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白细胞介素-6 和白细胞介素-10 基因型对肾移植受者他克莫司剂量需求的影响:蒙特卡罗分析。

Impact of IL-6 and IL-10 genotypes on tacrolimus dose requirements in kidney transplant recipients: Monte Carlo analysis.

机构信息

University of Nis, Faculty of Medicine, Department of Pharmacy, Nis, Serbia.

University of Nis, Faculty of Medicine, Nis, Serbia.

出版信息

Pharmacogenomics. 2024;25(7):315-327. doi: 10.1080/14622416.2024.2379227. Epub 2024 Jul 29.

Abstract

IL-6 and IL-10 may affect the activity of cytochrome P450 (CYP) 3A enzymes involved in tacrolimus (Tac) metabolism. Moreover, the effect of IL-6 and IL-10 on Tac pharmacokinetics may differ with respect to the genetic variations in their genes. To examine the influence of IL-6 and IL-10 gene polymorphisms on Tac dose requirements and exposure over a 5-year period following kidney transplantation. Univariate and standard multivariate linear regression and Monte Carlo analysis were performed to investigate potential covariates influencing Tac dose-adjusted trough concentration (C/D) in various post-transplantation periods. IL-6 (-174G > C), IL-10 (-1082G > A, -819C > T and -592C > A) genotype, Tac daily dose, C, C/D and intrapatient variability data were collected from 113 patients. Multivariate regression analysis and accompanied Monte Carlo simulation underscore the importance of considering IL-6 -174G > C and IL-10 -1082G > A gene polymorphisms, alongside Tac metabolic phenotype and post-transplantation period, when tailoring Tac dosage regimen. This study provides valuable insights regarding the individualized adjustment of Tac treatment in various post-transplantation periods.

摘要

IL-6 和 IL-10 可能影响细胞色素 P450 (CYP) 3A 酶的活性,这些酶参与他克莫司 (Tac) 的代谢。此外,IL-6 和 IL-10 对 Tac 药代动力学的影响可能因基因的遗传变异而有所不同。为了研究 IL-6 和 IL-10 基因多态性对肾移植后 5 年内 Tac 剂量需求和暴露的影响。采用单变量和标准多变量线性回归和蒙特卡罗分析,研究了在不同移植后时期影响 Tac 剂量调整后的谷浓度 (C/D) 的潜在协变量。收集了 113 名患者的 IL-6(-174G>C)、IL-10(-1082G>A、-819C>T 和 -592C>A)基因型、Tac 日剂量、C、C/D 和患者内变异性数据。多变量回归分析和伴随的蒙特卡罗模拟强调了在调整 Tac 剂量方案时,除了 Tac 代谢表型和移植后时期外,还需要考虑 IL-6-174G>C 和 IL-10-1082G>A 基因多态性的重要性。本研究为个体化调整 Tac 治疗在不同移植后时期提供了有价值的见解。

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