MINI REVIEW article
Front. Aging
Sec. Aging and the Immune System
Volume 6 - 2025 | doi: 10.3389/fragi.2025.1603847
This article is part of the Research TopicImpact of Aging Gut Microbiota and Mucosal Immunology in HealthView all articles
Drug-Mediated Disruption of the Aging Gut Microbiota and Mucosal Immune System
Provisionally accepted
- Lake Erie College of Osteopathic Medicine, Erie, United States
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The human gut microbiota is comprised predominantly of bacteria, and also includes archaea, fungi, and viruses. The gastrointestinal epithelium, mucosal barrier, and mucosal immune system balance protection against infection at mucosal entry points with symbiosis and tolerance to non-harmful organisms and antigens. Aging is associated with notable changes in both gut microbiota and mucosal immunity, including reduced microbial diversity, increased proportion of pathobionts relative to commensals, immunosenescence, and chronic inflammation. These changes may disrupt gastrointestinal function and homeostasis and increase susceptibility to infection and inflammatory conditions. Multiple drug classes are also associated with disruption of the gut microbiota and mucosal immunity, including antibacterials, proton pump inhibitors (PPIs), metformin, and steroidal and non-steroidal anti-inflammatory agents. This review describes the mechanisms by which these drugs affect the gut microbiota and mucosal immunity to provide perspective of the concurrent effects of drugs and age-related changes.
Keywords: Aging, Gut Microbiota, mucosal immunity, antibacterials, PPIs, Metformin, Anti-Inflammatory Agents, corticosteroids
Received: 01 Apr 2025; Accepted: 18 Sep 2025.
Copyright: © 2025 Totleben, Thomas and Austin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Daniel Austin, daustin@lecom.edu
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