Bugs and Drugs—the Gut Microbiome as Hidden Metabolic Organ and Its Role in Personalized Pharmacotherapeutics

Dear Colleagues,

Pharmacomicrobiomics is a new, dynamically developing field of medicine. The microbiome enzyme apparatus contributing to the intestinal ecosystem is—at least—partially responsible for the metabolism of xenobiotics, including drugs and dietary supplements. This activity may lead to several enzymatic reactions potentially responsible for a given therapeutic effect or lack of drug efficacy. The metabolites of the intestinal microbiota may compete with drugs for enzymes or receptors involved in therapeutic pathways of common medicines.

Recently, consumption of commonly used drugs designed to target human cells and prescribed by psychiatrists, gastroenterologists, diabetologists, and other medical professionals has been shown to possess a high potential to alter the composition and function of intestinal microbes. Additionally, gut microbiota shape the response of anticancer therapies and serve as a target to enhance their efficacy and minimize drug toxicity. As gut microbes also shape the structure and function of the gut barrier, it is plausible that even minor and subclinical drug–microbe-mediated injury to intestinal mucosa can result in significant, tough delayed, metabolic consequences, which may seriously affect the health of an individual. Therapies aimed at microbiota modulation—e.g., probiotics, prebiotics, fecal microbiota transplantation or non-absorbable antibiotics (rifaximin)—serve as effective tools to support the gut microbiome and optimize the use of various pharmaceuticals. Further, expanding the basic and clinical knowledge on drug–microbiome interaction to predict either beneficial or harmful outcomes is important and of interest to most contemporary healthcare professionals. 

With this Special Issue in the Journal of Clinical Medicine, entitled “Bugs and Drugs - The Gut Microbiome as a Hidden Metabolic Organ and Its Role in Personalized Pharmacotherapeutics”, we focus on studies exploring the amazing interactions between gut microbes and the variety of medicine and dietary supplements commonly used in everyday clinical practice. We invite authors to share the results of their research. We welcome original and review papers on topics related to pharmacotherapy or any other therapeutic modalities with the potential to influence and interact with gut microbiota. Last but not least, therapies aimed at improving the metabolic status of an individual through microbiota modulation are welcome.

Dr. Anastasios Koulaouzidis
Dr. Wojciech Marlicz
Dr. Karolina Skonieczna-Żydecka
Guest Editors

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