Журнал лекарственного метаболизма и токсикологии
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The Gut Microbiome and Pre-systemic Metabolism: Current State and Evolving Research

Oliver Grundmann

The evolution of the complex metabolic interaction between intestinal microbiota in the human gut with its host is multidimensional. Our understanding of this complex interaction has evolved in the past years either with the use of more sophisticated analytical techniques or by reported adverse drug effects that have been associated with intestinal drug metabolism such as with sorivudine. The composition of the intestinal microbiome is initially determined by environmental and genetic factors although external influences as well as host immune reactions provide for adjustment of the delicate balance in both health and disease conditions. The metabolism of drugs by both intestinal bacteria and further by enterocytes leading to their systemic absorption deserves further attention and may provide valuable insights into pre-systemic drug metabolism, delivery, and toxicity. A better understanding of the metabolic pathways may aid in the drug development and toxicity evaluation process.