Influencia del polimorfismo de CYP3A4 y CYP3A5 en la farmacocinética de tacrolimus en receptores de trasplante renal. Revisión narrativa

Autores/as

  • Karla Escobar Castro Doctorado en Ciencias Biomédicas, Escuela de Estudios de Postgrado, Facultad de Ciencias Médicas, Universidad de San Carlos https://orcid.org/0000-0002-8722-0350
  • Armando Caceres Laboratorio de Investigación de Productos Naturales, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala,Laboratorio de Investigación de Productos Naturales, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala https://orcid.org/0000-0002-1098-9137

DOI:

https://doi.org/10.36829/63CTS.v8i2.1040

Palabras clave:

Trasplante renal, Farmacogenética, Tacrolimus, Polimorfismo CYP3A4/5

Resumen

El uso de inhibidores de calcineurina, en particular de tacrolimus como terapia inmunosupresora se ha generalizado a nivel mundial, permitiendo mejorar la tasa de sobrevida del injerto y la calidad de vida del paciente trasplantado. Con el acceso a los estudios de farmacogenética, los grupos de trasplante a nivel mundial se han visto motivados a realizar estudios genéticos que permitan interpretar la influencia de polimorfismos de genes como mTOR, PPP3CA, FKBP1A, FKBP2, y FOXP3, sin embargo, los más estudiados en la población trasplantada para optimizar la dosis de tacrolimus y ciclosporina son los polimorfismos del citocromo p450, CYP3A4 y CYP3A5. El objetivo de la presente revisión narrativa es examinar publicaciones recientes que estudien la relación entre el polimorfismo de CYP3A4/5 y el metabolismo de tacrolimus en pacientes trasplantados renales. Se revisó literatura reciente extraída de los sitios NCBI PubMed y PharmGKB.org en la que se hubiera investigado la influencia de los polimorfismos de CYP3A4/5 en el metabolismo de tacrolimus en trasplantados renales. Se identificó variaciones genéticas de CYP3A4/5 en pacientes trasplantados tratados con tacrolimus que permitirán a los médicos trasplantólogos dosificar de manera precisa el inmunosupresor. El uso de análisis farmacogenéticos permite determinar las variables genéticas del CYP3A4/5, y por lo tanto la toma de decisiones personalizadas en la dosis de inicio y de mantenimiento del inmunosupresor tacrolimus para alcanzar los niveles óptimos y con ello disminuir el riesgo de rechazo, de infecciones asociadas a inmunosupresión, y de toxicidad por el medicamento.

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Biografía del autor/a

Karla Escobar Castro, Doctorado en Ciencias Biomédicas, Escuela de Estudios de Postgrado, Facultad de Ciencias Médicas, Universidad de San Carlos

Mas de 15 años de experiencia como químico biologo, de los cuales los ultimos 10 han sido como director del laboratorio de inmunogenetica del hospital general san juan de dios.

Actualmente curso el ultimo semestre del doctorado en ciencias biomedicas dde la facultad de ciencias medicas de la usac, y me gradue en nov 2019 de la especialidad en bioinformatica de la facultad de ingenieria de la usac

realizando tesis de doctorado

Citas

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2021-12-12

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Escobar Castro, K., & Caceres, A. (2021). Influencia del polimorfismo de CYP3A4 y CYP3A5 en la farmacocinética de tacrolimus en receptores de trasplante renal. Revisión narrativa. Ciencia, Tecnologí­a Y Salud, 8(2), 220–231. https://doi.org/10.36829/63CTS.v8i2.1040

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