Can Altering Gut Microbes Reduce Chemo Side Effects

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In a new study published in Chemistry & Biology researchers concluded that some of chemotherapy’s side effects result from gut microbes that latch onto the drugs as they are eliminated from the body and transform them into toxic species that cause severe diarrhea. It is possible to shut down this process in mice as a first step in helping cancer patients.

They say bacteria consume a sugar called glucuronic  acid through the use of a bacterial enzyme called Beta-glucuronidase from small chemicals sent by the body to the gastrointestinal tract for elimination.  The chemo drug irinotecan is linked to glucuronic acid to mark it for elimination, and when the GI tract bacteria remove the sugar, they release a virulent toxic drug back into the intestine that causes diarrhea in up to 90% of people who take irinotecan. Researchers have characterized various forms of Beta-glucuronidase    produced by different strains of bacteria residing in the gut, and show that inhibiting GI bacterial Beta-glucuronidases in mice does not affect irinotecan that is circulating in the blood and is  needed to combat cancer. This new understanding provies a promising new set of targets for controlling drug-induced GI toxicity.

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