The influence of pharmacogenetics and cofactors on clinical outcomes in kidney transplantation
| Autor: | Nicolas Picard, Pierre Marquet |
|---|---|
| Přispěvatelé: | Pharmacologie des Immunosuppresseurs et de la Transplantation (PIST), Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut National de la Santé et de la Recherche Médicale (INSERM), Marquet, Pierre |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
MESH: IMP Dehydrogenase
Pharmacology Toxicology 030226 pharmacology & pharmacy MESH: Glucuronosyltransferase MESH: Dose-Response Relationship Drug MESH: Kidney Transplantation MESH: Genotype IMP Dehydrogenase 0302 clinical medicine Cytochrome P-450 CYP3A Enzyme Inhibitors Glucuronosyltransferase Kidney transplantation Randomized Controlled Trials as Topic pharmacogenetics MESH: Treatment Outcome MESH: Cytochrome P-450 CYP3A 0303 health sciences TOR Serine-Threonine Kinases MESH: Polymorphism Single Nucleotide General Medicine [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences 3. Good health [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences Treatment Outcome MESH: Enzyme Inhibitors UDP-Glucuronosyltransferase 1A9 MESH: Calcineurin MESH: Immunosuppressive Agents Immunosuppressive Agents medicine.drug ATP Binding Cassette Transporter Subfamily B MESH: P-Glycoprotein Genotype Calcineurin Inhibitors MESH: Pharmacogenetics kidney transplantation Single-nucleotide polymorphism Biology Polymorphism Single Nucleotide Article Mycophenolic acid 03 medical and health sciences Therapeutic index medicine Humans ATP Binding Cassette Transporter Subfamily B Member 1 Adverse effect MESH: TOR Serine-Threonine Kinases 030304 developmental biology MESH: Mycophenolic Acid MESH: Humans Dose-Response Relationship Drug Mycophenolic Acid medicine.disease Calcineurin Immunosuppressants MESH: Randomized Controlled Trials as Topic Pharmacodynamics Pharmacogenetics |
| Zdroj: | Expert Opinion on Drug Metabolism and Toxicology Expert Opinion on Drug Metabolism and Toxicology, Taylor & Francis, 2011, 7 (6), pp.731-43. ⟨10.1517/17425255.2011.570260⟩ |
| ISSN: | 1742-5255 1744-7607 |
| DOI: | 10.1517/17425255.2011.570260⟩ |
| Popis: | International audience; INTRODUCTION: Immunosuppressive drugs have a narrow therapeutic range and large inter-individual response variability. This has prompted pharmacogenetic studies, mostly with regard to their dose-concentration relationships, but also about proteins involved in their pharmacodynamics. Some polymorphisms of genes involved in their disposition pathways were shown to affect their dose-concentration relationships. The impact of pharmacogenetics on tissue distribution and the resulting clinical effects have less often been studied. More importantly, a few single nucleotide polymorphisms seem to have a significant impact on the incidence of acute rejection or the adverse effects of immunosuppressants. Environmental factors often interact with such genotype-phenotype relationships. AREAS COVERED: This article reviews the impact of genetic polymorphisms of the metabolic enzymes, membrane transporters and target proteins of mycophenolic acid, calcineurin inhibitors and mammalian target of rapamycin inhibitors on clinical outcomes in kidney transplantation. EXPERT OPINION: The current level of evidence is not yet high enough to recommend pharmacogenetic personalization of immunosuppressive regimens in transplant recipients. The prevention of cellular toxicity associated with local metabolism or transport, which cannot be addressed by routine monitoring, is worth investigating further. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|