The Gut Response Shedding light on the microbiome’s interaction with oral medicines including ADT

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The Gut Response

Shedding light on the microbiome’s interaction with oral medicines

What happens when first-line treatments fail? For patients living with prostate cancer, androgen deprivation therapy (ADT) is often the first approach. The treatment lowers the levels of male hormones in the body, starving the cancer – but it doesn’t work for everyone and many researchers have sought to find out why.

One possible example,
“ A. muciniphila was also associated with an increase in bacterial metabolism genes predicted to be involved in the biosynthesis of vitamin K2. Given that the vitamin can target prostate cancers resistant to ADTs in vitro, these results may help explain the higher-than-expected efficacy of AA,” he says.

“Learning about these interactions will likely lead to a future where microbiome pre-screening is commonplace in personalized medicine,” Burton says. “We may be just as likely to undergo a microbiome analysis as we are to receive a test on our own genomic material to determine the inter-compatibility of drugs and treatment outcomes.”

Further work is needed, but if additional studies prove that the gut bacteria can help determine how men respond to prostate cancer treatment, it may be that targeting the gut microbiome – in the form of prebiotics, probiotics, or even fecal transplant – may make ADT and other forms of treatment much more effective. This research was published in Prostate Cancer and Prostatic Diseases.

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Phoenix, Arizona (UroToday.com) Dr. Karen Sfanos presented the variations in the microbiome in men who receive androgen deprivation therapy (ADT). The microbiome is regarded as the forgotten organ. Our microbes are crucial to our function and can do some things that we cannot do. These include:

  1. Production of beneficial metabolites and vitamins
  2. Break down certain dietary components
  3. Shape the immune system
  4. Ward off pathogens
  5. Assist with maintaining epithelial barriers

There are many factors that influence the microbiome. These include gender, pathogens, medications, weight, hygiene, environmental exposures, antibiotics, hormones, sleep, stress, age, exercise, diet, and genetics.

The microbiota has a correlation to genitourinary cancer which can either be direct or indirect. Direct interactions include infections, inflammation, the presence of urinary microbiome, and urinary microbiota metabolites. Indirect interactions include xenobiotic metabolism (dietary carcinogens, drug metabolism), cancer therapy/treatment response, systemic inflammation/cytokines, and treatment related toxicities. The gut microbiome modulates treatment response to chemotherapy and immunotherapy.

One of the proposed mechanism that link gut microbiota to cancer is through androgen modulation. Specific changes in hormone levels correlate with the presence of gut microbiota. The microbiota produces and secrets hormones, responds to host hormones and regulates expression levels of host hormones (figure 1).