The P450 oxidoreductase *28 SNP is associated with low initial tacrolimus exposure and increased dose requirements in CYP3A5-expressing renal recipients
Autor: | Dirk Kuypers, Diether Lambrechts, Hylke de Jonge, Maarten Naesens, Christoph Metalidis |
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Rok vydání: | 2011 |
Předmět: |
Adult
Male Heterozygote Genotype Single-nucleotide polymorphism Biology Pharmacology Polymorphism Single Nucleotide Loading dose Tacrolimus Nephrotoxicity Pharmacokinetics Genetics Cytochrome P-450 CYP3A Humans CYP3A5 Alleles Genetic Association Studies Aged NADPH-Ferrihemoprotein Reductase Middle Aged Kidney Transplantation Calcineurin surgical procedures operative Molecular Medicine Female Immunosuppressive Agents Pharmacogenetics Follow-Up Studies |
Zdroj: | Pharmacogenomics. 12:1281-1291 |
ISSN: | 1744-8042 1462-2416 |
DOI: | 10.2217/pgs.11.77 |
Popis: | Aim: Recently a SNP of the gene encoding P450 oxidoreductase (POR*28; rs1057868C>T) has been associated with increased in vivo CYP3A activity using midazolam as a drug probe. Because tacrolimus is metabolized by CYP3A isoenzymes, this SNP might affect tacrolimus pharmacokinetics. Materials & methods: To test this hypothesis we performed a study in a cohort of 298 de novo renal allograft recipients stratified according to CYP3A5 genotype, which has a known impact on tacrolimus pharmacokinetics. Results: We found that in CYP3A5 expressers (CYP3A5*1 allele carriers) receiving a standard loading dose of 0.2 mg/kg, POR*28T allele carriers had lower tacrolimus C0 levels in the first days post-transplantation and reached target C0 levels significantly later as compared with POR*28CC homozygous patients. The POR*28T allele carriers had significantly higher tacrolimus dose requirements throughout the first year. In CYP3A5 nonexpressers (CYP3A5*3/*3) the POR*28 SNP did not affect tacrolimus pharmacokinetics. Conclusion: These data indicate that the POR*28 SNP is associated with additional increases in early tacrolimus dose-requirements in patients carrying a CYP3A5*1 allele. Original submitted 22 April 2011; Revision submitted 28 May 2011 |
Databáze: | OpenAIRE |
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