Crucial New Insights Into the Metabolism of Medications
When we examine the interactions of medicines with the body, we are interested in what the medicine does to the body, and also what the body does to the medicine: what we call pharmacokinetics and pharmacodynamics. But it has long been known that these two essential considerations are far from being the whole story: there are enormous differences in the ways in which people respond to medicines: some people need huge doses of a medicine, whilst there are others who cannot tolerate medicines at all. Though part of the explanation for those differences is clearly not just pharmacological – the same people who are super-sensitive to medicines are often also extraordinarily sensitive to acupuncture and homeopathy – there is a new kid on the block: a new factor in drug metabolism.
Men and women handle medicine differently, the time of day that a medicine is taken, as well as things like the food eaten in the last few hours can all impact the outcomes of taking a medicine. We have also known that there are many other variables in a person’s response to a medicine.
For more than two decades physicians and pharmacologists have wondered if the three pounds of bacteria living peacefully in our intestines might have a major impact on the metabolism of medicines. This question was first prompted by clinical observations: first, people with no intestinal bugs exhibited many oddities in how they handled medicine, and second, there are some rare situations in which overgrowth with unusual bacteria can chew up certain essential nutrients.
New research reported by the BBC confirms these clinical observations.
Researchers at Imperial College London and the pharmaceutical giant Pfizer have used a “pharmaco-metabonomic” approach that uses a combination of advanced chemical analysis and mathematical modeling to predict responses to drugs. Details of the research are published in the journal Nature.
The method is based on an analysis of the chemical products of the body’s metabolism. We think that examining these patterns can help diagnose diseases, predict an individual’s future illnesses, and their response to treatment.
The principle investigator is Professor Jeremy Nicholson and he has said the ‘pharmaco-metabonomic’ approach appears able to take account of individual differences in the way that drugs are absorbed and processed by the body. It differs from person to person depending on factors including the type and amount of bacteria found in the intestines.
These new techniques could be the first step towards the development of more personalized pharmacological treatments. For those of us practicing integrated medicine, this is a most welcome development.
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