Interesting articlses on bug-drug interactions, mo

Interesting articlses on bug-drug interactions, mostly talking about small molecule pill interaction with gut bacteria, which apparently can cause some serious side effects in some cases, reduced efficacy, etc. But it also has some interesting talk about hiv drugs.

https://cen.acs.org/biological-chemistry/micr...pop/97/i34

Quote:

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“She said the side effects were a nightmare,” Redinbo says, describing how a large number of people on the drug, marketed as Camptosar, suffer from diarrhea and nausea. “Some days she could not get out of bed and certainly could not leave the house.”
Their conversation stayed with him. Why were irinotecan’s side effects so debilitating? Could they be prevented? The answers, Redinbo would find out, were hidden in the bacteria in our intestines.
As they study microbiome-drug interactions, researchers are learning not only that intestinal microbes dine on a great many of the small-molecule drugs that we take—those like irinotecan—but also that what the microbes are doing to those drugs may affect whether they work and whether they are safe. Yet with rare exceptions, we still know little about how these bugs slice and dice our medications and what happens to the fragments they leave behind. The reactions happening within our guts could reshape the way drugmakers create and test medicinal compounds.
“I’ve talked to a couple of companies about what I can do to help them test stuff, and then I don’t hear from them again,” says Nichole Klatt, a researcher at the University of Miami who has found that vaginal microbes deactivate HIV drugs. “So, do they care? I don’t know. Should they care? I think definitely yes because I think this has a much bigger impact on human health than people ever could have imagined.”

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Klatt, the HIV researcher at the University of Miami, has found that some HIV drugs are metabolized by vaginal microbes. One in particular is dapivirine, a therapeutic released from vaginal rings that is nearing Phase III tests as an HIV preventive for teens and young women in parts of Africa, including South Africa. Klatt says earlier trials found the ring reduced the risk of HIV infection by only about 30%, and she believes the groups running the trials should consider whether dapivirine is the right drug to use in a vaginal ring.


“These are the girls that are at the highest risk of HIV infection, and I think it’s downright unethical because the people running this trial know this,” Klatt says, explaining that the low efficacy means that women in the trial who might otherwise be on more effective preventives could get infected


https://cen.acs.org/biological-chemistry/micr...eb/2019/06

In a study that one microbiome researcher calls “one of the most important papers that has come out in the entire microbiome field,” a team of scientists has cataloged how dominant species of microbes living in our guts metabolize some two-thirds of common drugs that treat a wide assortment of human diseases. The findings suggest that how well an oral drug works may not just be a function of how well our bodies absorb it, but what our intestinal microbes do to it