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Nature Reviews Microbiology 3, 431–438 (1 May 2005) | doi:10.1038/nrmicro1152

Gut microorganisms, mammalian metabolism and personalized health care

Jeremy K. Nicholson , Elaine Holmes & Ian D. Wilson

The mammalian gut microbiota interact extensively with the host through metabolic exchange and co-metabolism of substrates. Such metabolome–metabolome interactions are poorly understood, but might be implicated in the aetiology of many human diseases. In this paper, we assess the importance of the gut microbiota in influencing the disposition, fate and toxicity of drugs in the host, and conclude that appropriate consideration of individual human gut microbial activities will be a necessary part of future personalized health-care paradigms.