All Inclusive: Personalized Drug Metabolism by Microbiota in Gut Organoids

The metabolism of drugs takes place for the most part in the liver. Next to the liver, however, microbiota in the gut also play an active role in the metabolism of drugs, either in generating active compounds or deactivation of the drug. In vivo, the gastrointestinal tract is populated by a complex, and highly individual microbiota. Gut organoids are powerful ex vivo tools for studying drug metabolism. Organoids also allow for studying the role of microbiota in drug metabolism. The technical challenges in co-culturing eukaryotic organoids with prokaryotic bacteria can be overcome. Next steps will be to mimic the complex composition of the gut microbiome. This manuscript provides a state of the art overview of current concepts and of most promising avenues for future research and applications in drug development.