[Cytochrome P450 3A polymorphism and its importance in cyclosporine and tacrolimus therapy in transplanted patients].
The calcineurin inhibitors cyclosporine (CsA) and tacrolimus (Tac) are widely used in the prevention of acute rejection after solid organ transplantation. However, their clinical use is associated with many adverse reactions. The calcineurin inhibitors CsA and Tac have a narrow therapeutic index and show highly variable pharmacokinetics. The low CsA and Tac bioavailability has been attributed to interindividual differences in the expression of the metabolizing enzyme cytochrome P450 3A. The genes for CYP3A4 and 3A5 undergo genetic polymorphism. The results of many studies focusing on the impact of CYP 3A polymorphism on CsA and Tac pharmacokinetics are clear with Tac, where an association between CYP 3A polymorphism and the pharmacokinetic consequences has been shown. However, the results with CsA are controversial.
Ostravská univerzita, Zdravotne-sociální fakulta, Ustav klinické farmakologie FN, Ostrava. jankaduricova@seznam.cz
J
J
Duricová
M
M
Grundmann
D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000493:pharmacokinetics / Q000627:therapeutic use*; D051544:Cytochrome P-450 CYP3A / Q000235:genetics*; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016377:Organ Transplantation; D011110:Polymorphism, Genetic; D016559:Tacrolimus / Q000493:pharmacokinetics / Q000627:therapeutic use*
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003577:Cytochrome P-450 Enzyme System; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human; D016559:Tacrolimus