Application of calcineurin inhibitor guided by CYP3A5 genotypes after liver transplantation
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摘要: 肝移植术后早期的成功移植和长期优质的生活取决于免疫抑制剂治疗效果和不良反应之间的平衡,仅保持治疗性药物有效的血药浓度水平是有局限性的,还需根据受者的细胞色素P4503A5(CYP3A5)遗传背景和个体的高危因素选择合适的钙神经蛋白抑制剂(CNI),并选择适当的药物剂量。但目前CYP3A5与环孢素(CsA)合适剂量或初始剂量之间的关系仍需要进一步探讨。本文从CYP3A5的特点、CYP3A5基因表达对肝移植术后CNI用药的影响、CYP3A5基因多态性对临床疗效的影响、根据基因型个性化精准化选用CNI等方面进行述评。关注CNI的精准化用药,从针对所有受者的综合治疗方案向个性化精准化治疗方案转变。
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表 1 既往部分选择CsA受者的供、受者基因型列表
Table 1. Donors and recipients genotype list of partly previously selected CsA recipients
序 号 供者 受者 1 CYP3A5*1/*1 CYP3A5*1/*3 2 CYP3A5*1/*3 CYP3A5*1/*3 3 CYP3A5*1/*1 CYP3A5*3/*3 4 CYP3A5*1/*3 CYP3A5*1/*3 5 CYP3A5*1/*3 CYP3A5*1/*3 6 CYP3A5*1/*3 CYP3A5*1/*1 7 CYP3A5*1/*3 CYP3A5*1/*3 表 2 既往部分选择FK506受者的供、受者基因型列表
Table 2. Donors and recipients genotype list of partly previously selected FK506 recipients
序 号 供者 受者 1 CYP3A5*3/*3 CYP3A5*3/*3 2 CYP3A5*1/*3 CYP3A5*3/*3 3 CYP3A5*3/*3 CYP3A5*1/*3 4 CYP3A5*3/*3 CYP3A5*3/*3 5 CYP3A5*1/*3 CYP3A5*3/*3 6 CYP3A5*3/*3 CYP3A5*1/*3 7 CYP3A5*3/*3 CYP3A5*3/*3 8 CYP3A5*3/*3 CYP3A5*3/*3 9 CYP3A5*3/*3 CYP3A5*1/*3 -
[1] FANG Y, GAO J, WANG T, et al. Intraindividual variation and correlation of cytochrome P450 activities in human liver microsomes[J]. Mol Pharm, 2018, 15(11):5312-5318. DOI: 10.1021/acs.molpharmaceut.8b00787. [2] LIAO JH, LI CC, WU SH, et al. Gene variations of sixth complement component affecting tacrolimus metabolism in patients with liver transplantation for hepatocellular carcinoma[J]. Chin Med J (Engl), 2017, 130(14):1670-1676. DOI: 10.4103/0366-6999.209886. [3] REN L, TENG M, ZHANG T, et al. Donors FMO3 polymorphisms affect tacrolimus elimination in Chinese liver transplant patients[J]. Pharmacogenomics, 2017, 18(3):265-275. DOI: 10.2217/pgs-2016-0098. [4] CZERWIŃSKI M, AMUNOM I, PIRYATINSKY V, et al. Direct and cytokine-mediated effects of albumin-fused growth hormone, TV-1106, on CYP enzyme expression in human hepatocytes in vitro[J]. Pharmacol Res Perspect, 2018, 6(3):e00397. DOI: 10.1002/prp2.397. [5] PASTERNAK AL, ZHANG L, HERTZ DL. CYP3A pharmacogenetic association with tacrolimus pharmacokinetics differs based on route of drug administration[J]. Pharmacogenomics, 2018, 19(6):563-576. DOI: 10.2217/pgs-2018-0003. [6] HENDERSON LM, CLAW KG, WOODAHL EL, et al. P450 pharmacogenetics in Indigenous North American populations[J]. J Pers Med, 2018, 8(1): E9. DOI: 10.3390/jpm8010009. [7] LIN G, ZHANG X, ZHANG K, et al. Evaluation of tacrolimus-related CYP3A5 genotyping in China: results from the first external quality assessment exercise[J]. J Clin Lab Anal, 2018, 32(8):e22563. DOI: 10.1002/jcla.22563. [8] KANEKO T, ARAI M, WATANABE A, et al. Effectiveness of measuring genetic polymorphisms in metabolizing enzymes of tacrolimus within one medical facility[J]. J Nippon Med Sch, 2017, 84(6):274-279. DOI: 10.1272/jnms.84.274. [9] LIU J, OUYANG Y, CHEN D, et al. Donor and recipient P450 gene polymorphisms influence individual pharmacological effects of tacrolimus in Chinese liver transplantation patients[J]. Int Immunopharmacol, 2018, 57:18-24. DOI: 10.1016/j.intimp.2018.02.005. [10] DENG R, LIAO Y, LI Y, et al. Association of CYP3A5, CYP2C8, and ABCB1 polymorphisms with early renal injury in Chinese liver transplant recipients receiving tacrolimus[J]. Transplant Proc, 2018, 50(10):3258-3265. DOI: 10.1016/j.transproceed.2018.06.040. [11] KUYPERS DR. " What do we know about tacrolimus pharmacogenetics in transplant recipients?" [J]. Pharmacogenomics, 2018, 19(7):593-597. DOI: 10.2217/pgs-2018-0035. [12] JI E, KIM MG, OH JM. CYP3A5 genotype-based model to predict tacrolimus dosage in the early postoperative period after living donor liver transplantation[J]. Ther Clin Risk Manag, 2018, 14:2119-2126. DOI: 10.2147/TCRM.S184376. [13] MIN S, PAPAZ T, LAFRENIERE-ROULA M, et al.A randomized clinical trial of age and genotype-guided tacrolimus dosing after pediatric solidorgan transplantation[J]. Pediatr Transplant, 2018, 22(7):e13285. DOI: 10.1111/petr.13285. [14] MOES DJ, VAN DER BENT SA, SWEN JJ, et al. Population pharmacokinetics and pharmacogenetics of once daily tacrolimus formulation in stable liver transplant recipients[J]. Eur J Clin Pharmacol, 2016, 72(2):163-174. DOI: 10.1007/s00228-015-1963-3. [15] HENDIJANI F, AZARPIRA N, KAVIANI M. Effect of CYP3A5*1 expression on tacrolimus required dose after liver transplantation: a systematic review and Meta-analysis[J]. Clin Transplant, 2018, 32(8):e13306. DOI: 10.1111/ctr.13306. [16] KATO H, USUI M, MURAKI Y, et al. Intravenous administration of tacrolimus stabilizes control of blood concentration regardless of CYP3A5 polymorphism in living donor liver transplantation: comparison of intravenous infusion and oral administration in early postoperative period[J]. Transplant Proc, 2018, 50(9):2684-2689. DOI: 10.1016/j.transproceed.2018.03.049. [17] OU B, LIU Y, ZHANG T, et al. TLR9 rs352139 genetic variant promotes tacrolimus elimination in Chinese liver transplant patients during the early posttransplantation period[J]. Pharmacotherapy, 2019, 39(1):67-76. DOI: 10.1002/phar.2204. [18] LIU Y, ZHANG T, ZHANG X, et al. A new donors' CYP3A5 and recipients' CYP3A4 cluster predicting tacrolimus disposition, and new-onset hypertension in Chinese liver transplant patients[J]. Oncotarget, 2017, 8(41):70250-70261. DOI: 10.18632/oncotarget.19606. [19] BOERNER BP, SHIVASWAMY V, WOLATZ E, et al. Post-transplant diabetes: diagnosis and management[J]. Minerva Endocrinol, 2018, 43(2):198-211. DOI: 10.23736/S0391-1977.17.02753-5. [20] RIVA N, DIP M, HALAC E, et al. Survival time to biopsy-proven acute rejection and tacrolimus adverse drug reactions in pediatric liver transplantation[J]. Ther Drug Monit, 2018, 40(4):401-410. DOI: 10.1097/FTD.0000000000000517. [21] MURAKI Y, MIZUNO S, NAKATANI K, et al. Monitoring of peripheral blood cluster of differentiation 4+ adenosine triphosphate activity and CYP3A5 genotype to determine the pharmacokinetics, clinical effects and complications of tacrolimus in patients with autoimmune diseases[J]. Exp Ther Med, 2018, 15(1):532-538. DOI: 10.3892/etm.2017.5364. [22] HEITS N, KESEROVIC D, MUND N, et al. Cognitive evaluation in liver transplant patients under calcineurin inhibitor maintenance therapy[J]. Transplant Direct, 2017, 3(4):e146. DOI: 10.1097/TXD.0000000000000658. [23] ZHANG X, LIN G, TAN L, et al. Current progress of tacrolimus dosing in solid organ transplant recipients: pharmacogenetic considerations[J]. Biomed Pharmacother, 2018, 102:107-114. DOI: 10.1016/j.biopha.2018.03.054. [24] CAMPAGNE O, MAGER DE, TORNATORE KM. Population pharmacokinetics of tacrolimus in transplant recipients: what did we learn about sources of interindividual variabilities?[J]. J Clin Pharmacol, 2019, 59(3):309-325. DOI: 10.1002/jcph.1325.
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