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Characterising and preventing the gut microbiota's inactivation of trifluridine, a colorectal cancer drug

McCoubrey, Laura E; Shen, Chenghao; Mwasambu, Sydney; Favaron, Alessia; Sangfuang, Nannapat; Thomaidou, Stavrina; Orlu, Mine; ... Basit, Abdul W; + view all (2024) Characterising and preventing the gut microbiota's inactivation of trifluridine, a colorectal cancer drug. European Journal of Pharmaceutical Sciences , 203 , Article 106922. 10.1016/j.ejps.2024.106922. Green open access

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Abstract

The gut microbiome can metabolise hundreds of drugs, potentially affecting their bioavailability and pharmacological effect. As most gut bacteria reside in the colon, drugs that reach the colon in significant proportions may be most impacted by microbiome metabolism. In this study the anti-colorectal cancer drug trifluridine was used as a model drug for characterising metabolism by the colonic microbiota, identifying correlations between bacterial species and individuals’ rates of microbiome drug inactivation, and developing strategies to prevent drug inactivation following targeted colonic delivery. High performance liquid chromatography and ultra-high performance liquid chromatography coupled with high resolution tandem mass spectrometry demonstrated trifluridine's variable and multi-route metabolism by the faecal microbiota sourced from six healthy humans. Here, four drug metabolites were linked to the microbiome for the first time. Metagenomic sequencing of the human microbiota samples revealed their composition, which facilitated prediction of individual donors’ microbial trifluridine inactivation. Notably, the abundance of Clostridium perfringens strongly correlated with the extent of trifluridine inactivation by microbiota samples after 2 hours (R2 = 0.8966). Finally, several strategies were trialled for the prevention of microbial trifluridine metabolism. It was shown that uridine, a safe and well-tolerated molecule, significantly reduced the microbiota's metabolism of trifluridine by acting as a competitive enzyme inhibitor. Further, uridine was found to provide prebiotic effects. The findings in this study greatly expand knowledge on trifluridine's interactions with the gut microbiome and provide valuable insights for investigating the microbiome metabolism of other drugs. The results demonstrate how protection strategies could enhance the colonic stability of microbiome-sensitive drugs.

Type: Article
Title: Characterising and preventing the gut microbiota's inactivation of trifluridine, a colorectal cancer drug
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ejps.2024.106922
Publisher version: http://dx.doi.org/10.1016/j.ejps.2024.106922
Language: English
Additional information: © 2024 Published by Elsevier B.V. under a Creative Commons license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Biotransformation, Pharmacomicrobiomics, Drug-microbiome interactions, Colonic drug delivery, Formulation design, Personalised medicine, Gut microbiota
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Pharmaceutics
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10198404
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