Did you know, as a patient, you present more organisms to your doctor for treatment than there are humans on earth? It’s okay if you didn’t, even Alexander Fleming probably didn’t realize when he discovered penicillin that the effects of this xenobiotic (foreign chemical substance found within an organism that is not naturally produced by or expected to be present within) depended on trillions (over ten trillion to be exact) of bacteria’s metabolic pathways. These bacteria account for the microbial world known as the gut microbiome, and their effects on xenobiotics can have beneficial, or sometimes deadly, effects.
For decades, therapeutic drug development focused on chemical composition tailored specifically to the human body’s metabolism. However, in a study discussed in Science, the gut microbiome actually provides a larger collective metabolic repertoire than human cells. From lifetime of drugs to the biological effects, the pharmacokinetic and pharmacodynamic properties of xenobiotics is very much at the whim of the gut microbiota. This, as you can imagine, throws a wrench in the works of therapeutic medicine. Much like running a country, a doctor now not only has to consider the whole of the patient, but also the sum of its parts (aka 10 trillion bacterial citizens).
Thus, it has become clear that medicine will have to become more personalized than ever before. Understanding individual gut microbial composition is becoming a large cornerstone in linking xenobiotic exposure to health outcomes. As explained in “Chemical transformation of xenobiotics by the human gut microbiota”, the association between ingestion of ingestion of xenobiotics processed by gut microbes and health status exists, however there is limited clinical information in regards to patient population. In addition, another struggle present is the amount of strain-level variation within the gut (which I may add that CosmosID is capable of identifying) has limited the assessment of the gut microbiota composition.
Nevertheless, it is quite clear how important it is to understand each individual patient’s gut microbiota composition and the implications it has on therapeutic treatment. By unlocking the gut microbiome, we unlock more efficient, personalized medicine.