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 
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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
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