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Experimental and Clinical Gastroenterology

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Medicinal-microbial interactions and ways of correcting iatrogenic intestinal dysbiosis

https://doi.org/10.31146/1682-8658-ecg-207-11-26-35

Abstract

The review presents up-to-date information on the pathogenesis of disorders of the intestinal microbiotope and the relationship of these disorders with the use of medications traditionally prescribed in treatment regimens for various diseases, presents the main aspects of drug-microbial interactions, highlights the issues of correction of iatrogenic intestinal dysbiosis. One of the main exogenous factors in the development of intestinal dysbiosis at the present time, of course, can be considered drug therapy. The extremely widespread and often uncontrolled use of antibacterial drugs, nonsteroidal anti-inflammatory drugs, laxatives, drugs for the correction of carbohydrate metabolism, proton pump inhibitors, glucocorticosteroids, antidepressants, cytostatic drugs to a greater or lesser extent has a negative effect on the human microbiotope. On the one hand, the microbiota is a drug target, on the other hand, the gut microbiota itself can have both direct and indirect effects on the metabolism of drugs. The potential of the influence of microorganisms on the absorption, distribution, and metabolism of drugs deserves increased attention and detailed study. At the same time, the issues of prevention and correction of intestinal microbiota disorders against the background of taking various medications deserve even more attention from doctors of various profiles with the mandatory inclusion of drugs that harmonize the intestinal microbiotope in the treatment regimens of the underlying disease.

About the Authors

I. G. Bakulin
North-West State Medical University named after I. I. Mechnikov
Russian Federation


M. Yu. Serkova
North-West State Medical University named after I. I. Mechnikov
Russian Federation


References

1. Loranskaya I.D., Lavrent’eva O.A. [Functional analysis of microbiocenosis of the gastrointestinal tract]. R M J. 2011;14:2-5. (in Russ.)@@ Лоранская И. Д., Лаврентьева О. А. Функциональный анализ микробиоценоза желудочно-кишечного тракта. РМЖ. 2011;14:2-5.

2. Serkova M. Yu., Pavlova E. Yu., Oganezova I. A. Functional dyspepsia and intestinal microbiota: is relationship possible? Farmateka. 2018;13:23-29. (in Russ.) doi: 10.18565/pharmateca.2018.13.23-29.@@ Серкова М. Ю., Павлова Е. Ю., Оганезова И. А. Функциональная диспепсия и кишечная микробиота: возможна ли взаимосвязь? Фарматека. 2018;13:23-29. doi: 10.18565/pharmateca.2018.13.23-29.

3. Sitkin S.I., Tkachenko E. I., Vakhitov T. Ya. Metabolic intestinal dysbiosis and its biomarkers. Experimental and clinical gastroenterology. 2015;124(12):6-29. (in Russ.)@@ Ситкин С. И., Ткаченко Е. И., Вахитов Т. Я. Метаболический дисбиоз кишечника и его биомаркеры. Экспериментальная и клиническая гастроэнтерология. 2015;124(12):6-29.

4. Rozenberg G. S. Information index and diversity: boltzmann, kotelnikov, shannon, weaver… Samarskaya Luka: problems of regional and global ecology. 2010; 19(2):4-25. (in Russ.)@@ Розенберг Г. С. Информационный индекс и разнообразие: Больцман, Котельников, Шеннон, Уивер… Самарская Лука: проблемы региональной и глобальной экологии. 2010; 19(2): 4-25.

5. Nikolaev Yu.N., Plakunov V. K. Biofilm is a «city of microbes» or an analogue of a multicellular organism. Microbiology. 2007;2:149-163. (in Russ.)@@ Николаев Ю. Н., Плакунов В. К. Биопленка - «город микробов» или аналог многоклеточного организма. Микробиология. 2007;(2):149-163.

6. Ardatskaya, M. D. Syndrome of excessive bacterial growth and violation of the processes of digestion and absorption. Polyclinic. 2009;(2):38-40. (in Russ.)@@ Ардатская, М. Д. Синдром избыточного бактериального роста и нарушение процессов пищеварения и всасывания. Поликлиника. 2009;2;38-40.

7. Wilson I.D., Nicholson J. K. Gut microbiome interactions with drug metabolism, efficacy, and toxicity. Translational Research. 2017 Jan;179:204-222. doi: 10.1016/j.trsl.2016.08.002.

8. Maev I.V., Bordin D. S., Bakulin I. G., et al. Clinical practice of managing patients with Helicobacter pylori-associated diseases in Moscow and St. Petersburg. Farmateka. 2021; 28(2):64-73. (in Russ.)@@ Маев И. В., Бордин Д. С., Бакулин И. Г., Бакулина Н. В., Скворцова Т. Э., Серкова М. Ю., и др. Клиническая практика ведения пациентов с Helicobacter pylori-ассоциированными заболеваниями в Москве и Санкт-Петербурге. Фарматека. 2021; Т. 28;2;64-73.

9. Bakulina N.V., Ilchishina T. A., Bakulin I. G. et al. Probiotics in Helicobacter pylori eradication regimens: current data and results of our own research. Consilium Medicum. 2019; 21 (8): 58-64. (in Russ.) doi: 10.26442/20751753.2019.8.190584.@@ Бакулина Н. В., Ильчишина Т. А., Бакулин И. Г. и др. Пробиотики в схемах эрадикации Helicobacter pylori: современные данные и результаты собственного исследования. Consilium Medicum. 2019; 21 (8): 58-64. doi: 10.26442/20751753.2019.8.190584.

10. Chernin V.V., Chervinets V. M. [Probiotics, antibacterial and antifungal drugs as the basis of therapeutic and rehabilitation measures to eliminate dysbacteriosis of the gastroduodenal zone in peptic ulcer and chronic gastritis]. Materials of the scientific program of the II International Congress “Restorative Medicine and Rehabilitation”, Moscow, September 20-21, 2005. (in Russ.)@@ Чернин В. В., Червинец В. М. Пробиотики, антибактериальные и антифунгальные препараты как основа лечебно-реабилитационных мероприятий ликвидации дисбактериоза гастродуоденальной зоны при язвенной болезни и хроническом гастрите. Материалы научной программы II Международного конгресса «Восстановительная медицина и реабилитация», Москва, 20-21 сентября 2005 года.

11. Sjolund M., Wreiber K., Andersson D. et al. Long-Term Persistence of Resistant Enterococcus Species after Antibiotics To Eradicate Helicobacter pylori. Ann Intern Med 2003;139:483-487. doi: 10.7326/0003-4819-139-6-200309160-00011.

12. Adamsson I., Nord C. E., Lundquist P., Sjöstedt S., Edlund C.Comparative effects of omeprazole, amoxycillin plus metronidazole versus omeprazole, clarithromycin plus metronidazole on the oral, gastric and intestinal microflora in Helicobacter pylori-infected patients. J Antimicrob Chemother. 1999 Nov;44(5):629-40. doi: 10.1093/jac/44.5.629.

13. Khusnutdinova D. R., Markelova M. I., Boulygina E. A., et al. The effect of Helicobacter pylori eradication on human microbiota: Metagenome analysis of the human gut microbiome. Uchenye Zapiski Kazanskogo Universiteta. Seriya Estestvennye Nauki. 2017, vol. 159, no. 2, pp. 217-231. (In Russ.)@@ Хуснутдинова Д. Р., Маркелова М. И., Булыгина Е. А. и др. Влияние эрадикационной терапии Helicobacter pylori на микробиоту человека: метагеномный анализ микробиома кишечника. Учен. зап. Казан. ун-та. Сер. Естеств. науки. 2017; Т. 159; кн.2:217-231.

14. Gilbert D. N. Infect Dis Clin Pract. 1995;4(Suppl 2): SI03-S9.

15. Dethlefsen L., Relman D. A. Incomplete recovery and individualized responses of the human distal gut microbiota to repeated antibiotic perturbation. Proc Natl Acad Sci USA. 2011;108:4554-61. doi: 10.1073/pnas.1000087107

16. Ivashkin V. T., Ivashkin K. V. Human microbiome, applied to clinical practice.Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017;27(6):4-13. (In Russ.) doi: 10.22416/1382-4376-2017-27-6-4-13@@ Ивашкин В. Т., Ивашкин К. В. Микробиом человека в приложении к клинической практике. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2017;27(6):4-13. doi: 10.22416/1382-4376-2017-27-6-4-13.

17. Lankelma J.M., Cranendonk D. R., Belzer C., de Vos A. F., de Vos W. M., van der Poll T., Wiersinga W. J. Antibiotic-induced gut microbiota disruption during human endotoxemia: a randomised controlled study. Gut. 2017;66(9):1623-1630. doi: 10.1136/gutjnl-2016-312132

18. Chernevskaya E.A., Beloborodova N. V. Gut Microbiome in Critical Illness (Review). General Reanimatology. 2018;14(5):96-119. (in Russ.) doi: 10.15360/1813-9779-2018-5-96-119.@@ Черневская Е. А., Белобородова Н. В. Микробиота кишечника при критических состояниях (обзор), General Reanimatology. 2018;14;5;96-119. doi: 10.15360/1813-9779-2018-5-96-119.

19. Wallace J. L., Syer S., Denou E. et al. Proton pump inhibitors exacerbate NSAID-induced small intestinal injury by inducing dysbiosis. Gastroenterology. 2011;141(4):1314-22. doi: 10.1053/j.gastro.2011.06.075

20. Lebwohl B., Spechler S. J., Wang T. C., Green P. H., Ludvigsson J. F. Use of proton pump inhibitors and subsequent risk of celiac disease. Dig Liver Dis. 2014 Jan;46(1):36-40. doi: 10.1016/j.dld.2013.08.128.

21. Untersmayr E., Bakos N., Scholl I. et al. Anti-ulcer drugs promote IgE formation toward dietary antigens in adult patients. FASEB J. 2005;19:656-8. doi: 10.1096/fj.04-3170fje.

22. Freedberg D. E., Toussaint N. C., Chen S. P., et al. Proton Pump Inhibitors Alter Specific Taxa in the Human Gastrointestinal Microbiome: A Crossover Trial. Gastroenterology. 2015;149(4):883-5.e9. doi: 10.1053/j.gastro.2015.06.043.

23. Freedberg D. E., Lamouse-Smith E.S., Lightdale J. R., et al. Use of Acid Suppression Medication is Associated With Risk for C. difficile Infection in Infants and Children: A Population-based Study. Clin Infect Dis. 2015;15;61(6):912-7. doi: 10.1093/cid/civ432.

24. Melchers K., Herrmann L., Mauch F., et al. Properties and function of the P type ion pumps cloned from Helicobacter pylori. Acta Physiol Scand Suppl. 1998 Aug;643:123-35. PMID: 9789554.

25. Hoskins J., Alborn W. E., Arnold J. Genome of the bacterium Streptococcus pneumoniae strain r6. J Bacteriol. 2001 Oct;183(19):5709-17. doi: 10.1128/JB.183.19.5709-5717.2001.

26. Afeltra J., Verweij P. E. Antifungal activity of nonantifungal drugs. Eur J Clin Microbiol Infect Dis. 2003;22(7):397-407. doi: 10.1007/s10096-003-0947- x.

27. Lombardo L., Foti M., Ruggia O., Chiecchio A. Increased incidence of small intestinal bacterial overgrowth during proton pump inhibitor therapy. Clin Gastroenterol Hepatol. 2010 Jun;8(6):504-8. doi: 10.1016/j.cgh.2009.12.022.

28. Lo W. K., Chan W. W. Proton pump inhibitor use and the risk of small intestinal bacterial overgrowth: a metaanalysis. Clin Gastroenterol Hepatol. 2013 May;11(5):483-90. doi: 10.1016/j.cgh.2012.12.011.

29. Shindo K., Machida M., Fukumura M., Koide K., Yamazaki R. Omeprazole induces altered bile acid metabolism. Gut. 1998 Feb;42(2):266-71. doi: 10.1136/gut.42.2.266.

30. Khapaev B. A., Zhuravleva M. V., Rebrov V. G. [Undesirable effects of proton pump blockers and H2-histamine receptor blockers. Molecular mechanisms of adverse drug effects]. Moscow. Publishing house “Russian doctor”. 2005;249-293. (in Russ.)@@ Хапаев Б. А., Журавлева М. В., Ребров В. Г. Нежелательные эффекты блокаторов протонной помпы и блокаторов Н2-гистаминовых рецепторов. Молекулярные механизмы нежелательных эффектов лекарственных средств. Монография. М.: Издательский дом «Русский врач». 2005;249-293.

31. Tsuda A., Suda W., Morita H., et al. Influence of Proton-Pump Inhibitors on the Luminal Microbiota in the Gastrointestinal Tract. Clin Transl Gastroenterol. 2015 Jun 11;6(6): e89. doi: 10.1038/ctg.2015.20.

32. Seto C. T., Jeraldo P., Orenstein R. et al. Prolonged use of a proton pump inhibitor reduces microbial diversity: implications for Clostridium difficile susceptibility. Microbiome. 2014;2:42. doi: 10.1186/2049-2618-2-42.

33. Rumyantseva D. Y., Trukhmanov A. S., Kudryavtseva A. V., Ivashkin V. T. Effect of antisecretory treatment on gastrointestinal microbiota.Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2018;28(1):78-88. (In Russ.) doi: 10.22416/1382-4376-2018-28-1-78-88.@@ Румянцева Д. Е., Трухманов А. С., Кудрявцева А. В., Ивашкин В. Т. Влияние кислотосупрессии на микробиоту желудочно-кишечного тракта. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2018;28(1):7888. doi: 10.22416/1382-4376-2018-28-1-78-88.

34. Del Piano M., Anderloni A., Balzarini M., et al. The innovative potential of Lactobacillus rhamnosus R06, Lactobacillus pentosus LPS01, Lactobacillus plantarum LP01, and Lactobacillus delbrueckii Subsp. delbrueckii LDD01 to restore the “gastric barrier effect” in patients chronically treated with PPI: a pilot study. J Clin Gastroenterol. 2012;46 Suppl: S18-S26. doi: 10.1097/MCG.0b013e318267b55d.

35. Sun Q.H., Wang H. Y., Sun S. D., Zhang X., Zhang H. Beneficial effect of probiotics supplements in reflux esophagitis treated with esomeprazole: A randomized controlled trial. World J Gastroenterol. 2019 May 7;25(17):2110-2121. doi: 10.3748/wjg.v25.i17.2110.

36. Whang A. et al. Bi-directional drug-microbiome interactions of anti-diabetics. EBioMedicine. 2019;39;591-602. doi: 10.1016/j.ebiom.2018.11.046.

37. Ruyatkina L. A., Ruyatkin D. S. Multidimensional effects of metformin in patients with type 2 diabetes. Diabetes mellitus. 2017;20(3):210-219. (In Russ.) doi: 10.14341/DM2003458-64.@@ Руяткина Л. А., Руяткин Д. С. Многоплановые эффекты метформина у пациентов с сахарным диабетом 2 типа. Сахарный диабет. 2017;20(3):210-219. doi: 10.14341/DM2003458-64.

38. Forslund K., Hildebrand F., Nielsen T., Falony G., et al. Disentangling the effects of type 2 diabetes and metformin on the human gut microbiota. Nature. 2015;528:262-6. doi: 10.1038 / nature15766.

39. Shin N. R., Lee J. C., Lee H. Y., Kim M. S., et al. An increase in the Akkermansia spp. Population induced by metformin treatment improves glucose homeostasis in diet-induced obese mice. Gut. 2014;63:727-35. doi: 10.1136 / gutjnl-2012-303839.

40. Wang L., Li P., Tang Z., Yan X., et al. Structural modulation of the gut microbiota and the relationship with body weight: compared evaluation of liraglutide and saxagliptin treatment. Sci Rep. 2016;6: Article ID 33251. doi: 10.1038 / srep33251.

41. Yan X., Feng B., Li P., Tang Z., et al. Microflora disturbance during progression of glucose intolerance and effect of sitagliptin: an animal study. J Diabetes Res. 2016; 2016: Article ID 2093171. doi: 10.1155/2016/2093171.

42. Gu Y., Wang X., Li J., et al. Analyses of gut microbiota and plasma bile acids enable stratification of patients for antidiabetic treatment. Nat Commun. 2017 Nov 27;8(1):1785. doi: 10.1038/s41467-017-01682-2.

43. Zhang X., Fang Z., Zhang C., Xia H., et al. Effects of acarbose on the gut microbiota of prediabetic patients: a randomized, double-blind, controlled crossover trial. Diabetes Ther. 2017;8:293-307. doi: 10.1007 / s13300-017-0226- у.

44. Su B., Liu H., Li J., Sunli Y., et al. Acarbose treatment affects the serum levels of inflammatory cytokines and the gut content of Bifidobacteria in Chinese patients with type 2 diabetes mellitus. J Diabetes. 2015;7:729-39. doi: 10.1111/1753-0407.12232.

45. Oganezova I. A., Medvedeva O. I. Changes in intestinal microbiota as a cause and potential therapeutic target in constipation syndrome.Russian Medical Inquiry. 2020;4(5):302-307. (in Russ.) doi: 10.32364/2587-6821-2020-4-5-302-307.@@ Оганезова И. А., Медведева О. И. Изменения кишечной микробиоты как причина и потенциальная терапевтическая мишень при синдроме констипации. РМЖ. Медицинское обозрение. 2020;4(5):302-307. doi: 10.32364/2587-6821-2020-4-5-302-307.

46. Kanerud L. et al. Effect of sulphasalazine on gastrointestinal microflora and on mucosal heat shock protein expression in patients with rheumatoid arthritis. Br J Rheumatol. 1994;33(11):1039-48. doi: 10.1093/ревматология/33.11.1039.

47. Serkova M. Yu., Avalueva E. B., Bakulin I. G., Sitkin S. I.Intestinal microbiocenosis and cytokine status in lung cancer patients receiving chemotherapy. Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3): 152-157. (in Russ.) doi: 10.18821/1560-9537-2017-20-3-152-157.@@ Серкова М. Ю., Авалуева Е. Б., Бакулин И. Г., Ситкин С. И. Кишечный биотоп и цитокиновый статус у пациентов с диагнозом рак легкого, получающих химиотерапию. Медико-социальная экспертиза и реабилитация. 2017;20(3): 152-157. doi: 10.18821/1560-9537-2017-20-3-152-157.

48. Maev I., Dicheva D., Andreev D. The role of probiotics in the correction of intestinal microflora disorders. Doctor. 2012;8:51-56.@@ Маев И., Дичева Д., Андреев Д. Роль пробиотиков в коррекции нарушений кишечной микрофлоры. Врач. 2012;8:51-56.

49. Ljungh A., Wadström T. Lactic acid bacteria as probiotics. Curr Issues Intest Microbiol. 2006 Sep;7(2):73-89. PMID: 16875422.

50. Rousseaux C., Thuru X., Gelot A. et al. Lactobacillus acidophilus modulates intestinal pain and induced opioid and cannabinoid receptors. Nat. Med. 2007;13:35-7. doi: 10.1038/nm1521.

51. Ejtahed H., Mohtadi-Nia J., Homayouni-Rad A. et al. Effect of probiotic yogurt containing Lactobacillus acidophilus and Bifidobacterium lactis on lipid profile in individuals with type 2 diabetes mellitus. J. Dairy. Sci. 2011;94:3288-94. doi: 10.3168/jds.2010-4128.

52. Luoto R., Laitinen K., Nermes M., et al. Impact of maternal probiotic-supplemented dietary counseling on pregnancy outcome and prenatal and postnatal growth: double-blind, placebo-controlled study. Br. J. Nutr. 2010;103:1792-9. doi: 10.1017/S0007114509993898.

53. Sadrzadeh-Yeganeh H., Elmadfa I., Djazayery A. et al. The effect of probiotic and conventional yoghurt in lipid profile in women. Br. J. Nutr. 2010;103:1778-83. doi: 10.1017/S0007114509993801.

54. Kabeerdoss J., Devi R., Mary R., et al. Bifidobacterium lactis BB-12® on faecal excretion of secretory immunoglobulin A and human beta-defensin 2 in healthy adult volunteers. Nutr. J. 2011;10:138. doi: 10.1186/1475-2891-10-138.

55. Mohan R., Koebnick C., Schidt J., et al. Effects of Bifidobacterium lactis BB-12 supplementation on body weight, fecal pH, acetate, lactate, calprotectin and IgA in preterm infants. Pediatr. Res. 2008;64:418-22. doi: 10.1203/PDR.0b013e318181b7fa.

56. De Vrese M., Kristen H., Rautenberg P., et al. Probiotic Lactobacilli and Bifidobacteria in a fermented milk product with added fruit preparation reduce antibiotic associated diarrhea and Helicobacter pylori activity. J Dairy Res. 2011;78:396-403. doi: 10.1017/S002202991100063X.

57. Lee B. J., Bak Y. T. Irritable bowel syndrome, gut microbiota and probiotics. J. Neurogastroenterol. Motil. 2011;17(3):252-266. doi: 10.5056/jnm.2011.17.3.252.

58. Kim H. J., Camilleri M., McKinzie S. et al. A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea predominant irritable bowel syndrome. Aliment. Pharmacol. Ther. 2003;17(7):895-904. doi: 10.1046/j.1365-2036.2003.01543.x.

59. Agafonova N. A., Yakovenko E. P., Ivanov A. N., Yakovenko A. V. Abdominal Pain and Visceral Hypersensitivity Are Two Facets of the Same Reality for IBS Patients. Effective pharmacotherapy. 2018; (32):26-33. (in Russ.)@@ Агафонова Н. А., Яковенко Э. П., Иванов А. Н., Яковенко А. В. Абдоминальная боль и висцеральная гиперчувствительность - две грани одной реальности для пациентов с СРК. Эффективная фармакотерапия. 2018; 32:26-33.

60. Ivashkin V. T., Mayev I. V., Abdulganieva D. I., et al. Practical Recommendations of Scientific Society for the Study of Human Microbiome and Russian Gastroenterological Association (RGA) for Probiotics in Treatment and Prevention of Gastroenterological Diseases in Adults.Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(2):76-89. (In Russ.) doi: 10.22416/1382-4376-2020-30-2-76-89.@@ Ивашкин В. Т., Маев И. В., Абдулганиева Д. И. и др. Практические рекомендации Научного сообщества по содействию клиническому изучению микробиома человека (НСОИМ) и Российской гастроэнтерологической ассоциации (РГА) по применению пробиотиков для лечения и профилактики заболеваний гастроэнтерологического профиля у взрослых. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2020;30(2):76-89. doi: 10.22416/1382-4376-2020-30-2-76-89.


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Bakulin I.G., Serkova M.Yu. Medicinal-microbial interactions and ways of correcting iatrogenic intestinal dysbiosis. Experimental and Clinical Gastroenterology. 2022;(11):26-35. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-207-11-26-35

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