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

Karla Escobar Castro; Armando Caceres

doi:10.36829/63CTS.v8i2.1040

Authors

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

Keywords:

Kidney transplant, Pharmacogenetics, Tacrolimus, Polymorphism, CYP3A4/5

Abstract

The use of the calcineurin inhibitor tacrolimus as immunosuppressive therapy, has become widespread worldwide, improving the graft’s survival rate and the quality of life of the transplanted patient. With access to pharmacogenetic studies, transplant groups worldwide have been motivated to conduct genetic studies to interpret the influence of polymorphisms of genes such as mTOR, PPP3CA, FKBP1A, FKBP2, and FOXP3. However the most studied in the transplanted population to optimize the dose of tacrolimus and cyclosporine are those of cytochrome p450, CYP3A4 and CYP3A5. The objective of this narrative review is to examine recent publications studying the relationship between CYP3A4/5 polymorphism, and tacrolimus metabolism in renal transplant patients. Literature extracted from the NCBI PubMed site and PharmGKB.org, from the past five years, which investigated the influence of CYP3A4/5 polymorphism on tacrolimus metabolism in renal transplants had been reviewed. Genetic variations of CYP3A4/5 were identified in transplant patients treated with tacrolimus that will allow transplant physicians to dose the immunosuppressant accurately. The use of pharmacogenetic analyses makes it possible to determine the genetic polymorphisms of CYP3A4/5, and therefore the decision-making customized at the starting and maintenance dose of the tacrolimus immunosuppressant to achieve optimal levels and thereby reduce the risk of rejection, immunosuppression-associated infections, and drug toxicity.

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Author Biography

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

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