Impact of medications on microbiota graver than perceived earlier

Summary: Gut microbiota plays a vital role in human health. Changes in microbiota are associated with an increased risk of non-communicable diseases. Although the disruptive effect of antibiotics on gut microbiota is well-known, the impact of other medications on gut microbiota is poorly understood. A new study shows that even cardiometabolic medications may adversely impact gut microbiota. Nevertheless, it appears that some drugs like aspirin may have a positive impact on gut microbiota. Researchers think that understanding the effect of medications on gut microbiota may help in better drug selection for patients living with certain health conditions.

 Science confirms that “no man is an island,” not only are humans dependent on each other, but it also appears that they are even more dependent on unicellular organisms for their existence. It seems that trillions of microbes residing in the human body are essential for existence.

It is estimated that the total weight of adult human microbiota is in excess of few kilograms, and it compromises 10 to 100 trillion microbes1.

However, understanding the role of these trillions of residents of the human body is quite complex. Experts have only developed some limited knowledge of their role in health and wellbeing. Nevertheless, after discovering the essential role of microbiota in human health, researchers are even questioning how we describe humans or even species?

In recent years there has been considerable change in the disease pattern. Though infectious diseases still remain a significant threat, more people are now likely to develop chronic non-infectious ailments. Researchers are stunned by the sudden and brisk rise of dementia, mood disorders, autoimmune disorders, allergies, food intolerances, intestinal disorders, and so on.

The rise of these disorders indeed has something to do with changing lifestyle choices and environmental factors. Now, researchers are questioning if a higher incidence of specific diseases has some relationship to worsening microbiota or dysbiosis2.

Understanding the negative impact of antibiotics on gut microbiota is relatively straightforward. Researchers know that multiple courses of antibiotics may considerably disrupt gut microbiota, thus increasing the risk of numerous health disorders.

However, what about the influence of other medications that people take to manage various other health disorders like diabetes, hypertension, etc. Moreover, many people need to take these medications daily.

Now researchers think their studies indicate that perhaps the impact of medications might be graver than supposed earlier. 

This latest research was done by more than 20 leading European institutes, analyzing the impact of various drugs and drug combinations on gut health. Apart from antibiotics, the study focused on the effects of medications used to manage cardiometabolic disorders3.

They analyzed the impact of 28 commonly prescribed drugs on gut health and microbiota. They found that apart from antibiotics, many other drugs also negatively impact the composition of gut microbiota. Interestingly, they also found that some medicines may instead have a positive impact, like aspirin.

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They also found that the effect of medications accumulates. Thus, those who had multiple courses of antibiotics for five years became less healthy. The study intended to demonstrate that worsening of microbiota due to the use of multiple medications could be one of the contributing factors to the rise of various ailments.

For the study, researchers analyzed the data of 2000 patients living with cardiometabolic disorders.

Researchers said that although it is known that worsening of microbiota is associated with poor health outcomes. However, what is poorly understood is how various medications used to treat chronic disorders affect the microbiota and thus contributing to poor health.

By using complex analytics, researchers were able to identify the role of various drugs in the worsening of microbiota and health outcomes. In addition, these complex analytics helped them exclude the impact of other confounding factors.

Additionally, their study showed medications could also alter specific biomarkers and thus mask the risk of certain diseases. 

Although these are quite early findings, researchers think this would help them better choose medications for different patients by considering the impact of medicines on various lesser-known biomarkers.

References

1. Ursell LK, Metcalf JL, Parfrey LW, Knight R. Defining the Human Microbiome. Nutr Rev. 2012;70(Suppl 1):S38-S44. doi:10.1111/j.1753-4887.2012.00493.x
2. Carding S, Verbeke K, Vipond DT, Corfe BM, Owen LJ. Dysbiosis of the gut microbiota in disease. Microb Ecol Health Dis. 2015;26:10.3402/mehd.v26.26191. doi:10.3402/mehd.v26.26191
3. Forslund SK, Chakaroun R, Zimmermann-Kogadeeva M, et al. Combinatorial, additive and dose-dependent drug–microbiome associations. Nature. 2021;600(7889):500-505. doi:10.1038/s41586-021-04177-9