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Drug-microbiota interactions and treatment response: Relevance to rheumatoid arthritis

Ellie Sayers1,2, Alex MacGregor1, Simon R Carding1,2

  • 1Gut Health and Food Safety Programme, Quadram Institute Bioscience, Norwich, Norfolk, NR4 7UA, UK.

AIMS Microbiology
|July 12, 2019
PubMed

Insights

The gut microbiota significantly impacts drug effectiveness and toxicity. Understanding these interactions can personalize treatments for diseases like rheumatoid arthritis, improving patient outcomes.

Area of Science:

  • Microbiology
  • Pharmacology
  • Immunology

Background:

  • Growing knowledge links intestinal microbiota changes to disease pathogenesis.
  • Drug-microbiota interactions and their impact on treatment responses are less understood.
  • The gut microbiota possesses extensive metabolic capabilities, acting as a key site for drug modification.

Purpose of the Study:

  • To review known and emerging examples of drug-microbiota interactions influencing patient treatment responses.
  • To explore mechanisms by which the intestinal microbiota affects responses to methotrexate in rheumatoid arthritis.
  • To highlight the potential for personalized treatment strategies based on microbiota signatures.

Main Methods:

  • Literature review of drug-microbiota interactions.
  • Focus on specific diseases: inflammatory bowel disease, type 2 diabetes, cancer, and rheumatoid arthritis.
  • Proposed mechanisms for microbiota influence on methotrexate efficacy in rheumatoid arthritis.

Main Results:

  • Drug-microbiota interactions can directly alter drug bioavailability, efficacy, and toxicity via microbial enzymes.
  • Drugs can profoundly influence the microbiota, altering host-microbe interactions.
  • Individual microbiota variations contribute to significant differences in patient drug responses.

Conclusions:

  • Drug-microbiota interactions are crucial in determining treatment outcomes across various diseases.
  • Further research into these interactions, particularly for rheumatoid arthritis and methotrexate, is warranted.
  • Incorporating microbiota signatures into treatment strategies may predict and improve patient outcomes.
Keywords:
drug responseintestinal microbiotametabolismmethotrexate

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