs) has received much attention because of increasing biomedical applications. However, little has been known about how cadmium telluride (CdTe) QDs influence the gut microbiota and lipid metabolism. In this study, mice were exposed orally to CdTe QDs (200 μL of 0.2, 2, 20 or 200 μm ; twice per week) for 4 weeks. The oral experiments showed CdTe QD exposure led to a decrease of the Firmicutes/Bacteroidetes (F/B) ratio of gut microbiota, which highly negatively correlated with the low-density lipoprotein (LDL), triglyceride (TG) and total cholesterol (TC) levels in serum. In addition, the low-dose (0.2 and 2 μm ) CdTe QDs significantly increased the diversity of gut microbiota, and did not elevate the LDL, TG and TC levels in serum. The medium dose (20 μm ) of CdTe QDs caused the biggest decrease of the F/B ratio, so it significantly increased the LDL, TG and TC levels compared with the control. Furthermore, high-dose (200 μm ) CdTe QDs caused various toxicities in the histopathology of liver and intestine, liver function and intestinal immunity, but did not significantly lead to changes of the LDL, TG and TC levels in serum. This study demonstrates that high-dose oral CdTe QDs mainly lead to tissue damage of the liver and intestine, while the medium and low doses of oral CdTe QDs induce shifts of gut microbiota structure, which are associated with blood lipid levels.     

肠道菌群与糖尿病

摘要： 近年来, 肠道菌群与糖尿病的关系成为研究热点。随着对肠道菌群认识的深入, 肠道菌群作为环境因素在调节免疫及代谢性疾病发生中的作用逐渐被大家认识。目前国内外已有大量研究关注肠道菌群影响肥胖和糖尿病的发病机制, 也有研究发现肠道菌群能够从食物难以消化的成分中获取能量, 从而影响人体的能量平衡和代谢。人们通过基因组测序的方法揭示不同类型糖尿病患者肠道菌群的组成、 丰度等, 并在动物体内进行验证, 明确和糖尿病相关的细菌功能。肠道菌群携带的遗传信息可能是未来治疗糖尿病的新突破口。关于2型糖尿病 （T2DM） 及1 型糖尿病 （T1DM） 肠道菌群的研究较多, 但妊娠期糖尿病 （GDM） 肠道菌群的相关研究报道较少。因此, 本文对不同类型糖尿病的肠道菌群特点及肠道菌群参与糖尿病发生的机制作一综述。     

The influence of gut microbiota on drug metabolism and toxicity

Introduction: Gut microbiota plays critical roles in drug metabolism. The variation of gut microbiota contributes to the interindividual differences toward drug therapy including drug-induced toxicity and efficacy. Accordingly, the investigation and elucidation of gut microbial impacts on drug metabolism and toxicity will not only facilitate the way of personalized medicine, but also improve rational drug design.

Areas covered: This review provides an overview of the microbiota–host co-metabolism on drug metabolism and summarizes 30 clinical drugs that are co-metabolized by host and gut microbiota. Moreover, this review is specifically focused on elucidating the gut microbial modulation of some clinical drugs, in which the gut microbial influences on drug metabolism, drug-induced toxicity and efficacy are discussed.

Expert opinion: The gut microbial contribution to drug metabolism and toxicity is increasingly recognized, but remains largely unexplored due to the extremely complex relationship between gut microbiota and host. The mechanistic elucidation of gut microbiota in drug metabolism is critical before any practical progress in drug design or personalized medicine could be made by modulating human gut microbiota. Analytical technique innovation is urgently required to strengthen our capability in recognizing microbial functions, including metagenomics, metabolomics and the integration of multidisciplinary knowledge.     

Microbial Metabolism Studies of the Antimalarial Drug Arteether

Microbial metabolism studies of the antimalarial drug arteether (1) have shown that arteether is metabolized by a number of microorganisms. Large-scale fermentation with Aspergillus niger (ATCC 10549) and Nocardia corallina (ATCC 19070) have resulted in the isolation of four microbial metabolites which have been characterized using two-dimensional nuclear magnetic resonance (2D-NMR) techniques. These metabolites have been identified as AEM1 (2), 3-hydroxydeoxyarteether (3), 3-hydroxydeoxydihydroartemisinin (4), and deoxydihydroartemisinin (5).     

介绍物理化学方法研究药物吸收、分布、代谢和排泄

目的介绍用于研究药物吸收、分布、代谢和排泄的物理化学方法。方法总结了药物溶解度、解离常数和亲脂性的各种测定方法。结果与结论药物的物理化学性质在药物代谢和药物动力学的研究中起着非常关键的作用。