Gut Pharmacomicrobiomics: The Tip of an Iceberg of Complex Interactions between Drugs and Gut-Associated Microbes
The gut microbiota is the most predominant and most diverse microbial community residing in the human body . It comprises hundreds of microbial species, together constituting about 10 times the number of body cells [2,3], and contributes substantially to human metabolic processes to the extent that up to 36 % of small molecules in human blood are contributed by the gut microbiome . The gut microbiota’s impact on drug response and metabolism has been explored since the mid 20th century (reviewed in ); however, past studies have mostly focused on assessing the metabolic activity of gut microbial communities on antibiotics and botanicals [6-9]. Meanwhile, the influence of the host genetic makeup on drug response occupied the center stage of personalized medicine research, specifically in the clinical domain, leading to the rise of pharmacogenomic
approaches to personalized therapy, while a pivotal player in xenobiotic metabolism, the microbiota, was mostly being overlooked [10,11].