Turolo Stefano, Edefonti Alberto, Syren Marie Luise, Montini Giovanni
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Nephrology, Dialysis and Transplant Unit, 20122 Milan, Italy.
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
J Clin Med. 2023 Jul 3;12(13):4454. doi: 10.3390/jcm12134454.
Kidney transplantation is the preferred therapeutic option for end-stage kidney disease, but, despite major therapeutic advancements, allograft rejection continues to endanger graft survival. Every patient is unique due to his or her clinical history, drug metabolism, genetic background, and epigenetics. For this reason, examples of "personalized medicine" and "precision medicine" have steadily increased in recent decades. The final target of precision medicine is to maximize drug efficacy and minimize toxicity for each individual patient. Immunosuppressive drugs, in the setting of kidney transplantation, require a precise dosage to avoid either adverse events (overdosage) or a lack of efficacy (underdosage). In this review, we will explore the knowledge regarding the pharmacogenomics of the main immunosuppressive medications currently utilized in kidney transplantation. We will focus on clinically relevant pharmacogenomic data, that is, the polymorphisms of the genes that metabolize immunosuppressive drugs.
肾移植是终末期肾病的首选治疗方案，然而，尽管治疗取得了重大进展，但同种异体移植排斥反应仍然危及移植物存活。由于每位患者的临床病史、药物代谢、基因背景和表观遗传学不同，所以每个患者都是独特的。因此，近几十年来，“个性化医疗”和“精准医疗”的实例稳步增加。精准医疗的最终目标是使每位患者的药物疗效最大化且毒性最小化。在肾移植中，免疫抑制药物需要精确的剂量，以避免不良事件（用药过量）或疗效不佳（用药不足）。在本综述中，我们将探讨目前肾移植中使用的主要免疫抑制药物的药物基因组学知识。我们将重点关注临床相关的药物基因组学数据，即代谢免疫抑制药物的基因多态性。
