Vancomycin relieves mycophenolate mofetil–induced gastrointestinal toxicity by eliminating gut bacterial β-glucuronidase activity
MR Taylor, KL Flannigan, H Rahim, A Mohamud… - Science …, 2019 - science.org
Science advances, 2019•science.org
Mycophenolate mofetil (MMF) is commonly prescribed and has proven advantages over
other immunosuppressive drugs. However, frequent gastrointestinal side effects through an
unknown mechanism limit its use. We have found that consumption of MMF alters the
composition of the gut microbiota, selecting for bacteria expressing the enzyme β-
glucuronidase (GUS) and leading to an up-regulation of GUS activity in the gut of mice and
symptomatic humans. In the mouse, vancomycin eliminated GUS-expressing bacteria and …
other immunosuppressive drugs. However, frequent gastrointestinal side effects through an
unknown mechanism limit its use. We have found that consumption of MMF alters the
composition of the gut microbiota, selecting for bacteria expressing the enzyme β-
glucuronidase (GUS) and leading to an up-regulation of GUS activity in the gut of mice and
symptomatic humans. In the mouse, vancomycin eliminated GUS-expressing bacteria and …
Mycophenolate mofetil (MMF) is commonly prescribed and has proven advantages over other immunosuppressive drugs. However, frequent gastrointestinal side effects through an unknown mechanism limit its use. We have found that consumption of MMF alters the composition of the gut microbiota, selecting for bacteria expressing the enzyme β-glucuronidase (GUS) and leading to an up-regulation of GUS activity in the gut of mice and symptomatic humans. In the mouse, vancomycin eliminated GUS-expressing bacteria and prevented MMF-induced weight loss and colonic inflammation. Our work provides a mechanism for the toxicity associated with MMF and a future direction for the development of therapeutics.
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