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Age-mediated changes in the gastrointestinal tract.

Hamid A Merchant1, Fang Liu2, Mine Orlu Gul3

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Age-related changes in the gastrointestinal tract affect how children and older adults process drugs. Understanding these gut physiology differences is crucial for optimizing drug therapy in these populations.

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Area of Science:

  • Pharmacology
  • Gastroenterology
  • Gerontology

Background:

  • Physiological functions in children and older adults differ from young adults, impacting drug pharmacokinetics.
  • The gastrointestinal tract is vital for oral drug dissolution, absorption, and metabolism.
  • Age-mediated alterations in gut physiology can significantly change drug pharmacokinetics.

Purpose of the Study:

  • To review and synthesize current knowledge on age-related changes in gut physiology.
  • To identify knowledge gaps in the developing and aging gut's function concerning drug therapy.
  • To provide a foundation for optimizing drug therapy in pediatric and geriatric populations.

Main Methods:

  • Literature review focusing on age-related changes in gut physiology (luminal fluid, microbiota, transit, motility, mucosa).
  • Comparison of gut physiology in children and older adults to that of healthy young adults.
  • Analysis of existing evidence on how these changes affect drug pharmacokinetics.

Main Results:

  • Significant developmental changes in certain gastrointestinal aspects were observed in children and older adults.
  • The study identified substantial gaps in understanding the developing and aging gut's physiology and function.
  • Age-specific alterations in the gut environment can reshape drug pharmacokinetics.

Conclusions:

  • Current understanding of age-related gut physiology and its impact on drug pharmacokinetics is limited.
  • Further research is needed to fully characterize the human gastrointestinal tract across the lifespan.
  • Improved characterization will enable optimized drug therapy for children and older adults.