European Journal of Biomedical and Pharmaceutical Sciences

DYSBIOSIS AND HUMAN HEALTH, DRUG–MICROBIOME INTERACTIONS: AN EMERGING MICROBIOME THERAPEUTICS

*Dr. Virendra Kushwaha, Dr. Pooja Agrawal, Dr. Anuj Kumar, Dr. Sonali Chandra, Dr. Sarthak Goel, Dr. Mourriyan Elanchezhiyan

ABSTRACT

Dysbiosis refers to disruption of the normal microbial balance within the gastrointestinal tract, resulting in altered microbial diversity, impaired host–microbe interactions, and abnormal microbial metabolite production. The gut microbiota functions as a highly active metabolic and immunological organ involved in nutrient metabolism, epithelial barrier maintenance, immune regulation, neurotransmitter synthesis, bile acid metabolism, and xenobiotic metabolism. Increasing evidence demonstrates that dysbiosis contributes significantly to gastrointestinal, metabolic, cardiovascular, neurological, autoimmune, and oncological disorders through mechanisms involving chronic inflammation, oxidative stress, epithelial barrier dysfunction, immune dysregulation, and endotoxemia. From a pharmacological perspective, the gut microbiota significantly influences drug absorption, metabolism, bioavailability, efficacy, and toxicity. Intestinal microorganisms possess enzymatic pathways capable of activating, inactivating, or transforming therapeutic agents. Conversely, several medications including antibiotics, proton pump inhibitors, antidepressants, chemotherapeutic agents, and non-steroidal anti-inflammatory drugs can induce dysbiosis and alter microbial diversity. Recent advances in pharmacomicrobiomics, metagenomics, metabolomics, and synthetic biology have facilitated development of microbiome-based therapeutics including probiotics, prebiotics, synbiotics, postbiotics, engineered live biotherapeutics, bacteriophage therapy, and fecal microbiota transplantation (FMT). Recently approved microbiome formulations such as Rebyota and Vowst represent major advances in microbiome pharmacology and precision medicine. This review discusses the pharmacological mechanisms underlying dysbiosis, microbiome–drug interactions, dysbiosis-associated diseases, current microbiome therapeutics, approved microbiome formulations, and future perspectives in microbiome-directed pharmacotherapy.

Keywords: Dysbiosis, gut microbiota, pharmacomicrobiomics, probiotics, fecal microbiota transplantation, microbiome therapeutics.