Aspirin
Although many people enjoy their daily cup of coffee, most are likely unaware of how coffee affects the gut microbiome, particularly in relation to aspirin. In a prospective study by Kim and colleagues, administration of coffee bean extract changed the biodiversity of gut bacteria, leading to an increase in the number of Lactobacillaceae and Muribaculaceae organisms in the gut and a decrease in Proteobacteria, Helicobacteriaceae, and Bacteroidaceae concentrations.[6] The researchers also evaluated blood concentrations of aspirin in mice as well as adult men treated with a combination of coffee bean extract and aspirin. Gut bacteria hydrolyze aspirin to an ionized form that is less likely to be absorbed in the intestines, but because coffee bean extract impairs the activity of gut microbes, the coffee-aspirin combination resulted in increased concentrations of nonionized, highly bioavailable drug (the absolute increase in absorption was very small, however).[6]
Interestingly, and apart from its cardiovascular uses, aspirin may also confer a protective effect against colorectal cancer by modulating gut flora. Results from Prizment and colleagues' pilot randomized, controlled trial of 50 patients demonstrated that a 6-week course of aspirin was associated with an increase in the number of Akkermansia organisms, which have been associated with improved survival and anticancer immune responses in patients with colorectal cancer.[11] Aspirin also reduced the concentrations of Parabacteroides and Dorea species, which are typically increased in these patients.[11]
US Pharmacist. 2023;48(2):18-22. © 2023 Jobson Publishing
