The tiny pharmacists within: How the microbiome impacts the treatment of human disease

Abstract

Although the importance of human genetic polymorphisms and drug‐drug interactions in precision medicine is increasingly understood, the role of specific genotypic variants and products elaborated by our “second genome” (the microbiome) has been largely overlooked. In this presentation I will describe a microbiome‐centric approach to pharmacology, working to elucidate the direct and indirect mechanisms through which the human microbiome shapes the efficacy and toxicity of small molecule and biologic therapies. For example, recent research in my laboratory has revealed a complex interplay between human drug transporters in the intestine and commonly used excipients prevalent in foods and many drug products. This interplay is mediated by gut microbes which metabolize excipients leading to unexpected effects on drug absorption. We are also working on the metabolism of drugs used to treat heart disease, cancer, rheumatoid arthritis, and Parkinson’s Disease by human gut bacteria. Collectively, attendees will learn about exciting new research at the interface between pharmacology and the human microbiome.