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Preventing drug reactivation and toxicity by inhibiting gut microbial enzymes. (A) Microbial cleavage of the glucuronidated drug conjugate of the cancer chemotherapeutic SN-38 leads to drug reactivation and toxicity within the gut. UDP, uridine diphosphate. (B) High-throughput screening identified specific inhibitors of bacterial β-glucuronidases. These compounds alleviated the GI toxicity associated with irinotecan metabolism. Et, ethyl.
