Not all drugs are effective for all patients. Occasionally, susceptible people may have adverse reactions to drugs. In today's study, researchers from Imperial College London and Pfizer RD said that before taking a dose of medicine, by observing the level of different metabolites (i.e. metabolites) in urine, we can predict the reaction of different individuals to a drug.

The researchers said that this "metabolic analysis" may eventually become a valuable tool for predicting the response of different individuals to drugs, enabling drug developers to match drug treatment according to individual needs and avoid adverse side effects. They believe that those who develop new personalized drug methods need to consider metabolism and gene analysis when developing drugs, so as to fully describe the composition of different individuals.

The metabolic spectrum reflects the complex gene-environment interaction and the activity of intestinal bacteria - factors that can affect drug metabolism and toxicity.

Bacteria or intestinal microorganisms in the intestine coexist in humans and animals, and people are increasingly aware that they play an important role in affecting human metabolic composition. Today's research provides evidence that gut microbes play a crucial role in determining a person's response to a specific drug.

The new study investigated 99 healthy male volunteers aged between 18 and 64 who took a dose of acetaminophen, a commonly used painkiller widely known as paracetamol in the UK. The researchers collected urine samples from these men before and within 6 hours after taking paracetamol dose, and analyzed the metabolites in the samples using 1H NMR spectroscopy.

The research results showed that a compound called p-cresol sulfate was extracted from p-cresol produced by intestinal bacteria and was an indicator of how men metabolize the dose of paracetamol. Those with higher p-cresol content in the body metabolize the drug differently from those with lower p-cresol content in the body. Scientists believe that this is because the human body uses sulfur compounds to effectively treat paracetamol and other drugs, and p-cresol can deplete the sulfur compounds in the body.

Researchers said that the human body uses sulfur to treat various drugs, not only paracetamol, so the new discovery of p-cresol may have a significant impact on a whole group of drugs. Further work is needed to explore such fields as the relationship between p-cresol and other drugs, and whether p-cresol is related to acetaminophen accidental poisoning.

Researchers also suggested that when bacteria in the gut affect the ability of the human body to process specific drugs, the composition of these bacteria may eventually change, so that the human body can process various drugs more effectively and safely.

Senior author of this study Professor Jeremy Nicholson of the Department of Biomolecular Medicine at Imperial College London said: "This result is very encouraging. Preclinical studies have shown that it is possible to predict the individual's response to drugs by observing the distribution of pre-dose metabolites, but this is the first time that someone can convincingly prove that this test can work in humans. The beauty of pre-dose metabolites analysis is that it can excavate the genetic and environmental factors that affect the results of drug treatment.

"Our findings also highlight the potential importance of intestinal bacteria in determining the response of different people to drug treatment. This study gives us some unexpected insights into how normal adults are exposed to microbial metabolites, and how their sulfur reserves are relatively easily consumed. This may have a broader impact on understanding the development of some diseases, in which the destruction of sulfur metabolism is an important factor Professor Nicholson added.

Dr. Jeremy Everett is the vice president of the Pfizer Global Research and Development Center in Sandwich, UK, and another author of the study, He said: "Pfizer and other pharmaceutical companies are using genetic information to select the target of drug action, and also select the patients who will benefit the most from specific drug treatment during clinical trials and drug marketing. Although this is the first of the same kind of research, further research is needed, but this discovery indicates that in the future, researchers may need to select the target of drug discovery project and patients for future clinical trials Consider human metabolic spectrum and genetic spectrum. "