ArticleGut microbes
Mechanistic insight into digoxin inactivation by Eggerthella lenta augments our understanding of its pharmacokinetics.
Article in Gut microbes. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 1 of them a synthesis that pooled it.
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Who cites it
91 citing papers in PubMed, 1 synthesis or guideline pooled it, 177 citations in OpenAlex.
- Stool metatranscriptomics: A technical guideline for mRNA stabilisation and isolation.BMC genomics · 2015Guideline
- The effect of elastic-band resistance training on fecal microbiota and derived metabolites of aged individuals with possible sarcopenia.Frontiers in medicine · 2026Trial
- Genetic variants in cellular transport do not affect mesalamine response in ulcerative colitis.PloS one · 2018Trial
- The microbiota at the interface of environmental toxicants and the brain.Cell metabolism · 2026Review
- Role of the Gut Microbiome in Natural and Synthetic Drug Efficacy and Safety: A Narrative Review.Applied microbiology (Basel, Switzerland) · 2026Article
- Insights into the Complexities of Pharmacotherapy Parameters in Artificial Intelligence Models for Drug Selection, Precision Personalised Medicine and Optimal Therapeutic Outcomes.Pharmaceutics · 2026Review
- Microbiome-Associated Drug Response Variability in Heart Failure Treatment.Life (Basel, Switzerland) · 2026Review
- The microbial metabolome: remodeling the therapeutic landscape in hematologic malignancies.NPJ biofilms and microbiomes · 2026Review
- Navigating a thorny path: oral nanomedicines for the precision management of radiation-induced intestinal injury.Journal of nanobiotechnology · 2026Review
- Infant gut microbiota coverage by different culture media.BMC microbiology · 2026Article
- Microbiota-based PBPK model: new approach methodology for assessing the kinetics of drugs and chemicals.Frontiers in pharmacology · 2026Review
- Gut Microbiota in the Regulation of Intestinal Drug Transporters: Molecular Mechanisms and Pharmacokinetic Implications.International journal of molecular sciences · 2025Review
- MetaMDA: explainable prediction of microbe-drug association utilizing random walks on a microbe-metabolite-drug heterogeneous network.Bioinformatics (Oxford, England) · 2025Article
- Cardiotonic Steroids as a Potential Novel Approach for Immunomodulation in Inflammatory Bowel Disease.Journal of clinical medicine · 2025Review
- Mechanisms and implications of the gut microbial modulation of intestinal metabolic processes.npj metabolic health and disease · 2025Review
- Review
- Gut microbiome and inflammation in cardiovascular drug response: trends in therapeutic success and commercial focus.Inflammopharmacology · 2025Review
- GutBugDB: a web resource to predict the human gut microbiome-mediated biotransformation of biotic and xenobiotic molecules.Gut microbiome (Cambridge, England) · 2025Article
- Bacteriophages targeting Enterococcus faecalis enhance the therapeutic efficacy of levodopa in an MPTP-induced Parkinson's disease mouse model with E. faecalis gut colonization.Scientific reports · 2024Article
- Utilization of the microbiome in personalized medicine.Nature reviews. Microbiology · 2024Review
31 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
The human gut microbiota plays a key role in pharmacology, yet the mechanisms responsible remain unclear, impeding efforts toward personalized medicine. We recently identified a cytochrome-encoding operon in the common gut Actinobacterium Eggerthella lenta that is transcriptionally activated by the cardiac drug digoxin. These genes represent a predictive microbial biomarker for the inactivation of digoxin. Gnotobiotic mouse experiments revealed that increased protein intake can limit microbial drug inactivation. Here, we present a biochemical rationale for how the proteins encoded by this operon might inactivate digoxin through substrate promiscuity. We discuss digoxin signaling in eukaryotic systems, and consider the possibility that endogenous digoxin-like molecules may have selected for microbial digoxin inactivation. Finally, we highlight the diverse contributions of gut microbes to drug metabolism, present a generalized approach to studying microbe-drug interactions, and argue that mechanistic studies will pave the way for the clinical application of this work.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.