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Gut microbes get first dibs on heart meds

The next time you pop a pill, know that the microbes in your gut might get to it before you do. Some people harbor a strain of bacteria that inactivates a common cardiac drug, a finding that could explain why people have different reactions to some medications.

“Microbes have long been known to ‘steal’ drugs by converting them into inactive forms,” says Peter Turnbaugh of Harvard University, who led the study. But picking out the specific culprits among the gut’s throngs of bacterial suspects has been a challenge for scientists, he says.

Turnbaugh’s team focused on microbial interactions with the cardiac drug digoxin. Made by the foxglove plant, digoxin has been used for more than 200 years to treat irregular heartbeat. More than 30 years ago, scientists discovered that some patients harbor a common gut bacterium, Eggerthella lenta, that could convert the drug to an inactive form, dihydrodigoxin. But researchers were confounded by the observation that some E. lenta carriers still had the active drug in their blood.

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