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白细胞介素-10 基因多态性对中国肝移植患者移植后早期他克莫司剂量需求的影响。

Impact of interleukin-10 gene polymorphisms on tacrolimus dosing requirements in Chinese liver transplant patients during the early posttransplantation period.

机构信息

Department of Pharmacy, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, 200080, China.

出版信息

Eur J Clin Pharmacol. 2011 Aug;67(8):803-13. doi: 10.1007/s00228-011-0993-8. Epub 2011 Feb 26.

Abstract

AIM

Pharmacogenetics holds the potential to elucidate the inherited basis of differences between individual responses to drugs. Impacts of CYP3A5 and ABCB1 gene polymorphisms on the immunosuppressant tacrolimus have been reported in previous studies of liver transplantation. The functions of interleukin-10 (IL-10) gene expression are complex in the early period after liver transplantation. In this study, we examined the IL-10 genotypes of both recipients and donors to clarify the influence of these genetic variants on tacrolimus dose requirements and pharmacokinetics.

METHODS

Genetic polymorphisms of IL-10, CYP3A5, and ABCB1 were evaluated for 53 liver transplant recipients and 53 donors. Tacrolimus doses and blood concentrations were determined at 1, 2, and 3 weeks, and 1 month after transplantation. IL-10 polymorphisms at G-1082A, C-819 T, and C-592A; CYP3A5 polymorphisms at A6986G; and ABCB1 polymorphisms at C1236T, G2677T, and C3435T were assessed by PCR amplification and DNA sequencing.

RESULTS

Recipients who received organs from CYP3A5*3/*3 donors had higher tacrolimus C/D ratios. In the first 2 weeks, the tacrolimus C/D ratios of the recipients with donors who were CYP3A5 nonexpressors and had a low IL-10 production genotype (-819TT, -592 AA) were higher than those with donors who were CYP3A5 nonexpressors and had a high IL-10 production genotype (-819CC or CT, -592CC or AC). There were no significant differences in laboratory data or clinical characteristics (which could influence the tacrolimus C/D ratio) between the two groups of patients (P > 0.05).

CONCLUSION

Determining IL-10 and CYP3A5 polymorphisms of donors may allow individualized tacrolimus dosage regimens to be determined for liver transplant patients during the early posttransplantation period.

摘要

目的

药物遗传学有可能阐明个体对药物反应差异的遗传基础。先前的肝移植研究报道了 CYP3A5 和 ABCB1 基因多态性对免疫抑制剂他克莫司的影响。白细胞介素 10(IL-10)基因表达的功能在肝移植后早期较为复杂。在这项研究中,我们检测了受体和供体的 IL-10 基因型,以阐明这些遗传变异对他克莫司剂量需求和药代动力学的影响。

方法

评估了 53 例肝移植受者和 53 例供者的 IL-10、CYP3A5 和 ABCB1 的遗传多态性。在移植后 1、2、3 周和 1 个月时测定他克莫司剂量和血药浓度。通过 PCR 扩增和 DNA 测序评估 IL-10 的 G-1082A、C-819T 和 C-592A 多态性、CYP3A5 的 A6986G 多态性以及 ABCB1 的 C1236T、G2677T 和 C3435T 多态性。

结果

接受 CYP3A5*3/*3 供者器官的受者他克莫司 C/D 比值较高。在前 2 周,CYP3A5 无表达且 IL-10 产生低基因型(-819TT、-592AA)的受者的他克莫司 C/D 比值高于 CYP3A5 无表达且 IL-10 产生高基因型(-819CC 或 CT、-592CC 或 AC)的供者。两组患者的实验室数据或临床特征(可能影响他克莫司 C/D 比值)无显著差异(P>0.05)。

结论

确定供者的 IL-10 和 CYP3A5 多态性可能允许在肝移植患者移植后早期确定个体化的他克莫司剂量方案。

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