Gut microbes are vulnerable to wide range of drugs | Hacker News Reader

Gut microbes are vulnerable to wide range of drugs

nature.com

161 pointsmclide37 comments

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.

> 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_Confiden...

People sure are different!

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.

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

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.

Great. Now I'm hungry.

you just listed my regular cravings

I think your space key is broken.

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

My point is that it's unclear whether the effect the medication has on the gut microbiome is harmful, beneficial or neutral.

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-r...

"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-r...

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?

You could always opt for a fecal transplant.

you can stick that idea up your.... uh.

It is actually a real thing.

Hopefully using this eventually, instead of the real thing: https://microbiomejournal.biomedcentral.com/articles/10.1186...

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.

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 (see figure 6)

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.

How long until we have a better delivery method for "good" species, and will that solve all microbiome related problems?

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-a...

I think that the best thing one can do for their microbiome is to stop trying to kill germs in everything around us. Also, when a dog wants to kiss you, accept it. They are good at maintaining theirs.

Look at the ingredients on all the products you use. Unless it's Dr. Bronner's soap or something similar, chances it's harmful to both humans and microbes. Just stop using and stop buying that shit!

Sterility is good for the operating table, but not for everyday life.

A lot more people used to die of disease before we figured out to wash our hands regularly.

Are mortality rates significantly lower in the modern developed world (I am assuming this is true) because people in general wash their hands more? Is that what you're trying to imply?

I don't buy it. I'd attribute the difference more to technologies like vaccines and antibiotics.

Proper sanitation has saved more lives than vaccines and antibiotics. Check for example this well researched Quora answer: https://www.quora.com/How-much-have-sanitation-vaccination-a...

"Proper sanitation" includes much more than just hand washing (e.g. properly disposing of urine and feces rather than throwing them into the street), so you're refuting a statement that I never made.

If you can disentangle hand washing from the effects of modern sanitation in general, I'm interested to hear more.

I agree to a point, but a lot of dogs don't get proper dental care, eat poop and lick buttholes-- sorry, but I don't want any of that on my face, I don't care how magical their saliva is supposed to be.

Not to mention I find dog slobber to be extremely off-putting for reasons other than germs. Just like I would find it extremely off-putting if someone went up to me with a clean wet washcloth and started rubbing it on me.

This is an indicator of your conditioning.

I suggest reading the current wisdom from Dr. Les Dethlefson, human microbiota researcher at Stanford's Relman lab [0].

In the link he addresses the difference between addressing an acute condition with probiotics versus long-term maintenance of health. Your question seems to land somewhere in the middle. So see what he has to say and please remember, this is far from settled science!

[0] https://humanmicrobiota.weebly.com/prebiotics--probiotics.ht...

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.

The published article itself (paywall): https://www.nature.com/articles/nature25979

And EMBL announcement with short video: https://news.embl.de/science/commonly-used-drugs-affect-gut-...

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

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.

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

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