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CYP3A5基因多态性、ABCB1基因C3435T和G2677T/A多态性对中国成年肝移植患者他克莫司药代动力学的影响。

Effects of CYP3A5 genotypes, ABCB1 C3435T and G2677T/A polymorphism on pharmacokinetics of Tacrolimus in Chinese adult liver transplant patients.

作者信息

Zhu LiQin, Yang JianWei, Zhang Yuan, Jing YaQing, Zhang YanWen, Li Guang

机构信息

a Department of Pharmacy , Tianjin First Central Hospital , Tianjin , China and.

出版信息

Xenobiotica. 2015;45(9):840-6. doi: 10.3109/00498254.2015.1021733. Epub 2015 Jun 12.

Abstract

1. The purpose of this study was to establish a population pharmacokinetic (PK) model of tacrolimus and evaluate the influence of clinical covariates, including the genetic polymorphisms of the cytochrome P450 3A5 gene (CYP3A5) and gene-encoding P-glycoprotein (ABCB1), on the PK parameters in Chinese adult liver transplant recipients. 2. Details of drug dose, sampling times and concentrations were collected retrospectively from routine therapeutic drug monitoring data early after liver transplant. Tacrolimus PKs was studied by a non-linear mixed-effect modeling (NONMEM) method. CYP3A5 genotypes, ABCB1 C3435T and G2677T/A polymorphism and a number of clinical covariates were tested for their influence on TAC PKs. 3. A one-compartment model with first-order absorption and elimination adequately described the data. Apparent clearance (CL/F) and apparent volumes of distribution (V/F) in final population model were 17.6 L/h and 225 L, respectively. The absorption rate constant (Ka) was fixed at 4.48 h(-1). The inter-individual variability in CL/F and V/F was 53.9 and 68%, respectively. In the final model, CYP3A5 genotype, post-operative day, alanine aminotransferase, total bilirubin, hematocrit and blood urea nitrogen were found to significantly influence the CL/F, whereas POD and HB influence V/F. 4. Population PK analysis of tacrolimus in Chinese adult liver transplant patients resulted in identification of the CYP3A5 genotype, POD, BUN, ALP, HCT, TBIL and HB as significant covariates on the PK parameters of tacrolimus.

摘要
  1. 本研究的目的是建立他克莫司的群体药代动力学(PK)模型,并评估临床协变量,包括细胞色素P450 3A5基因(CYP3A5)和编码P-糖蛋白基因(ABCB1)的基因多态性对中国成年肝移植受者PK参数的影响。2. 从肝移植术后早期的常规治疗药物监测数据中回顾性收集药物剂量、采样时间和浓度的详细信息。采用非线性混合效应建模(NONMEM)方法研究他克莫司的药代动力学。测试CYP3A5基因型、ABCB1 C3435T和G2677T/A多态性以及一些临床协变量对他克莫司药代动力学的影响。3. 具有一级吸收和消除的单室模型能充分描述数据。最终群体模型中的表观清除率(CL/F)和表观分布容积(V/F)分别为17.6 L/h和225 L。吸收速率常数(Ka)固定为4.48 h⁻¹。CL/F和V/F的个体间变异性分别为53.9%和68%。在最终模型中,发现CYP3A5基因型、术后天数、丙氨酸转氨酶、总胆红素、血细胞比容和血尿素氮对CL/F有显著影响,而术后天数和血红蛋白对V/F有影响。4. 对中国成年肝移植患者他克莫司的群体PK分析结果表明,CYP3A5基因型、术后天数、血尿素氮、碱性磷酸酶、血细胞比容、总胆红素和血红蛋白是他克莫司PK参数的显著协变量。

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