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CYP3A5和ABCB1基因分型影响肾移植受者中他克莫司和西罗莫司的药代动力学。

CYP3A5 and ABCB1 genotype influence tacrolimus and sirolimus pharmacokinetics in renal transplant recipients.

作者信息

Li Yi, Yan Lin, Shi Yunying, Bai Yangjuan, Tang Jiangtao, Wang Lanlan

机构信息

Department of Clinical Immunological Laboratory, West China Hospital, Sichuan University, Chengdu, 610041 The People's Republic of China.

Department of Nephrology, West China Hospital, Sichuan University, Chengdu, 610041 The People's Republic of China.

出版信息

Springerplus. 2015 Oct 23;4:637. doi: 10.1186/s40064-015-1425-5. eCollection 2015.

Abstract

CYP3A5 and ABCB1 polymorphisms have been shown to influence tacrolimus blood concentrations and dose requirements, but the conclusion in the current reports were inconformity. Sirolimus are also metabolized by CYP3A subfamily and are substrates of the P-gp. The aim was to determine whether these polymorphisms affect tacrolimus (TAC) and sirolimus (SRL) trough concentrations and dose requirements after renal transplantation. 153 renal transplant recipients were enrolled into this study, 112 were treated with TAC-based regimen, Another 43 recipients received SRL-based regimen. The recipients' mean follow-up time was 20 mo (range 15-27 mo). All renal transplant recipients were all in a stable stage. The trough concentration and daily dose of TAC and SRL were gained from each recipient. All recipients were genotyped for CYP3A5 (6986A>G), CYP3A4 intron 6 (CYP3A422), CYP3A418, ABCB1 exon 26 (3435C>T), exon 12 (1236C>T) and 2677G>T/A SNPs by HRM analysis (high-resolution melting curve analysis). The TAC and SRL concentration/dose ratio (C/D) in recipients with CYP3A5 ()3/()3 were significantly higher than that of those with (*)1 allele (P < 0.05). However, there was no significant correlation between adjusted TAC and SRL trough concentrations or dose requirements with CYP3A4 and ABCB1 SNPs genetic polymorphisms. In recipients with TAC-based or SRL-based therapy, the CYP3A5 genes (6986A>G) can influence the TAC and SRL pharmacokinetics in renal transplant recipients.

摘要

细胞色素P450 3A5(CYP3A5)和三磷酸腺苷结合盒转运蛋白B1(ABCB1)基因多态性已被证明会影响他克莫司的血药浓度和剂量需求,但目前报告中的结论并不一致。西罗莫司也由细胞色素P450 3A亚家族代谢,并且是P-糖蛋白的底物。本研究旨在确定这些基因多态性是否会影响肾移植后他克莫司(TAC)和西罗莫司(SRL)的谷浓度及剂量需求。153例肾移植受者纳入本研究,其中112例接受基于他克莫司的治疗方案,另外43例接受基于西罗莫司的治疗方案。受者的平均随访时间为20个月(范围15 - 27个月)。所有肾移植受者均处于稳定期。获取每位受者的他克莫司和西罗莫司的谷浓度及每日剂量。通过高分辨率熔解曲线分析(HRM分析)对所有受者进行细胞色素P450 3A5(6986A>G)、细胞色素P450 3A4内含子6(CYP3A422)、CYP3A418、ABCB1第26外显子(3435C>T)、第12外显子(1236C>T)和2677G>T/A单核苷酸多态性(SNP)基因分型。携带CYP3A5()3/()3的受者中他克莫司和西罗莫司的浓度/剂量比(C/D)显著高于携带(*)1等位基因的受者(P<0.05)。然而,调整后的他克莫司和西罗莫司谷浓度或剂量需求与细胞色素P450 3A4和ABCB1单核苷酸多态性基因多态性之间无显著相关性。在接受基于他克莫司或基于西罗莫司治疗的受者中,CYP3A5基因(6986A>G)可影响肾移植受者中他克莫司和西罗莫司的药代动力学。

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