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Chan M, Ghadieh C, Irfan I, Khair E, Padilla N, Rebeiro S, Sidgreaves A, Patravale V, Disouza J, Catanzariti R, Pont L, Williams K, De Rubis G, Mehndiratta S, Dhanasekaran M, Dua K. Exploring the influence of the microbiome on the pharmacology of anti-asthmatic drugs. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:751-762. [PMID: 37650889 PMCID: PMC10791706 DOI: 10.1007/s00210-023-02681-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
The microbiome is increasingly implicated in playing a role in physiology and pharmacology; in this review, we investigate the literature on the possibility of bacterial influence on the pharmacology of anti-asthmatic drugs, and the potential impact this has on asthmatic patients. Current knowledge in this area of research reveals an interaction between the gut and lung microbiome and the development of asthma. The influence of microbiome on the pharmacokinetics and pharmacodynamics of anti-asthmatic drugs is limited; however, understanding this interaction will assist in creating a more efficient treatment approach. This literature review highlighted that bioaccumulation and biotransformation in the presence of certain gut bacterial strains could affect drug metabolism in anti-asthmatic drugs. Furthermore, the bacterial richness in the lungs and the gut can influence drug efficacy and could also play a role in drug response. The implications of the above findings suggest that the microbiome is a contributing factor to an individuals' pharmacological response to anti-asthmatic drugs. Hence, future directions for research should follow investigating how these processes affect asthmatic patients and consider the role of the microbiome on drug efficacy and modify treatment guidelines accordingly.
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Affiliation(s)
- Michael Chan
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Chloe Ghadieh
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Isphahan Irfan
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Eamen Khair
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Natasha Padilla
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Sanshya Rebeiro
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Annabel Sidgreaves
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Vandana Patravale
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Matunga, Mumbai, Maharashtra, India
| | - John Disouza
- Department of Pharmaceutics, Tatyasaheb Kore College of Pharmacy, Warananagar, Tal: Panhala, Maharashtra, 416113, India
| | - Rachelle Catanzariti
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Lisa Pont
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Kylie Williams
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Gabriele De Rubis
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Sydney, Australia
| | - Samir Mehndiratta
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Sydney, Australia
| | | | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia.
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Sydney, Australia.
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Pearson CR, Khair E, Forsyth F, Sowden E, Deaton C. Keeping the plates spinning: a qualitative study of the multifaceted role of caregiving in HFpEF. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health Research School for Primary Care Research
OnBehalf
Optimise HFpEF
Background
Heart failure with preserved ejection fraction (HFpEF) accounts for 50% of all heart failure cases yet remains poorly understood, diagnosed and managed, which can add complexity to the caregiver role. No study to date has explicitly investigated the experiences of informal caregivers of people with HFpEF.
Objective
The aim of this study was to explore and understand the role and experiences of informal caregivers of people with HFpEF.
Methods and design
A qualitative study using semi-structured interviews involving caregivers alone, patients alone or caregiver/patient dyads. The interviews were performed as part of a larger programme of research in HFpEF. Participants were recruited from three regions of England. Interviews were transcribed verbatim and analysed thematically.
Results
22 interviews were conducted with a total of 38 participants, 17 of which were informal caregivers. Three inter-related themes were identified: (1) ‘spinning plates’ - the multifaceted nature of informal caregiving: household manager, health manager and motivator; (2) ‘the spinning falters’- the barriers to caregiving: lack of HFpEF awareness, information and support, the burden of multimorbidity, caregiver stress and the caregiver’s health status; (3) ‘keeping the plates spinning’- the facilitators of caregiving: being informed, being appreciated, having a champion (a health care professional that is key to managing the patient’s HFpEF), and engaging a wider support network.
Conclusions
Informal caregivers play an important role in supporting people with HFpEF. The experience of caregiving to people with HFpEF is similar to HFrEF, but complicated by challenges of poor HFpEF information and support, and the burden of multimorbidity. Healthcare providers should assess the needs of informal caregivers as part of patient care in HFpEF. Caregivers and patients would both benefit from improved information and management of HFpEF and associated multi-morbidities. Helping caregivers ‘keep the plates spinning’ will require innovative approaches and coordination across the care continuum.
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Affiliation(s)
- CR Pearson
- University of Cambridge, Cambridge, United Kingdom of Great Britain & Northern Ireland
| | - E Khair
- University of Cambridge, Public Health and Primary Care, Cambridge, United Kingdom of Great Britain & Northern Ireland
| | - F Forsyth
- University of Cambridge, Public Health and Primary Care, Cambridge, United Kingdom of Great Britain & Northern Ireland
| | - E Sowden
- University of Manchester, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - C Deaton
- University of Cambridge, Public Health and Primary Care, Cambridge, United Kingdom of Great Britain & Northern Ireland
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