8 ms·

Gut microbes are vulnerable to wide range of drugs

161 points by mclide 8y ago

adrianN 8y ago
It's unclear to me how to interpret the result. It makes sense to test the influence of drugs on gut microbes, but to put the effect into context I'd be interested in the effect of, for example, normal food. How many species of gut microbes are affected by apples or coffee or whole grain bread? I also imagine that eating fermented foods causes a slaughter in your gut as the different microbes battle for dominance.
- CaliforniaKarl 8y ago
  > to put the effect into context I'd be interested in the effect of, for example, normal food. I bet that it's also gonna depend alot on the person, and their history. This has always stuck with me: > After he was fired for incompetence, he took it on himself to sue the restaurant, claiming that his gastrointestinal problem, caused apparently by amoebas, was a result of his work there. Management took this litigation seriously enough to engage the services of an epidemiologist, who obtained stool samples from every employee. The results-which I was privy to-were enlightening to say the least. The waiter's strain of amoebas, it was concluded, was common to persons of his lifestyle, and to many others. What was interesting were the results of our Mexican and South American prep cooks. These guys were teeming wWh numerous varieties of critters, none of which, in their cases, caused illness or discomfort. It was explained that the results in our restaurant were no different from results at any other restaurant and that, particularly amongst my recently arrived Latino brethren, this sort of thing is normal-that their systems are used to it, and it causes them no difficulties at all. Bourdain, Anthony. KITCHEN CONFIDENTIAL: Adventures in the Culinary Underbeily. Bloomsbury Publishing, 2014. https://archive.org/stream/Anthony_Bourdain_Kitchen_Confidential/Anthony_Bourdain_Kitchen_Confidential_djvu.txt https://archive.org/stream/Anthony_Bourdain_Kitchen_Confiden... People sure are different!
  - mathattack 8y ago
    How could they force everyone to take that test without it being an invasion of privacy? I’ve seen the symptom first hand in SE Asia. Things that got me sick wouldn’t phase the locals who were used to it.
    - bfuller 8y ago
      They can't force you, but if you tell someone their coworker has an amoeba they will want to know if they have it too
- vixen99 8y ago
  Yes, a battle too horrible to contemplate! Imagine the slaughter consequent on ingesting coffee,chocolate,tea,sourdough bread,cheese,buttermilk,crème fraîche,yogurt,kefir,salami,wine,beer,sauerkraut,dill pickles,kimchi,kombucha,fish sauce,vinegar,miso or tempeh.
  - passiveincomelg 8y ago
    Great. Now I'm hungry.
  - bfuller 8y ago
    you just listed my regular cravings
  - jwilk 8y ago
    I think your space key is broken.
- Arn_Thor 8y ago
  Yes and no? I'm sure it's a fierce fight, but AFAIK a diet of fermented foods is considered healthy, and good for digestion. So presumably a diet of fermented foods can result in some beneficial equilibrium
  - adrianN 8y ago
    My point is that it's unclear whether the effect the medication has on the gut microbiome is harmful, beneficial or neutral.
    - HillaryBriss 8y ago
      I don't know the answer but I wonder the same thing. One intriguing view of it is: "... most popular pharmaceuticals, NSAIDs, statins, anti-depressants, anti-diabetics, etc., also have substantial antibiotic activity. Most of these pharmaceuticals started out as phytoalexins and then were found to also have pharmaceutical activity. Pharmaceuticals are just repurposed natural antibiotics. When you take an aspirin or Metformin or a statin, you are taking an antibiotic. When you take a pharmaceutical, you are selecting for multiple antibiotic resistance plasmids in your gut flora and you may be making the next superbug." From http://coolinginflammation.blogspot.com/2014/06/antibiotic-resistance-superbugs-and.html http://coolinginflammation.blogspot.com/2014/06/antibiotic-r...
- HillaryBriss 8y ago
  "All organisms, plants, fungi and animals/humans produce chemicals that kill bacteria, i.e. antibiotics. ... The flavoring chemicals in herbs and spices have a far more important use in food preparation than titillation of taste buds, since those chemicals kill common food pathogens. More profoundly, it is important to realize that the selective advantage of phytochemicals/polyphenols/alkaloids/essential oils to the plants that make them, is as natural antibiotics. Plants kill bacteria, as well as fungi and insects, for a living." From http://coolinginflammation.blogspot.com/2014/06/antibiotic-resistance-superbugs-and.html http://coolinginflammation.blogspot.com/2014/06/antibiotic-r...
Semirhage 8y ago
What I want to know is what to do about it by way of probiotic therapy or buffering agents and such. Efficacy of probiotics in practice seems mixed, so what exactly is the takeaway here for the practically minded person who sometimes takes anti-inflammatory medications?
- bkovacev 8y ago
  Why would you limit yourself only to probiotics when prebiotics/symbiotics exist? I recently learned about them - bear with me as I have zero experience and lack of terminology in pharma - prebiotics will create a better environment/surface for probiotics to feed on and symbiotics are both pre and pro in a single pill.
  - Lasso2 8y ago
    It isn't really clear that synbitoics work yet, the evidence for metabolic outcomes at least is sparse as of now http://www.mdpi.com/2073-4425/9/3/167/htm http://www.mdpi.com/2073-4425/9/3/167/htm (see figure 6)
- Lasso2 8y ago
  I work in the microbiome field, and colleagues and i discussed this paper a few days ago. The overall impression seems to be that this is not for the practically-minded but primarily science for scientists. A lot of microbiome studies have suffered from inadequate exclusion critera because of the lack of this systematic knowledge.
  - amelius 8y ago
    How long until we have a better delivery method for "good" species, and will that solve all microbiome related problems?
    - Lasso2 8y ago
      There is a lot of work done right now on formulation of defined faeces microbe sets, partly because most people expect that ultimately these treatments will have to be approved by the authorities. This is probably a good idea, as the microbiome consists of both bacteria, virus and eukaryote organisms, and the survey people use for 95% of all microbiome work can only capture the bacterial fraction, so a faeces transplant that look good from the bacterial perspective could potentially include nasty virus or parasites. How long this work will take is difficult to say, but years at the very least. The second part is that right now it is somewhat unclear what is actually microbiome related problems. Clearly, associations to all kinds of diseases and conditions have been made, but the casuality and dynamics of the interaction with the immune system and host factors is not well-defined for now. It seems obvious that diseases in which we can intervene with a fecal transplant and improve an outcome are microbiome-related, but there isn't actually that many solid cases for this. C.diff infection is well-established. A recent RCT looks really promising for insulin resistance (i saw the senior author talk about it at a conference and i was certainly convinced), but naggingly insulin resistance wasn't actually the registrered primary outcome of the trial http://www.stephanguyenet.com/microbiota-and-obesity-is-it-all-hype/ http://www.stephanguyenet.com/microbiota-and-obesity-is-it-a...
xr4ti 8y ago
The converse is also true -- a wide range of drugs are subject to metabolism by gut microbes. This can throw off plasma concentrations and reduce effectiveness, or cause unwanted side effects or unexpected toxicity in the worst cases.
collyw 8y ago
Completely anecdotal, but after two and a half weeks of antibiotics (for an infection in my leg) I felt crap.
- Madmallard 8y ago
  If you took any of the quinolones you may have gotten floxed. The drugs are very dangerous and should only used as last resorts, according to the FDA. Mechanisms of toxicity are multiple but the common theories are iron/magnesium chelation and mitochondrial toxicity. Both of which can lead to long term severe and potentially life threatening side effects.
IndrekR 8y ago
The published article itself (paywall): https://www.nature.com/articles/nature25979 https://www.nature.com/articles/nature25979 And EMBL announcement with short video: https://news.embl.de/science/commonly-used-drugs-affect-gut-bacteria/ https://news.embl.de/science/commonly-used-drugs-affect-gut-...
220V_USKettle 8y ago
I have often wondered about the affects of pesticides on foods made with cord by-products, like syrup, etc.

161 points by mclide 8y ago

It's unclear to me how to interpret the result. It makes sense to test the influence of drugs on gut microbes, but to put the effect into context I'd be interested in the effect of, for example, normal food. How many species of gut microbes are affected by apples or coffee or whole grain bread? I also imagine that eating fermented foods causes a slaughter in your gut as the different microbes battle for dominance.

CaliforniaKarl 8y ago
> to put the effect into context I'd be interested in the effect of, for example, normal food. I bet that it's also gonna depend alot on the person, and their history. This has always stuck with me: > After he was fired for incompetence, he took it on himself to sue the restaurant, claiming that his gastrointestinal problem, caused apparently by amoebas, was a result of his work there. Management took this litigation seriously enough to engage the services of an epidemiologist, who obtained stool samples from every employee. The results-which I was privy to-were enlightening to say the least. The waiter's strain of amoebas, it was concluded, was common to persons of his lifestyle, and to many others. What was interesting were the results of our Mexican and South American prep cooks. These guys were teeming wWh numerous varieties of critters, none of which, in their cases, caused illness or discomfort. It was explained that the results in our restaurant were no different from results at any other restaurant and that, particularly amongst my recently arrived Latino brethren, this sort of thing is normal-that their systems are used to it, and it causes them no difficulties at all. Bourdain, Anthony. KITCHEN CONFIDENTIAL: Adventures in the Culinary Underbeily. Bloomsbury Publishing, 2014. https://archive.org/stream/Anthony_Bourdain_Kitchen_Confidential/Anthony_Bourdain_Kitchen_Confidential_djvu.txt https://archive.org/stream/Anthony_Bourdain_Kitchen_Confiden... People sure are different!
- mathattack 8y ago
  How could they force everyone to take that test without it being an invasion of privacy? I’ve seen the symptom first hand in SE Asia. Things that got me sick wouldn’t phase the locals who were used to it.
  - bfuller 8y ago
    They can't force you, but if you tell someone their coworker has an amoeba they will want to know if they have it too
vixen99 8y ago
Yes, a battle too horrible to contemplate! Imagine the slaughter consequent on ingesting coffee,chocolate,tea,sourdough bread,cheese,buttermilk,crème fraîche,yogurt,kefir,salami,wine,beer,sauerkraut,dill pickles,kimchi,kombucha,fish sauce,vinegar,miso or tempeh.
- passiveincomelg 8y ago
  Great. Now I'm hungry.
- bfuller 8y ago
  you just listed my regular cravings
- jwilk 8y ago
  I think your space key is broken.
Arn_Thor 8y ago
Yes and no? I'm sure it's a fierce fight, but AFAIK a diet of fermented foods is considered healthy, and good for digestion. So presumably a diet of fermented foods can result in some beneficial equilibrium
- adrianN 8y ago
  My point is that it's unclear whether the effect the medication has on the gut microbiome is harmful, beneficial or neutral.
  - HillaryBriss 8y ago
    I don't know the answer but I wonder the same thing. One intriguing view of it is: "... most popular pharmaceuticals, NSAIDs, statins, anti-depressants, anti-diabetics, etc., also have substantial antibiotic activity. Most of these pharmaceuticals started out as phytoalexins and then were found to also have pharmaceutical activity. Pharmaceuticals are just repurposed natural antibiotics. When you take an aspirin or Metformin or a statin, you are taking an antibiotic. When you take a pharmaceutical, you are selecting for multiple antibiotic resistance plasmids in your gut flora and you may be making the next superbug." From http://coolinginflammation.blogspot.com/2014/06/antibiotic-resistance-superbugs-and.html http://coolinginflammation.blogspot.com/2014/06/antibiotic-r...
HillaryBriss 8y ago
"All organisms, plants, fungi and animals/humans produce chemicals that kill bacteria, i.e. antibiotics. ... The flavoring chemicals in herbs and spices have a far more important use in food preparation than titillation of taste buds, since those chemicals kill common food pathogens. More profoundly, it is important to realize that the selective advantage of phytochemicals/polyphenols/alkaloids/essential oils to the plants that make them, is as natural antibiotics. Plants kill bacteria, as well as fungi and insects, for a living." From http://coolinginflammation.blogspot.com/2014/06/antibiotic-resistance-superbugs-and.html http://coolinginflammation.blogspot.com/2014/06/antibiotic-r...

Semirhage 8y ago

What I want to know is what to do about it by way of probiotic therapy or buffering agents and such. Efficacy of probiotics in practice seems mixed, so what exactly is the takeaway here for the practically minded person who sometimes takes anti-inflammatory medications?

bkovacev 8y ago
Why would you limit yourself only to probiotics when prebiotics/symbiotics exist? I recently learned about them - bear with me as I have zero experience and lack of terminology in pharma - prebiotics will create a better environment/surface for probiotics to feed on and symbiotics are both pre and pro in a single pill.
- Lasso2 8y ago
  It isn't really clear that synbitoics work yet, the evidence for metabolic outcomes at least is sparse as of now http://www.mdpi.com/2073-4425/9/3/167/htm http://www.mdpi.com/2073-4425/9/3/167/htm (see figure 6)
Lasso2 8y ago
I work in the microbiome field, and colleagues and i discussed this paper a few days ago. The overall impression seems to be that this is not for the practically-minded but primarily science for scientists. A lot of microbiome studies have suffered from inadequate exclusion critera because of the lack of this systematic knowledge.
- amelius 8y ago
  How long until we have a better delivery method for "good" species, and will that solve all microbiome related problems?
  - Lasso2 8y ago
    There is a lot of work done right now on formulation of defined faeces microbe sets, partly because most people expect that ultimately these treatments will have to be approved by the authorities. This is probably a good idea, as the microbiome consists of both bacteria, virus and eukaryote organisms, and the survey people use for 95% of all microbiome work can only capture the bacterial fraction, so a faeces transplant that look good from the bacterial perspective could potentially include nasty virus or parasites. How long this work will take is difficult to say, but years at the very least. The second part is that right now it is somewhat unclear what is actually microbiome related problems. Clearly, associations to all kinds of diseases and conditions have been made, but the casuality and dynamics of the interaction with the immune system and host factors is not well-defined for now. It seems obvious that diseases in which we can intervene with a fecal transplant and improve an outcome are microbiome-related, but there isn't actually that many solid cases for this. C.diff infection is well-established. A recent RCT looks really promising for insulin resistance (i saw the senior author talk about it at a conference and i was certainly convinced), but naggingly insulin resistance wasn't actually the registrered primary outcome of the trial http://www.stephanguyenet.com/microbiota-and-obesity-is-it-all-hype/ http://www.stephanguyenet.com/microbiota-and-obesity-is-it-a...

xr4ti 8y ago

The converse is also true -- a wide range of drugs are subject to metabolism by gut microbes. This can throw off plasma concentrations and reduce effectiveness, or cause unwanted side effects or unexpected toxicity in the worst cases.

collyw 8y ago

Completely anecdotal, but after two and a half weeks of antibiotics (for an infection in my leg) I felt crap.

Madmallard 8y ago
If you took any of the quinolones you may have gotten floxed. The drugs are very dangerous and should only used as last resorts, according to the FDA. Mechanisms of toxicity are multiple but the common theories are iron/magnesium chelation and mitochondrial toxicity. Both of which can lead to long term severe and potentially life threatening side effects.

IndrekR 8y ago

The published article itself (paywall): https://www.nature.com/articles/nature25979 https://www.nature.com/articles/nature25979 And EMBL announcement with short video: https://news.embl.de/science/commonly-used-drugs-affect-gut-bacteria/ https://news.embl.de/science/commonly-used-drugs-affect-gut-...

220V_USKettle 8y ago

I have often wondered about the affects of pesticides on foods made with cord by-products, like syrup, etc.