DMARDs–Gut Microbiota Feedback: Implications in the Response to Therapy

Zaragoza-García, Óscar; Castro-Alarcón, Natividad; Pérez-Rubio, Gloría; Guzmán‐Guzmán, Iris Paola

doi:10.3390/biom10111479

Cited by 18 publications

(10 citation statements)

References 126 publications

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“…This makes it difficult to accurately compare the outcomes of these studies and the clinical significance of the percentage relative changes shown in Figure 3 and Figure 4 . Since medications influence the microbiome in different ways and many different medications were used in the trials, there is a further need to interpret the outcomes with caution [ 109 , 110 ]. Furthermore, short-term fiber supplementation may increase gastro-intestinal symptoms and disease activity in IBD patients, thus increasing the difficulty of comparing results of fiber interventions in IBD patients to other diseases [ 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Dietary Interventions on Chronic Inflammatory Diseases in Relation to the Microbiome: A Systematic Review

et al. 2021

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Chronic inflammation plays a central role in the pathophysiology of various non-communicable diseases. Dietary interventions can reduce inflammation, in part due to their effect on the gut microbiome. This systematic review aims to determine the effect of dietary interventions, specifically fiber intake, on chronic inflammatory diseases and the microbiome. It aims to form hypotheses on the potential mediating effects of the microbiome on disease outcomes after dietary changes. Included were clinical trials which performed a dietary intervention with a whole diet change or fiber supplement (>5 g/day) and investigated the gut microbiome in patients diagnosed with chronic inflammatory diseases such as cardiovascular disease (CVD), type 2 diabetes (T2DM), and autoimmune diseases (e.g., rheumatoid arthritis (RA), inflammatory bowel disease (IBD)). The 30 articles which met the inclusion criteria had an overall moderate to high risk of bias and were too heterogeneous to perform a meta-analysis. Dietary interventions were stratified based on fiber intake: low fiber, high fiber, and supplemental fiber. Overall, but most pronounced in patients with T2DM, high-fiber plant-based dietary interventions were consistently more effective at reducing disease-specific outcomes and pathogenic bacteria, as well as increasing microbiome alpha diversity and short-chain fatty acid (SCFA)-producing bacteria, compared to other diets and fiber supplements.

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Section: Discussionmentioning

confidence: 99%

The Effect of Dietary Interventions on Chronic Inflammatory Diseases in Relation to the Microbiome: A Systematic Review

et al. 2021

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“…However, a significant non-response rate of 30 to 40%, as well as the impossibility of predicting the patient’s response to treatment, are evident impasses [ 39 ]. The recent literature has indicated multiple factors involved with MTX responsiveness, including the participation of the gut microbiota in drug metabolism and efficiency [ 40 , 41 ]. Understanding how the microbiota affects the response to MTX and, in turn, what impact this drug has on the microbiota is important not only because the modulation of the gut microbiota may offer a novel therapeutic or preventive approach for patients with RA, but also because it may be helpful in predicting the response to treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Another report also noted that the microbiota of RA patients was sensitive to MTX, to changes in gut bacterial taxa, and to gene family abundance [ 42 ]. The fine line that separates this effect from dysbiosis may depend on the intrinsic ability to metabolize the drug or on factors such as the pharmacological combination, the dose administered, or the length of time the drug is prescribed [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Methotrexate and Non-Surgical Periodontal Treatment Change the Oral–Gut Microbiota in Rheumatoid Arthritis: A Prospective Cohort Study

Oliveira,

de Arruda,

Corrêa

et al. 2023

Microorganisms

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This study evaluated the changes in the composition of oral–gut microbiota in patients with rheumatoid arthritis (RA) caused by methotrexate (MTX) and non-surgical periodontal treatment (NSPT). Assessments were performed at baseline (T0), 6 months after MTX treatment (T1), and 45 days after NSPT (T2). The composition of the oral and gut microbiota was assessed by amplifying the V4 region of the 16S gene from subgingival plaques and stools. The results of the analysis of continuous variables were presented descriptively and non-parametric tests and Spearman’s correlation were adopted. A total of 37 patients (27 with periodontitis) were evaluated at T0; 32 patients (24 with periodontitis) at T1; and 28 patients (17 with periodontitis) at T2. MTX tended to reduce the alpha diversity of the oral–gut microbiota, while NSPT appeared to increase the number of different species of oral microbiota. MTX and NSPT influenced beta diversity in the oral microbiota. The relative abundance of oral microbiota was directly influenced by periodontal status. MTX did not affect the periodontal condition but modified the correlations that varied from weak to moderate (p < 0.05) between clinical parameters and the microbiota. MTX and NSPT directly affected the composition and richness of the oral–gut microbiota. However, MTX did not influence periodontal parameters.

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“…The main aminosalicylates are sulfasalazine (SASP), which is cleaved to 5-aminosalicylic acid (5-ASA) and sulfasalazine (SP) by the action of azo reductase in the normal intestinal flora after oral administration. Among them, 5-ASA is the main active ingredient in drug therapy 1 , 2 . SASP is usually utilized to treat mild and moderate UC and needs to be combined with other types of drugs in the treatment of severe UC.…”

Section: Introductionmentioning

confidence: 99%

Comparison of effects of aminosalicylic acid, glucocorticoids and immunosuppressive agents on the expression of multidrug-resistant genes in ulcerative colitis

Chen

Wang

Zhang

et al. 2022

Sci Rep

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To compare the effects of aminosalicylic acid, glucocorticoids and immunosuppressants on the expression levels of multidrug resistance genes in patients with ulcerative colitis (UC), with the aim of providing a theoretical and therapeutic basis for the diagnosis, treatment, and prevention of UC. Fresh colonic mucosal tissues or postoperative pathological biopsies from 148 UC patients were collected, and the distribution sites and morphology of P-glycoprotein (P-gp) were detected using immunohistochemical staining. RT-PCR was used to quantify the expression levels of multidrug resistance gene (MDR1) mRNA before and after the corresponding treatment, and the effects of aminosalicylic acid, glucocorticoids and immunosuppressive drugs on P-gp were compared. In addition, the effects of the three drugs on MDR1 mRNA were analyzed. Administration of 5-aminosalicylic acid (5-ASA) drugs did not correlate with MDR1 expression in UC, whereas administration of glucocorticoids and immunosuppressive drugs was positively correlated with MDR1 expression profile. The expression levels of MDR1 mRNA and its product P-gp were significantly upregulated in patients who did not respond to glucocorticoids and immunosuppressive drugs. 5-ASA had no effect on the expression levels of MDR1 and its product P-gp in patients with a confirmed diagnosis of UC. However, the use of glucocorticoids and immunosuppressants can increase the expression level of MDR1.

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DMARDs–Gut Microbiota Feedback: Implications in the Response to Therapy

Cited by 18 publications

References 126 publications

The Effect of Dietary Interventions on Chronic Inflammatory Diseases in Relation to the Microbiome: A Systematic Review

The Effect of Dietary Interventions on Chronic Inflammatory Diseases in Relation to the Microbiome: A Systematic Review

Methotrexate and Non-Surgical Periodontal Treatment Change the Oral–Gut Microbiota in Rheumatoid Arthritis: A Prospective Cohort Study

Comparison of effects of aminosalicylic acid, glucocorticoids and immunosuppressive agents on the expression of multidrug-resistant genes in ulcerative colitis

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