他克莫司意外过量血药浓度：牢记炎症的作用。
Unexpected overdose blood concentration of tacrolimus: Keep in mind the role of inflammation.
作者信息
Bonneville Edouard, Gautier-Veyret Elodie, Ihl Cordelia, Hilleret Marie-Noelle, Baudrant Magalie, Fonrose Xavier, Stanke-Labesque Françoise
机构信息
Laboratory of Pharmacology-Pharmacogenetics-Toxicology, Pôle de Biologie et Pathologie, CHU, Grenoble, Alpes, France.
Inserm, CHU Grenoble Alpes, HP2, Univ. Grenoble Alpes, Grenoble, 38000, France.
出版信息
Br J Clin Pharmacol. 2020 Sep;86(9):1888-1891. doi: 10.1111/bcp.14292. Epub 2020 Apr 20.
Abstract
Tacrolimus is the cornerstone of the therapeutic immunosuppressive strategy in liver transplantation. The inter-individual and intra-individual variability of its trough blood concentrations is a surrogated biomarker of allograft rejection. Here we described two cases of patients with liver transplant who exhibited increases of tacrolimus blood trough concentration adjusted on the dose while experiencing acute inflammatory episodes. These case reports highlight the inhibitory effect of acute inflammation on tacrolimus metabolism and show that it accounts for the longitudinal intra-individual variability of tacrolimus blood concentrations, beyond drug-drug interaction and observance.
摘要
他克莫司是肝移植治疗性免疫抑制策略的基石。其血药谷浓度的个体间和个体内变异性是同种异体移植排斥反应的替代生物标志物。在此，我们描述了两例肝移植患者的病例，他们在经历急性炎症发作时，尽管调整了剂量，但他克莫司血药谷浓度仍升高。这些病例报告突出了急性炎症对他克莫司代谢的抑制作用，并表明这是他克莫司血药浓度个体内纵向变异性的原因，而非药物相互作用和服药依从性。
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