CYP3A基因多态性对肾移植后高血压患者他克莫司血药浓度剂量比的影响
首发时间:2013-03-14
摘要:目的 探讨CYP3A4*1G、CYP3A5*3基因多态性对肾移植后高血压患者他克莫司血药浓度/剂量比(C/D)的影响。方法 随机筛选肾移植后高血压患者70例,患者连续服用他克莫司达至少3天后,采用微粒子酶免疫分析法(MEIA)测定患者的他克莫司血药谷浓度(c0),PCR-RFLP法和测序法检测患者CYP3A4*1G、CYP3A5*3基因型。结果 肾移植后高血压患者中,携带CYP3A4*1G野生型(*1*1)患者的他克莫司C/D明显高于CYP3A4突变杂合子(*1*1G)和CYP3A4突变纯合子(*1G*1G)携带者(P﹤0.05);CYP3A5*3突变纯合子(*3*3)患者的他克莫司C/D明显高于CYP3A5野生型(*1*1)和CYP3A5突变杂合子(*1*3)基因型患者(P﹤0.05)。要达到相同的目标血药浓度,CYP3A4*1G 的*1*1G和*1G*1G患者比*1*1患者需要更高剂量的他克莫司,CYP3A5*3的*1*1和*1*3患者比*3*3患者需要更高剂量的他克莫司。结论 CYP3A4*1G、CYP3A5*3基因多态性与肾移植后高血压患者的他克莫司C/D显著相关。
关键词: 他克莫司 细胞色素P-450 CYP3A 肾移植 高血压 基因多态性
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Effect of CYP3A gene polymorphism on the concentration/dose ratio of tacrolimus in renal transplant recipients with hypertension
Abstract:AIM To study the effects of CYP3A4*1G and CYP3A5*3 gene polymorphism on concentration/dose ratio (C/D) of tacrolimus. METHODS Seventy patients with post renal transplant hypertension were screened in the study. Tacrolimus trough level (c0) was determined by microparticle enzyme immunoassay (MEIA) when tacrolimus was administrated at a stable dose for at least 3 days. Polymerase restrictive fragment length polymorphism (PCR-RFLP) and PCR sequencing PCR technique were used to detect the CYP3A4*1G and CYP3A5*3 gene polymorphism. RESULTS Among the patients with post renal transplant hypertension, C/D of tacrolimus for patients with CYP3A4*1*1 was higher than that of those with CYP3A4*1*1G and CYP3A4*1G*1G (P﹤0.05). C/D of tacrolimus for patients with CYP3A5*3*3 was higher than that of those CYP3A5*1*1 and CYP3A5*1*3 (P﹤0.05). CYP3A4*1*1G and CYP3A4*1G*1G patients required higher dosage of tacrolimus than CYP3A4*1*1 patients, and CYP3A5*1*1 and CYP3A5*1*3 patients required higher dosage of tacrolimus than the CYP3A5*3*3 patients to get similar plasma tacrolimus concentration. CONCLUSION C/D of tacrolimus is significantly associated with the CYP3A4*1G and CYP3A5*3 gene polymorphism.
Keywords: Tacrolimus Cytochrome P-450 CYP3A Kidney Transplantation Hypertension Genetic Polymorphism
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CYP3A基因多态性对肾移植后高血压患者他克莫司血药浓度剂量比的影响
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