Baylor College of Medicine
The influence of non-antibiotic drugs on the gut microbiota has not been well studied. We examined the association between common non-antibiotic drugs use and the composition and structure of the colonic mucosa adherent gut microbiota.
This cross-sectional study included 83 snap-frozen colonic mucosal biopsies taken from 28 polyp-free participants. All participants had no exposure to antibiotics for 3 months before the study, and they discontinued non-essential drugs 2 weeks before the colonoscopy and stopped the antidiabetic drug one day before the colonoscopy. Drug use was assessed via interviewer-administered survey and classified as no-use or current-use. Microbial DNA was extracted, amplified, and sequenced for the 16S rRNA V4 region using the Illumina MiSeq platform. The UPARSE and SILVA database were used for operational taxonomic unit (OTU) classification. Beta-diversity was examined using the Weighted UniFrac as a distance matrix. The relative abundance of the bacterial taxa was compared based on drugs using the Mann–Whitney test. False discover rate (FDR)-adjusted P-values (q value) < 0.05 indicated statistical significance. Multivariable negative binomial regression analysis for panel data was used to assess the incidence rate ratio (IRR) and 95% confidence interval (CI) of having the bacterial count based on current drug use compared to no use.
Results: The beta diversity differed significantly based on the use of metformin, calcium channel blockers (CCB), proton pump inhibitors, and selective serotonin reuptake inhibitors (P values < 0.05). Table 1 shows the relative abundance of the common genera that significantly differed by drug use. Table 2 shows the IRR of the bacterial count that significantly differed by drug use. CCBs use was associated with an increase in Lachnospiraceae Unc01c0o (IRR=12.26 [95% CI 3.39-44.37]) and Lachnospiraceae Unc91005 (IRR=5.49 [95% CI 2.30-13.12]) and a decrease in Lachnospiraceae Unc94789 (IRR=0.24 [95% CI 0.07-0.88]) compared to no use. The use of ≥ 4 types of drugs was associated with an increase in Fusobacterium (IRR=4.63 [95% CI 1.17-18.36]) compared to the use of fewer drugs.
Discussion: The use of CCBs was associated with the alteration of several unclassified bacteria in the Lachnospiraceae family. The use of four or more drugs was associated with an increase in Fusobacterium. The interaction between the use of non-antibiotics drugs and gut microbiota deserves further investigation.
Table 1: Relative abundance of common (relative abundance >1%) bacteria genera based on drug use (q-value<0.05)
Table 2. Incidence rate ratio (IRR) and 95% confidence interval (CI) of having specific genera count for current use of drug compared to no use.
1. Negative binomial regression models for panel data adjusted for age.
2. Further adjustment for ethnicity, BMI, smoking status, alcohol use, dietary quality, type 2 diabetes mellitus and hypertension.
Anthony Xu indicated no relevant financial relationships.
Kristi Hoffman indicated no relevant financial relationships.
Aaron Chin indicated no relevant financial relationships.
Donna White indicated no relevant financial relationships.
Fasiha Kanwal indicated no relevant financial relationships.
Hashem El-Serag indicated no relevant financial relationships.
Joseph Petrosino indicated no relevant financial relationships.
Li Jiao indicated no relevant financial relationships.