时间标签：数据日期 2026-11-05 · 生成时间 2026-11-05 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/11/02 – 2026/11/06 ｜ 情报发生日期 2026-11-05
研究问题
By reframing the microbiome from a mechanistic curiosity into a dosing-relevant variable, we aim to move the field from recognizing that microbes affect drugs toward microbiome-informed precision dosing at the bedside.2Mechanisms: how the gut microbiome shapes drug pharmacokineticsThe gut microbiome is a metabolically active organ.；Whether such mechanistic quantification translates into measurable interindividual variability in real patients is the question taken up next.3Evidence for microbiome-driven interindividual pharmacokinetic variabilityEstablishing that gut bacteria can transform drugs does not by itself prove that microbial variation produces clinically meaningful differences between patients.；The relevant question for precision dosing is whether interpersonal differences in microbial composition and enzymatic capacity translate into measurable, and occasionally dominant, differences in drug exposure and response (Spanogiannopoulos et al., 2016).
方法
Patients given identical doses of the same drug often reach very different systemic exposures and clinical outcomes.；Both individualize dose from measured drug concentrations and patient-specific covariates (Darwich et al., 2021).；That review still treated the microbiome as a source of variability to be recognized, not a covariate to be measured and modeled.
核心结论
That makes this the clearest quantified instance of indirect modulation, consistent with broad microbial regulation of host phase I and phase II enzymes and drug transporters (Klaassen and Cui, 2015).Taken together, these four mechanistic classes give a reasonably complete vocabulary for how gut bacteria alter drug disposition.；These are Tier 4 findings in the sense that matters here: the phenotype is demonstrated on human material outside the body, establishing stable interindividual capacity without showing that the capacity governs exposure in the donor patient.3.2Tier 3 — microbial features tracking exposure and dose in patient cohortsIn patient cohorts, particular microbial features track drug exposure and the dose actually required to reach target.；That attribution was demonstrated for brivudine, using mice differing in a single microbiome-encoded enzyme, and extended to clonazepam as a drug subject to multiple competing metabolic routes.
局限
Host genetics alone, however, accounts for only a fraction of observed interpatient differences, leaving a persistent explanatory deficit (Spanogiannopoulos et al., 2016).Attention has therefore turned to the gut microbiome.；It did so, however, in gnotobiotic mice differing in a single microbiome-encoded enzyme, for mechanistic attribution.；Third, we specify four modeling routes by which a microbial measurement can reach a dose, with their data requirements, validation strategies, limitations, and prototyping status (Table 1).
对本项目的价值
中高价值：属「微生物组及其代谢物干预」方向；微生物组及其代谢物干预栏目可用作本项目文献库与综述素材。 ｜ 价值分 3.1/5（★★★☆☆）
全文来源
PubMed PMC JATS（正文 104,897 字符，题名指纹 0.88，已过 PubMed PMCID 官方关联 + 题名指纹 + 正文长度归属校验）
原文题录
- 中文题名：将肠道菌群整合入治疗药物监测与模型引导的精准给药：临床药学视角
- 英文标题：Integrating the gut microbiome into therapeutic drug monitoring and model-informed precision dosing: a clinical pharmacy perspective.
- 期刊与标识：Frontiers in pharmacology · PMID 42974058 · DOI 10.3389/fphar.2026.1938639 · PMC PMC13725088