Understanding and role of gut microbiota on drug response and toxicity

Abstract

The gut microbiota affects human health profoundly, and evidence is mounting that it can cause, worsen, or resolve illnesses. Particularly in drug-induced toxicity, its role in diverse toxicological reactions has garnered attention recently. Drugs may interact directly or indirectly, through the gut flora, whether or not they are taken orally, changing the toxicity. Current research focuses mainly on the one-way effect of xenobiotics on the makeup and activities of gut microbes, which leads to altered homeostasis. However, there are two-way interactions between the gut microbiota and xenobiotics, and it is important to consider how the gut microbiota affects xenobiotics, particularly medications. Therefore, we emphasise the microbiome, microbial metabolites, and microbial enzymes in this review to emphasise how the gut microbiota affects medication toxicity. To aid in the identification of micro-biologic targets and processes linked to drug toxicity, we establish connections between medications, the microbiome, microbial enzymes or metabolites, drug metabolites, and host toxicological reactions. In addition, a summary and discussion of contemporary mainstream approaches to control medication toxicity by microbiota targeting are provided.