覃利, 李嘉丽, 刘晓曼, 陈徐涛, 刘澍, 刘龙山, 王长希, 黄民. VDR基因多态性与肾移植患者他克莫司浓度相关性的研究J. 药学学报, 2017,52(5): 760-765. doi: 10.16438/j.0513-4870.2017-0125
引用本文: 覃利, 李嘉丽, 刘晓曼, 陈徐涛, 刘澍, 刘龙山, 王长希, 黄民. VDR基因多态性与肾移植患者他克莫司浓度相关性的研究J. 药学学报, 2017,52(5): 760-765. doi: 10.16438/j.0513-4870.2017-0125
QIN Li, LI Jia-li, LIU Xiao-man, CHEN Xu-tao, LIU Shu, LIU Long-shan, WANG Chang-xi, HUANG Min. Associations of VDR polymorphisms with tacrolimus concentrations in Chinese renal transplant recipientsJ. Acta Pharmaceutica Sinica, 2017,52(5): 760-765. doi: 10.16438/j.0513-4870.2017-0125
Citation: QIN Li, LI Jia-li, LIU Xiao-man, CHEN Xu-tao, LIU Shu, LIU Long-shan, WANG Chang-xi, HUANG Min. Associations of VDR polymorphisms with tacrolimus concentrations in Chinese renal transplant recipientsJ. Acta Pharmaceutica Sinica, 2017,52(5): 760-765. doi: 10.16438/j.0513-4870.2017-0125

VDR基因多态性与肾移植患者他克莫司浓度相关性的研究

Associations of VDR polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients

  • 摘要: 通过回顾性研究,探讨维生素D受体(VDR)的单核苷酸多态性(SNP)与肾移植术后早期患者体内他克莫司全血谷浓度的相关性。共纳入114例活体肾移植术后服用他克莫司+霉酚酸酯+糖皮质激素的患者,采用Agena Bioscience MassARRAY® system检测VDR rs2853559和rs1540339基因型,采用PCR-RFLP法检测CYP3A5*3基因型,术后第7天他克莫司全血谷浓度(C0)为临床治疗药物监测(TDM)数据,采用Spearman相关分析、Mann-Whitney U检验、Kruskal-Wallis H检验进行数据分析。结果显示,VDR基因rs2853559 GA+GG型他克莫司剂量校正谷浓度显著高于AA型。以CYP3A5*3基因型进行分层后,在CYP3A5非表达型组中VDRrs2853559 GA+GG型他克莫司剂量校正谷浓度显著高于AA型。回归分析表明,CYP3A5*3VDR rs2853559能解释45.6%的他克莫司剂量校正谷浓度个体差异,在CYP3A5非表达者中,VDR rs2853559能解释14.4%的他克莫司剂量校正谷浓度个体差异。肾移植术后患者VDR rs2853559基因多态性与他克莫司校正谷浓度相关,该基因型检测将有助于指导他克莫司的临床个体化用药。

     

    Abstract: The paper was aimed to investigate the association of VDR polymorphisms with tacrolimus (FK506) concentration in Chinese renal transplant recipients. A total of 114 renal transplant recipients receiving tacrolimus were genotyped for VDR rs1540339 and rs2853559 by Agena Bioscience MassARRAY® system and CYP3A5*3 by PCR-RFLP method. Trough concentrations of tacrolimus on day 7 after renal transplantation were collected from clinical data. Statistical analysis was performed with Spearman's correlation, Mann-Whitney U test and Kruskal-Wallis H test. The dose-adjusted concentration of tacrolimus in VDR rs2853559 GA and GG carriers were considerably higher than that of AA carriers. After stratification by CYP3A5*3 genotypes, VDR rs2853559 GA and GG carriers had a higher dose-adjusted tacrolimus concentration than that in AA carriers in CYP3A5 nonexpresser. CYP3A5*3 and VDR rs2853559 explained 45.6% variability of tacrolimus C0/D. In CYP3A5 non-expressers, VDR rs2853559 explained 14.4% variability of tacrolimus C0/D. The results illustrated that VDR rs2853559 polymorphisms was associated with tacrolimus concentrations, and the determination of this SNP may be useful for individualized medicine of tacrolimus.

     

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