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Hu N, Guan M, Gu B, Yang X, Qian Q, Zhao D, Xue H, Jiang J. Gene Polymorphisms Play an Important Role in the Drug Interaction Between Posaconazole and Tacrolimus in Renal Transplant Patients. Ther Drug Monit 2025; 47:330-336. [PMID: 40341589 PMCID: PMC12061382 DOI: 10.1097/ftd.0000000000001272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 08/26/2024] [Indexed: 05/10/2025]
Abstract
BACKGROUND Posaconazole (POSA), a second-generation triazole antifungal drug, inhibits CYP3A and P-glycoprotein. Here, the interaction between POSA and tacrolimus (TAC) in patients undergoing early renal transplantation was studied. METHODS Twenty-two renal transplant recipients who received POSA as antifungal therapy were studied. The following indicators were analyzed statistically: the blood concentration (C), dose (D), and concentration-dose ratio (C/D) of TAC before and after introducing POSA; the change of C/D (ΔC/D) after starting POSA; the genotypes of CYP3A5*3, ABCB1 3435, ABCB1 1236, and POR*28; other routine clinical indicators. RESULTS After starting POSA, the C, D, and C/D values of TAC were 1.29, 0.57, and 2.74 times the original values, respectively. A linear correlation was observed between the plasma levels of POSA and ΔC/D. The CYP3A5*3 gene polymorphism showed a significant impact on C, D, and C/D of TAC; however, it did not affect the ΔC/D. Polymorphism of the ABCB1 3435 gene had a significant effect on ΔC/D, and patients with the CC genotype in ABCB1 3435 had significantly lower ΔC/D than the CT/TT patients. CONCLUSIONS In renal transplant patients, considerable interindividual variability was observed in the drug interactions between POSA and TAC. The genotypes of CYP3A5*3 and ABCB1 3435 and the plasma level of POSA had strong impact on the interaction between POSA and TAC.
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Affiliation(s)
- Nan Hu
- Department of Pharmacy, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Mengmeng Guan
- Department of Pharmacy, The Third Affiliated Hospital of Soochow University, Changzhou
- College of Pharmaceutical Sciences, Soochow University, Suzhou
| | - Bin Gu
- Suzhou Medical College, Soochow University, Suzhou
| | - Xuping Yang
- Department of Pharmacy, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Qing Qian
- Department of Pharmacy, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Di Zhao
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing; and
| | - Hui Xue
- Department of Pharmacy, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Jingting Jiang
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, China
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Korkor MS, El-Desoky T, Mosaad YM, Salah DM, Hammad A. Multidrug resistant 1 (MDR1) C3435T and G2677T gene polymorphism: impact on the risk of acute rejection in pediatric kidney transplant recipients. Ital J Pediatr 2023; 49:57. [PMID: 37198710 DOI: 10.1186/s13052-023-01469-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/01/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Tacrolimus is the backbone drug in kidney transplantation. Single nucleotide polymorphism of Multidrug resistant 1 gene can affect tacrolimus metabolism consequently it can affect tacrolimus trough level and incidence of acute rejection. The aim of this study is to investigate the impact of Multidrug resistant 1 gene, C3435T and G2677T Single nucleotide polymorphisms on tacrolimus pharmacokinetics and on the risk of acute rejection in pediatric kidney transplant recipients. METHODS Typing of Multidrug resistant 1 gene, C3435T and G2677T gene polymorphism was done using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for 83 pediatric kidney transplant recipients and 80 matched healthy controls. RESULTS In Multidrug resistant 1 gene (C3435T), CC, CT genotypes and C allele were significantly associated with risk of acute rejection when compared to none acute rejection group (P = 0.008, 0.001 and 0.01 respectively). The required tacrolimus doses to achieve trough level were significantly higher among CC than CT than TT genotypes through the 1st 6 months after kidney transplantation. While, in Multidrug resistant 1 gene (G2677T), GT, TT genotypes and T allele were associated with acute rejection when compared to none acute rejection (P = 0.023, 0.033 and 0.028 respectively). The required tacrolimus doses to achieve trough level were significantly higher among TT than GT than GG genotypes through the 1st 6 months after kidney transplantation. CONCLUSION The C allele, CC and CT genotypes of Multidrug resistant 1 gene (C3435T) and the T allele, GT and TT genotypes of Multidrug resistant 1 gene (G2677T) gene polymorphism may be risk factors for acute rejection and this can be attributed to their effect on tacrolimus pharmacokinetics. Tacrolimus therapy may be tailored according to the recipient genotype for better outcome.
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Affiliation(s)
- Mai S Korkor
- Pediatric Nephrology Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Tarek El-Desoky
- Pediatric respiratory and allergy Unit, Faculty of Medicine, Mansoura University Children's Hospital, Mansoura University, Mansoura, Egypt
| | - Youssef M Mosaad
- Clinical Immunology Unit, clinical pathology department and Mansoura Research center for cord stem cells (MARC_CSC), Faculty of medicine, Mansura University, Mansoura, Egypt
| | - Doaa M Salah
- Pediatric Department, Pediatric Nephrology Unit & Kidney Transplantation Unit, Cairo University Children Hospital, Kasr Al-Ainy Faculty of Medicine, Cairo University , Cairo, Egypt
| | - Ayman Hammad
- Pediatric Nephrology Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Li Z, Wang X, Li D, Cheng S, Dong Y, Yang H, Li X. The Impact of ABCB1 SNPs on Tacrolimus Pharmacokinetics in Liver or Kidney Transplant Recipients: A Meta-analysis. Curr Pharm Des 2023; 29:2323-2335. [PMID: 37817654 DOI: 10.2174/0113816128259239231009112019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/27/2023] [Accepted: 09/08/2023] [Indexed: 10/12/2023]
Abstract
PURPOSE We aimed to investigate the association between ATP Binding Cassette Subfamily B Member 1 (ABCB1) single nucleotide polymorphisms (SNPs) and the pharmacokinetics of tacrolimus. METHODS A search was conducted in Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (SCI), MEDLINE, and Embase from inception to November 2022. Outcomes included weightadjusted daily dose (DD) and dose-adjusted trough concentration (C0/Dose). RESULTS A total of 1059 liver or kidney transplant recipients from 14 publications were included. For adult liver transplantation recipients, DD of ABCB1 3435C>T CC carriers was 0.03 mg/kg/day (WMD = 0.03, 95% CI: 0.01 to 0.05, I2 = 0%) higher than ABCB1 3435C>T T carriers at post-transplantation ≤ 7 days; C0/dose of ABCB1 3435C>T CC carriers were 31.88 (WMD = -31.88, 95% CI: -62.32 to -1.45, I2 = 83.5%) or 34.61 (ng/ml)/(mg/kg/day) (WMD = -34.61, 95% CI: -65.26 to -3.97, I2 = 55.3%) lower than ABCB1 3435C>T T carriers at post-transplantation ≤ 7 or 14 days, respectively. No difference in C0/dose was observed for ABCB1 2677G>T/A or ABCB1 1236C>T SNPs in both liver and kidney transplant recipients. CONCLUSION ABCB1 3435C>T SNP might have a potential impact on tacrolimus pharmacokinetics in the early stage after liver transplantation, indicating the probability of individualized immunosuppressive therapy based on genetic polymorphism. Given some limitations, further well-designed prospective studies are warranted to validate these conclusions.
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Affiliation(s)
- Ze Li
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Xiaozhen Wang
- Central Laboratory, Xuanwu Hospital, Capital Medical University, Beijing, 100050, China
| | - Dandan Li
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Sheng Cheng
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Yiwen Dong
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Hongge Yang
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Xingang Li
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
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Srinivas L, Gracious N, Nair RR. Pharmacogenetics Based Dose Prediction Model for Initial Tacrolimus Dosing in Renal Transplant Recipients. Front Pharmacol 2021; 12:726784. [PMID: 34916931 PMCID: PMC8669916 DOI: 10.3389/fphar.2021.726784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/09/2021] [Indexed: 01/08/2023] Open
Abstract
Tacrolimus, an immunosuppressant used in solid organ transplantation, has a narrow therapeutic index and exhibits inter-individual pharmacokinetic variability. Achieving and maintaining a therapeutic level of the drug by giving appropriate doses is crucial for successful immunosuppression, especially during the initial post-transplant period. We studied the effect of CYP3A5, CYP3A4, and ABCB1 gene polymorphisms on tacrolimus trough concentrations in South Indian renal transplant recipients from Kerala to formulate a genotype-based dosing equation to calculate the required starting daily dose of tacrolimus to be given to each patient to attain optimal initial post-transplant period drug level. We also investigated the effect of these genes on drug-induced adverse effects and rejection episodes and looked into the global distribution of allele frequencies of these polymorphisms. One hundred forty-five renal transplant recipients on a triple immunosuppressive regimen of tacrolimus, mycophenolate mofetil, and steroid were included in this study. Clinical data including tacrolimus daily doses, trough levels (C0) and dose-adjusted tacrolimus trough concentration (C0/D) in blood at three time points (day 6, 6 months, and 1-year post-transplantation), adverse drug effects, rejection episodes, serum creatinine levels, etc., were recorded. The patients were genotyped for CYP3A5*3, CYP3A4*1B, CYP3A4*1G, ABCB1 G2677T, and ABCB1 C3435T polymorphisms by the PCR-RFLP method. We found that CYP3A5*3 polymorphism was the single most strongly associated factor determining the tacrolimus C0/D in blood at all three time points (p < 0.001). Using multiple linear regression, we formulated a simple and easy to compute equation that will help the clinician calculate the starting tacrolimus dose per kg body weight to be administered to a patient to attain optimal initial post-transplant period tacrolimus level. CYP3A5 expressors had an increased chance of rejection than non-expressors (p = 0.028), while non-expressors had an increased risk for new-onset diabetes mellitus after transplantation (NODAT) than expressors (p = 0.018). Genotype-guided initial tacrolimus dosing would help transplant recipients achieve optimal initial post-transplant period tacrolimus levels and thus prevent the adverse effects due to overdose and rejection due to inadequate dose. We observed inter-population differences in allele frequencies of drug metabolizer and transporter genes, emphasizing the importance of formulating population-specific dose prediction models to draw results of clinical relevance.
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Affiliation(s)
- Lekshmy Srinivas
- Laboratory Medicine and Molecular Diagnostics, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - Noble Gracious
- Department of Nephrology, Government Medical College, Thiruvananthapuram, India
| | - Radhakrishnan R. Nair
- Laboratory Medicine and Molecular Diagnostics, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
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Radhakrishnan A, Kuppusamy G, Ponnusankar S, Mutalik S. Towards next-generation personalization of tacrolimus treatment: a review on advanced diagnostic and therapeutic approaches. Pharmacogenomics 2021; 22:1151-1175. [PMID: 34719935 DOI: 10.2217/pgs-2021-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The benefit of personalized medicine is that it allows the customization of drug therapy - maximizing efficacy while avoiding side effects. Genetic polymorphisms are one of the major contributors to interindividual variability. Currently, the only gold standard for applying personalized medicine is dose titration. Because of technological advancements, converting genotypic data into an optimum dose has become easier than in earlier years. However, for many medications, determining a personalized dose may be difficult, leading to a trial-and-error method. On the other hand, the technologically oriented pharmaceutical industry has a plethora of smart drug delivery methods that are underutilized in customized medicine. This article elaborates the genetic polymorphisms of tacrolimus as case study, and extensively covers the diagnostic and therapeutic technologies which aid in the delivery of personalized tacrolimus treatment for better clinical outcomes, thereby providing a new strategy for implementing personalized medicine.
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Affiliation(s)
- Arun Radhakrishnan
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, Tamilnadu, India
| | - Gowthamarajan Kuppusamy
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, Tamilnadu, India
| | - Sivasankaran Ponnusankar
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, Tamilnadu, India
| | - Srinivas Mutalik
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Karnataka, India
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Saab AAER, El-hadidi ES, Hussein MM, Shararah MSAEB, Aly HH. Clinical utility of ABCB1 single nucleotide polymorphism on tacrolimus dose requirements in Egyptian liver transplant patients. EGYPTIAN LIVER JOURNAL 2021. [DOI: 10.1186/s43066-021-00127-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Abstract
Background
Liver transplantation (LT) is the only effective radical cure for all types of end-stage liver diseases. Major advances have been made in the field of liver transplantation due to improvements in surgical techniques and organ conservation as well as optimization of intensive care and immunosuppressive management. We aimed to assess the influence of ABCB1 gene polymorphism of liver transplant recipients on blood level and dose requirements of oral tacrolimus, in an attempt to help in designing an individualized tacrolimus regimen for Egyptian liver transplant recipient. The study included 25 liver transplant recipients and their respective 25 donors. All subjects of this study were subjected to full medical history, clinical evaluation, laboratory investigations, and ABCB1 gene polymorphism evaluation by RT-PCR. Tacrolimus concentration was evaluated for all the recipients during the first 3 months post transplantation.
Results
The present study revealed that the presence of CC genotype was significantly correlated to the effect on tacrolimus C/D ratio and weight-adjusted tacrolimus dose during the first week of the first and 2nd months (Z = −2.108, P <0.05) but not the 3rd month post transplantation (p-value >0.05). Subjects carrying CC genotype required higher doses of tacrolimus to achieve the desired trough levels compared to subjects carrying CT and TT genotypes. The same effect was observed over the whole period of the study but the results were statistically non-significant (p-value>0.05). Recipients who received liver tissue from donors carrying CC genotype also required higher doses of tacrolimus and reached lower levels of blood tacrolimus trough levels.
Conclusion
The present study revealed that ABCB1 CC genotype of both recipients and donors of liver transplantation was significantly associated with increased required tacrolimus dose early after liver transplantation reaching statistically significant level in the first week of the first and second months.
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Mendrinou E, Mashaly ME, Al Okily AM, Mohamed ME, Refaie AF, Elsawy EM, Saleh HH, Sheashaa H, Patrinos GP. CYP3A5 Gene-Guided Tacrolimus Treatment of Living-Donor Egyptian Kidney Transplanted Patients. Front Pharmacol 2020; 11:1218. [PMID: 32848803 PMCID: PMC7431691 DOI: 10.3389/fphar.2020.01218] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/27/2020] [Indexed: 01/07/2023] Open
Abstract
Background Tacrolimus is an approved first-line immunosuppressive agent for kidney transplantations. Part of interindividual and interethnic differences in the response of patients to tacrolimus is attributed to polymorphisms at CYP3A5 metabolic enzyme. CYP3A5 gene expression status is associated with tacrolimus dose requirement in renal transplant recipients. Materials and Methods In this study, we determined the allelic frequency of CYP3A5*3 in 76 renal transplanted patients of Egyptian descent. Secondly, we evaluated the influence of the CYP3A5 gene variant on tacrolimus doses required for these patients as well on dose-adjusted tacrolimus trough-concentrations. Results The CYP3A5*3 variant was the most frequent allele detected at 85.53%. Additionally, our results showed that, mean tacrolimus daily requirements for heterozygous patients (CYP3A5*1/*3) were significantly higher compared to homozygous patients (CYP3A5*3/*3) during the first year after kidney transplantation. Conclusion This is the first study in Egypt contributing to the individualization of tacrolimus dosing in Egyptian patients, informed by the CYP3A5 genotype.
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Affiliation(s)
- Effrosyni Mendrinou
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Mohamed Elsayed Mashaly
- The Urology-Nephrology Center, Department of Dialysis and Transplantation, Mansoura University, Mansoura, Egypt
| | | | | | - Ayman Fathi Refaie
- The Urology-Nephrology Center, Department of Dialysis and Transplantation, Mansoura University, Mansoura, Egypt
| | - Essam Mahmoud Elsawy
- Urology and Nephrology Center, Department of Laboratories, Mansoura University, Mansoura, Egypt
| | - Hazem Hamed Saleh
- Urology and Nephrology Center, Department of Laboratories, Mansoura University, Mansoura, Egypt
| | - Hussein Sheashaa
- The Urology-Nephrology Center, Department of Dialysis and Transplantation, Mansoura University, Mansoura, Egypt
| | - George P Patrinos
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece.,Zayed Center of Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.,Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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Leung ICY, Chong CCN, Cheung TT, Yeung PC, Ng KKC, Lai PBS, Chan SL, Chan AWH, Tang PMK, Cheung ST. Genetic variation in ABCB5 associates with risk of hepatocellular carcinoma. J Cell Mol Med 2020; 24:10705-10713. [PMID: 32783366 PMCID: PMC7521249 DOI: 10.1111/jcmm.15691] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/02/2020] [Accepted: 07/10/2020] [Indexed: 01/05/2023] Open
Abstract
Expression of ATP‐binding cassette B5 (ABCB5) has been demonstrated to confer chemoresistance, enhance cancer stem cell properties and associate with poor prognosis in hepatocellular carcinoma (HCC). The aim of this study was to evaluate the genetic variations of ABCB5 in HCC patients with reference to healthy individuals and the clinicopathological significance. A pilot study has examined 20 out of 300 pairs HCC and paralleled blood samples using conventional sequencing method to cover all exons and exon/intron regions to investigate whether there will be novel variant sequence and mutation event. A total of 300 HCC and 300 healthy blood DNA samples were then examined by Sequenom MassARRAY genotyping and pyrosequencing for 38 SNP and 1 INDEL in ABCB5. Five novel SNPs were identified in ABCB5. Comparison of DNA from blood samples of HCC and healthy demonstrated that ABCB5 SNPs rs75494098, rs4721940 and rs10254317 were associated with HCC risk. Specific ABCB5 variants were associated with aggressive HCC features. SNP rs17143212 was significantly associated with ABCB5 expression level. Nonetheless, the paralleled blood and tumour DNA sequences from HCC patients indicated that ABCB5 mutation in tumours was not common and corroborated the TCGA data sets. In conclusion, ABCB5 genetic variants had significant association with HCC risk and aggressive tumour properties.
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Affiliation(s)
- Idy C-Y Leung
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Charing C-N Chong
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Tan T Cheung
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Philip C Yeung
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Kelvin K-C Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Paul B-S Lai
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Stephen L Chan
- State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Sir YK Pao Centre for Cancer, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Anthony W-H Chan
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Patrick M-K Tang
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Siu T Cheung
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Li Ka Shing Institute of Health Sciences, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Naushad SM, Pavani A, Rupasree Y, Hussain T, Alrokayan SA, Kutala VK. Recipient ABCB1, donor and recipient CYP3A5 genotypes influence tacrolimus pharmacokinetics in liver transplant cases. Pharmacol Rep 2019; 71:385-392. [PMID: 31003147 DOI: 10.1016/j.pharep.2019.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/30/2018] [Accepted: 01/10/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Effective immunosuppression through optimization of trough levels tacrolimus reduces post-transplant mortality rate in liver transplant cases. METHODS Meta-analysis was carried out to evaluate how donor/recipient CYP3A5 (n = 678) and recipient ABCB1 (n = 318) genotypes influence tacrolimus pharmacokinetics till one-month of transplantation. RESULTS The donor CYP3A5*3/*3 genotype exhibited higher concentration/dose (C/D) ratio of tacrolimus in week 1 (mean difference: 65.04, 95% CI: 15.30-114.79 ng/ml/mg/kg), week 2 (mean difference: 21.7, 95% CI: 12.6-30.9 ng/ml/mg/kg) and week 4 (mean difference: 43.28, 95% CI: 17.09 - 69.49 ng/ml/mg/kg) compared to *1/*1 and *1/*3 genotypes. The recipient CYP3A5 *3/*3 genotype did not showed significant difference in tacrolimus C/D ratio in week 1 compared to other two genotypes. However, week 2 (mean difference: 44.16, 95% CI: 3.68-84.65 ng/ml/mg/kg) and week 4 (mean difference: 43.74, 95% CI: 12.50-75.00 ng/ml/mg/kg) availability was higher in *3/*3 mutant recipients. However, the recipient ABCB1 3435 C > T polymorphism has no significant influence on tacrolimus pharmacokinetics till one month of transplant. CONCLUSIONS The donor and recipient CYP3A5*3 polymorphism influences tacrolimus pharmacokinetics in the first month post-transplantation, whereas the association with recipient ABCB1 3435 C > T is inconclusive.
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Affiliation(s)
| | - Addepalli Pavani
- Department of Pharmacogenomics, Sandor Lifesciences Pvt Ltd, Hyderabad, India
| | - Yedluri Rupasree
- Department of Pharmacogenomics, Sandor Lifesciences Pvt Ltd, Hyderabad, India
| | - Tajamul Hussain
- Center of Excellence in Biotechnology Research, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Salman A Alrokayan
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Vijay Kumar Kutala
- Department of Clinical Pharmacology and Therapeutics, Nizam's Institute of Medical Sciences, Hyderabad, India
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