{"id":3815,"date":"2019-06-19T20:05:09","date_gmt":"2019-06-19T11:05:09","guid":{"rendered":"http:\/\/163.180.4.222\/lab\/?p=3815"},"modified":"2019-06-19T20:05:09","modified_gmt":"2019-06-19T11:05:09","slug":"microbes-make-metabolic-mischief-by-targeting-drugs","status":"publish","type":"post","link":"https:\/\/biochemistry.khu.ac.kr\/lab\/?p=3815","title":{"rendered":"Microbes make metabolic mischief by targeting drugs"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h5>Tests of whether a range of gut bacteria can metabolize a diverse group of drugs has revealed that all the microbes metabolized some drugs and that more than half of the drugs were metabolized.<\/h5>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<div class=\"article__body serif cleared\">\n<p>All humans are different and, unsurprisingly, also differ in their response to drug treatments. It is usually thought that this variation is due mainly to differences in liver enzymes that specialize in detoxifying ingested molecules. Such enzymes can metabolize drugs, with consequences that include reducing or eliminating drug potency or making them toxic. Understanding how an individual will respond to a given drug is important in developing treatment plans. Yet our knowledge of drug fate in the body is still rudimentary, despite a long history of studies in this area.\u00a0<a href=\"https:\/\/www.nature.com\/articles\/s41586-019-1291-3\" data-track=\"click\" data-label=\"https:\/\/www.nature.com\/articles\/s41586-019-1291-3\" data-track-category=\"body text link\">Writing in\u00a0<i>Nature<\/i><\/a>, Zimmermann\u00a0<i>et al.<\/i><sup><a href=\"https:\/\/www.nature.com\/articles\/d41586-019-01851-x?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+nature%2Frss%2Fcurrent+%28Nature+-+Issue%29#ref-CR1\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">1<\/a><\/sup>\u00a0put human gut bacteria in the spotlight in the quest to understand how drugs are naturally metabolized.<\/p>\n<p>&nbsp;<\/p>\n<aside class=\"recommended pull pull--left sans-serif\" data-label=\"Related\"><a href=\"https:\/\/www.nature.com\/articles\/s41586-019-1291-3\" data-track=\"click\" data-track-label=\"recommended article\"><img decoding=\"async\" class=\"recommended__image\" src=\"https:\/\/media.nature.com\/w400\/magazine-assets\/d41586-019-01851-x\/d41586-019-01851-x_16817784.jpg\" \/><\/a><\/p>\n<p class=\"recommended__title serif\">Read the paper: Mapping human microbiome drug metabolism by gut bacteria and their genes<\/p>\n<\/aside>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>A handful of previous examples have revealed that the community of microorganisms residing in the gut, termed the gut microbiota, can affect drugs. A classic example is the case of prontosil, the first widely used antibiotic. In the 1930s, the microbiologist Gerhard Domagk found that prontosil could tackle infection by the bacterium\u00a0<i>Streptococcus pyogenes<\/i>\u00a0in mice<sup><a href=\"https:\/\/www.nature.com\/articles\/d41586-019-01851-x?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+nature%2Frss%2Fcurrent+%28Nature+-+Issue%29#ref-CR2\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">2<\/a><\/sup>. It was later established that prontosil is metabolized by gut bacteria to generate the molecule sulfanilamide, which is the active form of the drug<sup><a href=\"https:\/\/www.nature.com\/articles\/d41586-019-01851-x?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+nature%2Frss%2Fcurrent+%28Nature+-+Issue%29#ref-CR3\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">3<\/a><\/sup>. Interestingly, had prontosil been tested for activity against\u00a0<i>S. pyogenes<\/i>\u00a0in a test tube, as we do today, its capacity to generate an antibiotic would have been missed.<\/p>\n<p>Other examples of gut bacteria affecting drugs include the microbial inactivation of digoxin, which is used for heart conditions<sup><a href=\"https:\/\/www.nature.com\/articles\/d41586-019-01851-x?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+nature%2Frss%2Fcurrent+%28Nature+-+Issue%29#ref-CR4\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">4<\/a><\/sup>, and the bacterial modification of the chemotherapeutic agent irinotecan, which causes toxic side effects<sup><a href=\"https:\/\/www.nature.com\/articles\/d41586-019-01851-x?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+nature%2Frss%2Fcurrent+%28Nature+-+Issue%29#ref-CR5\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">5<\/a><\/sup>. Zimmermann and colleagues devised a large-scale approach to tackle the open question of how widespread drug metabolism by the microbiota is.<\/p>\n<p>The authors conducted\u00a0<i>in vitro<\/i>\u00a0tests to assess the ability of 76 bacterial strains from the human gut, representing 68 species from the main bacterial taxonomic groupings, to metabolize 271 drugs (Fig. 1). These drugs were chosen to provide a diverse group in terms of factors such as molecular structure or effect on the body. Zimmermann and colleagues report that 176 of the drugs tested underwent a substantial metabolic change, caused by least one bacterial strain, that resulted in a reduction in the level of the active drug molecule in bacteria. Each bacterial strain tested metabolized some of the drugs, with the numbers ranging from 11 to 95 drugs per strain. Given that the authors tested a broadly representative panel of drugs, the scale of these results is remarkable because it raises the possibility that most drugs are modified by the microbiota. This type of testing could also be a useful way of singling out drugs that would probably be deactivated by the microbiota.<\/p>\n<p>&nbsp;<\/p>\n<figure class=\"figure\">\n<div class=\"embed intensity--high\">\n<div class=\"embed intensity--high\"><img decoding=\"async\" class=\"figure__image\" src=\"https:\/\/media.nature.com\/w800\/magazine-assets\/d41586-019-01851-x\/d41586-019-01851-x_16813034.jpg\" alt=\"\" data-src=\"\/\/media.nature.com\/w800\/magazine-assets\/d41586-019-01851-x\/d41586-019-01851-x_16813034.jpg\" \/><\/div>\n<\/div><figcaption>\n<p class=\"figure__caption sans-serif\"><span class=\"mr10\"><b>Figure 1 | Studying drug metabolism by gut bacteria.<\/b>\u00a0<b>a<\/b>, To assess how commonly drugs are metabolized by bacteria in the human gut, Zimmermann\u00a0<i>et al.<\/i><sup><a href=\"https:\/\/www.nature.com\/articles\/d41586-019-01851-x?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+nature%2Frss%2Fcurrent+%28Nature+-+Issue%29#ref-CR1\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">1<\/a><\/sup>\u00a0tested the ability of 76 bacterial strains (representing 68 species across the main bacterial taxonomic groupings) to metabolize 271 drugs that have diverse structures and functions. This revealed that 65% of the drugs were metabolized \u2014 an unexpectedly high number. Some drugs were metabolized into more than one molecular form, and all the bacteria metabolized some of the drugs tested.\u00a0<b>b<\/b>, To identify some of the bacterial enzymes responsible for drug metabolism, the authors focused on the gut bacterium<i>Bacteroides thetaiotaomicron<\/i>, which metabolized numerous drugs. Zimmermann and colleagues isolated sections of the\u00a0<i>B. thetaiotaomicron<\/i>\u00a0genome and inserted them into pieces of circular DNA called plasmids. Plasmids were inserted into the bacterium<i>Escherichia coli<\/i>, which expressed the proteins, such as enzymes, encoded by the\u00a0<i>B. thetaiotaomicron<\/i>\u00a0DNA. When these\u00a0<i>E. coli<\/i>\u00a0bacteria were exposed to one of the drugs tested, diltiazem, some of the bacteria did not metabolize the drug, but those that did helped to identify the\u00a0<i>B. thetaiotaomicron<\/i>\u00a0enzymes responsible for its metabolism.<\/span><\/p>\n<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Zimmermann and colleagues analysed the products of the 176 metabolized drugs using mass spectrometry. This revealed that 868 molecules are derived from these drugs. The numbers indicate that more than one metabolite can be produced from the metabolism of some drugs by gut bacteria. The mass-spectrometry analysis revealed the types of drug modification that occurred, which covered a wide range of chemical alterations, including oxidation, reduction and acetylation (the addition of a C<sub>2<\/sub>H<sub>3<\/sub>O group). The implications of this unexpectedly high diversity of drug alterations will no doubt take researchers a while to address. In the meantime, Zimmermann\u00a0<i>et al<\/i>. report a few cases of drug metabolism that they examined in detail.<\/p>\n<p>To identify some bacterial enzymes responsible for drug metabolism, the authors chose to profile the gut bacterium\u00a0<i>Bacteroides thetaiotaomicron<\/i>. This species was a prolific drug metabolizer in their study, modifying 46 of the drugs tested. Zimmermann and colleagues studied how\u00a0<i>B. thetaiotaomicron<\/i>\u00a0metabolizes diltiazem, which is used to treat hypertension. The authors engineered\u00a0<i>Escherichia coli<\/i>\u00a0bacteria to express sequences from the genome of\u00a0<i>B. thetaiotaomicron<\/i>, and tested whether the engineered bacteria could metabolize diltiazem. They found that the\u00a0<i>B. thetaiotaomicron\u00a0<\/i>gene<i>\u00a0bt4096<\/i>\u00a0is required to metabolize the drug.<\/p>\n<p>To validate their finding, Zimmermann\u00a0<i>et al.<\/i>\u00a0engineered a strain of\u00a0<i>B. thetaiotaomicron\u00a0<\/i>that lacked\u00a0<i>bt4096<\/i>, gave germ-free mice either this strain or wild-type\u00a0<i>B. thetaiotaomicron,<\/i>\u00a0and then gave all the animals diltiazem. This confirmed that\u00a0<i>bt4096\u00a0<\/i>encodes an enzyme that metabolizes diltiazem. Taking a similar approach, the authors identified genes that are needed to metabolize 18 of the drugs that\u00a0<i>B. thetaiotaomicron<\/i>\u00a0can modify.<\/p>\n<p>This type of general strategy should enable the identification of the enzymes in gut bacteria that can metabolize any given clinically used drug or therapeutic molecule in development. Such information would also be useful when testing candidate therapeutics in clinical trials, to try to determine whether a person has gut bacteria that are particularly good at inactivating a particular drug.<\/p>\n<p>Zimmermann and colleagues\u2019 study offers a remarkable advance in our understanding of drug dynamics in the body, and will serve as a blueprint for other studies in the fledgling field that seeks to track the effect of microbes on drug metabolism. Yet despite the impressive scope and depth of this analysis, many questions remain, inviting an impatient reader to speculate in the meantime. One issue to consider is that, rather than being taken orally, many drugs are delivered by injection and thus would not be expected to encounter gut bacteria (although some drugs that are delivered by injection can reach the gut and re-emerge in the bloodstream). However, there is a general trend in drug delivery towards oral administration, and advanced methods to facilitate this are in development<sup><a href=\"https:\/\/www.nature.com\/articles\/d41586-019-01851-x?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+nature%2Frss%2Fcurrent+%28Nature+-+Issue%29#ref-CR6\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">6<\/a><\/sup><sup>,<\/sup><sup><a href=\"https:\/\/www.nature.com\/articles\/d41586-019-01851-x?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+nature%2Frss%2Fcurrent+%28Nature+-+Issue%29#ref-CR7\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">7<\/a><\/sup>. Over time, there might be a large-scale transition from the use of injected drugs for therapy to more widespread oral delivery. If so, the need to understand the microbiota\u2019s role in drug metabolism will become even more urgent.<\/p>\n<p>Drug metabolism by gut bacteria adds to the growing list of ways in which the microbiota can affect the human body. The considerable variation in the microbiota from individual to individual probably also results in variation in drug metabolism. In addition, diet can have a major effect on the composition of the microbiota<sup><a href=\"https:\/\/www.nature.com\/articles\/d41586-019-01851-x?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+nature%2Frss%2Fcurrent+%28Nature+-+Issue%29#ref-CR8\" data-track=\"click\" data-action=\"anchor-link\" data-track-label=\"go to reference\" data-track-category=\"references\">8<\/a><\/sup>. Does diet affect the efficiency of drugs by affecting the microbiota? Such issues highlight the complexity of considering a person\u2019s microbiota when trying to take a personalized-medicine approach. Adjusting the microbiota to suit our needs, including achieving individually tailored approaches to tackling drug metabolism, is probably where this field is heading.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<div class=\"emphasis\">doi: 10.1038\/d41586-019-01851-x<\/div>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>(\uc6d0\ubb38: <a href=\"https:\/\/www.nature.com\/articles\/d41586-019-01851-x?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+nature%2Frss%2Fcurrent+%28Nature+-+Issue%29\">\uc5ec\uae30<\/a>\ub97c \ud074\ub9ad\ud558\uc138\uc694~)<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; &nbsp; Tests of whether a range of gut bacteria can metabolize a diverse group of drugs has revealed that all the microbes metabolized some<a href=\"https:\/\/biochemistry.khu.ac.kr\/lab\/?p=3815\" class=\"more-link\">(more&#8230;)<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[33,34,29,30],"tags":[],"class_list":["post-3815","post","type-post","status-publish","format-standard","hentry","category-do-biology","category-lets-do-chemistry","category-lets-do-science","category-recent-science-news"],"aioseo_notices":[],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack-related-posts":[{"id":3781,"url":"https:\/\/biochemistry.khu.ac.kr\/lab\/?p=3781","url_meta":{"origin":3815,"position":0},"title":"Gut microbes metabolize Parkinson&#8217;s disease drug","author":"biochemistry","date":"June 17, 2019","format":false,"excerpt":"\u00a0 \u00a0 The trillions of microorganisms that form the gut microbiota contain a treasure trove of enzymes. These directly modify and metabolize dietary components, drugs, and toxins that humans ingest. Although this is often beneficial, the gut microbiota can modify drug bioavailability and efficacy (1,\u00a02). Levodopa (L-dopa), the major drug\u2026","rel":"","context":"In &quot;Let's Do Biology!&quot;","block_context":{"text":"Let's Do Biology!","link":"https:\/\/biochemistry.khu.ac.kr\/lab\/?cat=33"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":1158,"url":"https:\/\/biochemistry.khu.ac.kr\/lab\/?p=1158","url_meta":{"origin":3815,"position":1},"title":"Histidine metabolism boosts cancer therapy","author":"biochemistry","date":"July 18, 2018","format":false,"excerpt":"\u00a0 \u00a0 (\uc6d0\ubb38) \u00a0 \u00a0 Clinical use of the anticancer drug methotrexate can be limited by its high toxicity. It emerges that a diet rich in the amino acid histidine increases the effectiveness of methotrexate treatment and lowers toxicity in mice. \u00a0 \u00a0 \u00a0 Methotrexate was one of the first\u2026","rel":"","context":"In &quot;Let's Do Biology!&quot;","block_context":{"text":"Let's Do Biology!","link":"https:\/\/biochemistry.khu.ac.kr\/lab\/?cat=33"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":472,"url":"https:\/\/biochemistry.khu.ac.kr\/lab\/?p=472","url_meta":{"origin":3815,"position":2},"title":"How gut microbes are joining the fight against cancer","author":"biochemistry","date":"May 30, 2018","format":false,"excerpt":"\u00a0 \u00a0 (\uc6d0\ubb38) \u00a0 \u00a0 The intestinal microbiome seems to influence how well some cancer drugs work. But is the science ripe for clinical trials? \u00a0 \u00a0 \u00a0 Illustration by Ola Niepsuj Bertrand Routy earned a lamentable reputation with Parisian oncologists in 2015. A doctoral student at the nearby Gustave\u2026","rel":"","context":"In &quot;Let's Do Biology!&quot;","block_context":{"text":"Let's Do Biology!","link":"https:\/\/biochemistry.khu.ac.kr\/lab\/?cat=33"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":4197,"url":"https:\/\/biochemistry.khu.ac.kr\/lab\/?p=4197","url_meta":{"origin":3815,"position":3},"title":"DNA pushes back the microbiome frontier","author":"biochemistry","date":"October 6, 2019","format":false,"excerpt":"\u00a0 \u00a0 Over the past 15 years, researchers have come to appreciate how profoundly the diverse zoo of microbes in the human gut, skin, and mouth affects our health. But their identities and exactly how they exert their effects have remained mysterious. Now, two research groups have made this microbial\u2026","rel":"","context":"In &quot;Let's Do Biology!&quot;","block_context":{"text":"Let's Do Biology!","link":"https:\/\/biochemistry.khu.ac.kr\/lab\/?cat=33"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":935,"url":"https:\/\/biochemistry.khu.ac.kr\/lab\/?p=935","url_meta":{"origin":3815,"position":4},"title":"Genetically modified bacteria enlisted in fight against disease","author":"biochemistry","date":"June 22, 2018","format":false,"excerpt":"\u00a0 \u00a0 \uc774\uc81c \uc9c8\ubcd1 \uce58\ub8cc\ub97c \uc704\ud55c GMB (genetically modified bacteria)\uc778\uac00\uc694? \u00a0 \u00a0 (\uc6d0\ubb38) \u00a0 \u00a0 Engineered strains of\u00a0E. coli\u00a0and other microbes are being tested in people to combat a slew of illnesses. \u00a0 \u00a0 \u00a0 The\u00a0Escherichia coli\u00a0bacteria is being developed as a vehicle for gene therapy in people.Credit: Fernan Federici\u2026","rel":"","context":"In &quot;Let's Do Biology!&quot;","block_context":{"text":"Let's Do Biology!","link":"https:\/\/biochemistry.khu.ac.kr\/lab\/?cat=33"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":1438,"url":"https:\/\/biochemistry.khu.ac.kr\/lab\/?p=1438","url_meta":{"origin":3815,"position":5},"title":"Side effects of addiction treatment","author":"biochemistry","date":"August 24, 2018","format":false,"excerpt":"\u00a0 \u00a0 (\uc6d0\ubb38: \uc5ec\uae30\ub97c \ud074\ub9ad\ud558\uc138\uc694~) \u00a0 \u00a0 Science\u00a0\u00a024 Aug 2018: Vol. 361, Issue 6404, pp. 761 DOI: 10.1126\/science.aau6548 \u00a0 \u00a0 \u00a0 Antiaddiction drugs could help curtail the opioid epidemic, but they may pose risks of their own. \u00a0 \u00a0 \u00a0 Drug addiction is a major global health issue, and the\u2026","rel":"","context":"In &quot;Let's Do Biology!&quot;","block_context":{"text":"Let's Do Biology!","link":"https:\/\/biochemistry.khu.ac.kr\/lab\/?cat=33"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]}],"jetpack_sharing_enabled":false,"jetpack_shortlink":"https:\/\/wp.me\/p9Xo1j-Zx","_links":{"self":[{"href":"https:\/\/biochemistry.khu.ac.kr\/lab\/index.php?rest_route=\/wp\/v2\/posts\/3815","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/biochemistry.khu.ac.kr\/lab\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/biochemistry.khu.ac.kr\/lab\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/biochemistry.khu.ac.kr\/lab\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/biochemistry.khu.ac.kr\/lab\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3815"}],"version-history":[{"count":1,"href":"https:\/\/biochemistry.khu.ac.kr\/lab\/index.php?rest_route=\/wp\/v2\/posts\/3815\/revisions"}],"predecessor-version":[{"id":3816,"href":"https:\/\/biochemistry.khu.ac.kr\/lab\/index.php?rest_route=\/wp\/v2\/posts\/3815\/revisions\/3816"}],"wp:attachment":[{"href":"https:\/\/biochemistry.khu.ac.kr\/lab\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3815"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/biochemistry.khu.ac.kr\/lab\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3815"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/biochemistry.khu.ac.kr\/lab\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3815"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}