Influencia del polimorfismo de CYP3A4 y CYP3A5 en la farmacocinética de tacrolimus en receptores de trasplante renal. Revisión narrativa
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https://doi.org/10.36829/63CTS.v8i2.1040Palabras clave:
Trasplante renal, Farmacogenética, Tacrolimus, Polimorfismo CYP3A4/5Resumen
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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Ang, G. Y., Yu, C. Y., Johari James, R., Ahmad, A., Abdul Rahman, T., Mohd Nor, F., Shaari, S. A., Ismail, A. I., Teh, L. K., & Salleh, M. Z. (2018). A study on the genetic polymorphisms of CYP3A5 among the Orang Asli in Malaysia using a next generation sequencing platform. Annals of Human Biology, 45(2), 166-169. https://doi.org/10.1080/03014460.2018.1440004
Asempa, T. E., Rebellato, L. M., Hudson, S., Briley, K., & Maldonado, A. Q. (2018). Impact of CYP3A5 genomic variances on clinical outcomes among African American kidney transplant recipients. Clinical Transplantation, 32(1). https://doi.org/10.1111/ctr.13162
Bartlett, F. E., Carthon, C. E., Hagopian, J. C., Horwedel, T. A., January, S. E., & Malone, A. (2019). Tacrolimus concentration-to-dose ratios in kidney transplant recipients and relationship to clinical outcomes. Pharmacotherapy, 39(8), 827-836. https://doi.org/10.1002/phar.2300
Bentata, Y. (2020). Tacrolimus: 20 years of use in adult kidney transplantation. What we should know about its nephrotoxicity. Artificial Organs, 44(2), 140-152. https://doi.org/10.1111/aor.13551
Butler-Dawson, J., Krisher, L., Asensio, C., Cruz, A., Tenney, L., Weitzenkamp, D., Dally, M., Asturias, E. J., & Newman, L. S. (2018). Risk factors for declines in kidney function in sugarcane workers in Guatemala. Journal of Occupational and Environmental Medicine, 60(6), 548-558. https://doi.org/10.1097/JOM.0000000000001284
Campagne, O., Mager, D. E., Brazeau, D., Venuto, R. C., & Tornatore, K. M. (2018). Tacrolimus population pharmacokinetics and multiple CYP3A5 genotypes in black and white renal transplant recipients. Journal of Clinical Pharmacology, 58(9), 1184-1195. https://doi.org/10.1002/jcph.1118
Campos-Salazar, A. B., Dalla Vecchia Genvigir, F., Felipe, C. R., Tedesco-Silva, H., Medina-Pestana, J., Monteiro, G. V., De Gouveia Basso, R., Cerda, A., Hirata, M. H., & Hirata, R. D. C. (2018). Polymorphisms in mTOR and calcineurin signaling pathways are associated with long-term clinical outcomes in kidney transplant recipients. Frontiers in Pharmacology, 9, Article 1296. https://doi.org/10.3389/fphar.2018.01296
Chapman, E., Haby, M. M., Illanes, E., Sanchez-Viamonte, J., Elias, V., & Reveiz, L. (2019). Risk factors for chronic kidney disease of non-traditional causes: A systematic review. Revista Panamericana de Salud Pública, 43, Article e35. https://doi.org/10.26633/rpsp.2019.35
Chen, L., & Prasad, G. V. R. (2018). CYP3A5 polymorphisms in renal transplant recipients: Influence on tacrolimus treatment. Pharmacogenomics and Personalized Medicine, 11, 23-33. https://doi.org/10.2147/PGPM.S107710
Chen, T. K., Knicely, D. H., & Grams, M. E. (2019). Chronic kidney disease diagnosis and management: A review. Journal of the American Medical Association, 322(13), 1294-1304. https://doi.org/10.1001/jama.2019.14745
Dally, M., Butler-Dawson, J., Krisher, L., Monaghan, A., Weitzenkamp, D., Sorensen, C., Johnson, R. J., Carlton, E. J., Asensio, C., Tenney, L., & Newman, L. S. (2018). The impact of heat and impaired kidney function on productivity of Guatemalan sugarcane workers. PLoS ONE, 13(10), Article e0205181. https://doi.org/10.1371/journal.pone.0205181
Damon, C., Luck, M., Toullec, L., Etienne, I., Buchler, M., Hurault de Ligny, B., Choukroun, G., Thierry, A., Vigneau, C., Moulin, B., Heng, A.-E., Subra, J.-F., Legendre, C., Monnot, A., Yartseva, A., Bateson, M., Laurent-Puig, P., Anglicheau, D., Beaune, P., … Pallet, N. (2017). Predictive modeling of tacrolimus dose requirement based on high-throughput genetic screening. American Journal of Transplantation, 17(4), 1008-1019. https://doi.org/10.1111/ajt.14040
Deininger, K. M., Vu, A., Page, R. L., Ambardekar, A. V., Lindenfeld, J. A., & Aquilante, C. L. (2016). CYP3A pharmacogenetics and tacrolimus disposition in adult heart transplant recipients. Clinical Transplantation, 30(9), 1074-1081. https://doi.org/10.1111/ctr.12790
Elens, L., & Haufroid, V. (2017). Genotype-based tacrolimus dosing guidelines: With or without CYP3A4∗22? Pharmacogenomics, 18(16), 1473-1480. https://doi.org/ 10.2217/2017-0131
Flagg, A. J. (2018). Chronic renal therapy. Nursing Clinics of North America, 53(4), 511-519. https://doi.org/10.1016/j.cnur.2018.07.002
Flood, D., Wilcox, K., Ferro, A. A., Mendoza Montano, C., Barnoya, J., Garcia, P., Lou-Meda, R., Rohloff, P., & Chary, A. (2020). Challenges in the provision of kidney care at the largest public nephrology center in Guatemala: A qualitative study with health professionals. BMC Nephrology, 21(71). https://doi.org/10.1186/s12882-020-01732-w
Genvigir, F. D. V., Salgado, P. C., Felipe, C. R., Luo, E. Y. F., Alves, C., Cerda, A., Tedesco-Silva, H., Medina-Pestana, J. O., Oliveira, N., Rodrigues, A. C., Doi, S. Q., Hirata, M. H., & Hirata, R. D. C. (2016). Influence of the CYP3A4/5 genetic score and ABCB1 polymorphisms on tacrolimus exposure and renal function in Brazilian kidney transplant patients. Pharmacogenetics and Genomics, 26(10), 462-472. https://doi.org/10.1097/FPC.0000000000000237
Glassock, R. J., Warnock, D. G., & Delanaye, P. (2017). The global burden of chronic kidney disease: Estimates, variability and pitfalls. Nature Reviews Nephrology, 13(2), 104-114. https://doi.org/10.1038/nrneph.2016.163
Goldmannova, D., Karasek, D., Krystynik, O., & Zadrazil, J. (2016). New-onset diabetes mellitus after renal transplantation. Biomedical Papers, 160(2), 195-200. https://doi.org/10.5507/bp.2016.005
Hill, N. R., Fatoba, S. T., Oke, J. L., Hirst, J. A., O'Callaghan, C. A., Lasserson, D. S., & Hobbs, F. D. (2016). Global prevalence of chronic kidney disease - A systematic review and meta-analysis. PloS ONE, 11(7), Article e0158765. https://doi.org/10.1371/journal.pone.0158765
Hu, R., Barratt, D. T., Coller, J. K., Sallustio, B. C., & Somogyi, A. A. (2018). CYP3A5*3 and ABCB1 61A>G significantly influence dose-adjusted trough blood tacrolimus concentrations in the first three months post-kidney transplantation. Basic and Clinical Pharmacology and Toxicology, 123(3), 320-326. https://doi.org/10.1111/bcpt.13016.
Htun, Y. Y., Swe, H. K., & Saw, T. M. (2018). CYP3A5*3 Genetic polymorphism and tacrolimus concentration in Myanmar renal transplant patients. Transplantation Proceedings, 50, 1034-1040. https://doi.org/10.1016/j.transproceed.2018.02.032
in’t Veld, A. E., Grievink, H. W., Saghari, M., Stuurman, F. E., de Kam, M. L., de Vries, A. P. J., de, Winter, B. C. M. de, Burggraaf, J., Cohen, A. F., & Moerland, M. (2019). Immunomonitoring of tacrolimus in healthy volunteers: The first step from PK- to PD-based therapeutic drug monitoring? International Journal of Molecular Sciences, 20(19), 1-13. https://doi.org/10.3390/ijms20194710
Jarrar, Y. B., & Lee, S. J. (2019). Molecular functionality of cytochrome P450 4 (CYP4) genetic polymorphisms and their clinical implications. International Journal of Molecular Sciences, 20(17) 4274. https://doi.org/10.3390/ijms20174274
Jasiak, N. M., & Park, J. M. (2016). Immunosuppression in solid-organ transplantation essentials and practical tips. Critical Care Nursing Quarterly, 39(3), 227-240. https://doi.org/10.1097/CNQ.0000000000000117
Jennings, W. C., Lou-Meda, R., Mushtaq, N., Mallios, A., Méndez-Soveranis, S., Sosa Tejada, R. E., Lucas, J. F., & Gradman, W. S. (2019). Creating arteriovenous fistulas for children in Guatemala. Journal of Vascular Surgery, 70(5), 1635-1641. https://doi.org/10.1016/j.jvs.2019.02.022
Kalt, D. A. (2017). Tacrolimus: A review of laboratory detection methods and indications for use. Laboratory Medicine, 48(4), Article e62-e65. https://doi.org/10.1093/labmed/lmx056
Kotowski, M. J., Bogacz, A., Bartkowiak-Wieczorek, J., Tejchman, K., Dziewanowski, K., Ostrowski, M., Czerny, B., Grześkowiak, E., Machaliński, B., & Sieńko, J. (2019). Effect of multidrug-resistant 1 (MDR1) and CYP3A4*1B polymorphisms on cyclosporine-based immunosuppressive therapy in renal transplant patients. Annals of Transplantation, 24, 108-114.https://doi.org/10.12659/aot.914683
Kuypers, D. R. (2018). What do we know about tacrolimus pharmacogenetics in transplant recipients? Pharmacogenomics, 19(7), 593-597. https://doi.org/10.2217/2018-0035
Ladda, M. A., & Goralski, K. B. (2016). The effects of CKD on cytochrome P450-mediated drug metabolism. Advances in Chronic Kidney Disease, 23(2), 67-75. https://doi.org/10.1053/j.ackd.2015.10.002
Li, M., Xu, M., Liu, W., & Gao, X. (2018). Effect of CYP3 A4, CYP3 A5 and ABCB1 gene polymorphisms on the clinical efficacy of tacrolimus in the treatment of nephrotic syndrome. BMC Pharmacology and Toxicology, 19(1), 14. https://doi.org/10.1186/s40360-018-0202-9
Lim, M. A., Kohli, J., & Bloom, R. D. (2017). Immunosuppression for kidney transplantation: Where are we now and where are we going? Transplantation Reviews, 31(1), 10-17. https://doi.org/10.1016/j.trre.2016.10.006
Lloberas, N., Elens, L., Llaudó, I., Padullés, A., Van Gelder, T., Hesselink, D. A., Colom, H., Andreu, F., Torras, J., Bestard, O., Cruzado, J. M., Gil-Vernet, S., Van Schaik, R., & Grinyó, J. M. (2017). The combination of CYP3A4∗22 and CYP3A5∗3 single-nucleotide polymorphisms determine tacrolimus dose requirement after kidney transplantation. Pharmacogenetics and Genomics, 27(9), 313-322. https://doi.org/.10.1097/FPC.0000000000000296
Manikandan, P., & Nagini, S. (2017). Cytochrome P450 structure, function and clinical significance: A review. Current Drug Targets, 19(1), 38-54. https://doi.org/10.2174/1389450118666170125144557
Malat, G., & Culkin, C. (2016). The ABCs of immunosuppression: A primer for primary care physicians. Medical Clinics of North America, 100(3), 505-518. https://doi.org/10.1016/j.mcna.2016.01.003
Nanga, T. M., Doan, T. T. P., Marquet, P., & Musuamba, F. T. (2019). Toward a robust tool for pharmacokinetic-based personalization of treatment with tacrolimus in solid organ transplantation: A model-based meta-analysis approach. British Journal of Clinical Pharmacology, 85(12), 2793-2823. https://doi.org/10.1111/bcp.14110
Nemes, B., Szederkényi, E., Nagy, K. K., Hartyánszky, I., Ablonczy, L., Vámos, F. R., Mihály, S., & Máthé, Z. (2019). A summary of transplantation activity in Hungary. Transplantation Proceedings, 51(4), 1202-1208. https://doi.org/10.1016/j.transproceed.2019.04.006
Oppenheimer Salinas, F., Pascual Santos, J., & Pallardó Mateu, L. (s.f). Inmunosupresión en el trasplante renal. Nefrología al Día.Recuperado el 25 de junio de 2020 https://www.nefrologiaaldia.org/es.
Piedrasanta, J., Galindo, F., Gómez, D., & Sapón, B. (2017). Trasplante renal como opción terapéutica en Guatemala. Revista de la Asociación de Medicina Interna de Guatemala, 21, 33-38
Prytuła, A., & van Gelder, T. (2019). Clinical aspects of tacrolimus use in paediatric renal transplant recipients. Pediatric Nephrology, 34(1), 31-43. https://doi.org/10.1007/s00467-018-3892-8
Reveiz, L., Pinzón-Flórez, C., Glujovsky, D., Elias, V., & Ordunez, P. (2018). Establecimiento de prioridades de investigación en la enfermedad renal crónica de causas no tradicionales en Centroamérica. Revista Panamericana de Salud Pública, 42, Article e13. https://doi.org/10.26633/rpsp.2018.13
Rojas, L., Neumann, I., Herrero, M. J., Bosó, V., Reig, J., Poveda, J. L., Megías, J., Bea, S., & Aliño, S. F. (2015). Effect of CYP3A5∗3 on kidney transplant recipients treated with tacrolimus: A systematic review and meta-analysis of observational studies. Pharmacogenomics Journal, 15(1), 38-48. https://doi.org/10.1038/tpj.2014.38
Sałagacka-Kubiak, A., Żebrowska-Nawrocka, M., Jeleń, A., Mirowski, M., & Balcerczak. E. (2019). CYP2C19*2 Polymorphism in Polish Peptic Ulcer Patients. Pharmacological Reports, 71(2), 272-75. https://doi.org/10.1016/j.pharep.2018.12.011.
Sam-Colop, B. (2020). Prevalencia y mortalidad de Enfermedad Renal Crónica en Guatemala (2008-2018). Ciencia, Tecnología y Salud, 7(1), 112-123
Scalea, J. R., Levi, S. T., Ally, W., & Brayman, K. L. (2016). Tacrolimus for the prevention and treatment of rejection of solid organ transplants. Expert Review of Clinical Immunology, 12(3), 333-342. https://doi.org/10.1586/1744666X.2016.1123093
Shrestha, B. M. (2017). Two decades of tacrolimus in renal transplant: Basic science and clinical evidence. Experimental and Clinical Transplantation, 15(1). https://doi.org/10.6002/ect.2016.0157
Snowsill, T. M., Moore, J., Mota, R. E. M., Peters, J. L., Jones-Hughes, T. L., Huxley, N. J., Coelho, H. F., Haasova, M., Cooper, C., Lowe, J. A., Varley-Campbell, J. L., Crathorne, L., Allwood, M. J., & Anderson, R. (2017). Immunosuppressive agents in adult kidney transplantation in the National Health Service: A model-based economic evaluation. Nephrology Dialysis Transplantation, 32(7), 1251-1259. https://doi.org/10.1093/ndt/gfx074
Tamashiro, E. Y., Felipe, C. R., Genvigir, F. D. V., Rodrigues, A. C., Campos, A. B., Hirata, R. D. C., Tedesco-Silva, H., & Medina-Pestana, J. O. (2017). Influence of CYP3A4 and CYP3A5 polymorphisms on tacrolimus and sirolimus exposure in stable kidney transplant recipients. Drug Metabolism and Personalized Therapy, 32(2), 89-95. https://doi.org/10.1515/dmpt-2016-003
Thishya, K., Vattam, K. K., Naushad, S. M., Raju, S. B., & Kutala, V. K. (2018). Artificial neural network model for predicting the bioavailability of tacrolimus in patients with renal transplantation. PLoS ONE, 13(4), Article e0191921. https://doi.org/10.1371/journal.pone.0191921
Tornio, A., & Backman, J. T. (2018). Cytochrome P450 in pharmacogenetics: An update. Advances in Pharmacology, 83, 3-32. https://doi.org/10.1016/bs.apha.2018.04.007
Torres Espíndola, L. M., Rojo-Serrato, D., Álvaro-Heredia, A., Castillejos López, M. de J., de Uña-Flores, A., Pérez-García, M., Zapata-Tarres, M., Cárdenas-Cardos, R., Granados, J., Chávez-Pacheco, J. L., Salinas-Lara, C., de Arellano, I. T.-R., & Aquino-Gálvez, A. (2020). Analysis of CYP450 Gene Allelic Variants Can Predict Ifosfamide Toxicity in Mexican Paediatric Patients». Biomarkers, 25(4), 331-40. https://doi.org/10.1080/1354750X.2020.1754913
Tribut, O., Lessard, Y., Reymann, J.-M., Allain, H., & Bentué-Ferrer, D. (2002). Pharmacogenomics. Medical Science Monitor, 8(7), RA152-163.
Vanichanan, J., Udomkarnjananun, S., Avihingsanon, Y., & Jutivorakool, K. (2018). Common viral infections in kidney transplant recipients. Kidney Research and Clinical Practice, 37(4), 323-337. https://doi.org/10.23876/j.krcp.18.0063.
Webster, A. C., Nagler, E. V., Morton, R. L., & Masson, P. (2017). Chronic kidney disease. Lancet, 389(10075), 1238-1252. https://doi.org/10.1016/S0140-6736(16)32064-5
Whirl-Carrillo, M., McDonagh, E. M., Hebert, J. M., Gong, L., Sangkuhl, K., Thorn, C. F., Altman, R. B., & Klein, T. E. (2012). Pharmacogenomics knowledge for personalized medicine. Clinical Pharmacology and Therapeutics, 92(4), 414-417. https://doi.org/10.1038/clpt.2012.96
Woillard, J. B., Chouchana, L., Picard, N., & Loriot, M. A. (2017). Pharmacogenetics of immunosuppressants: State of the art and clinical implementation recommendations from the French National Network of Pharmacogenetics (RNPGx). Therapie, 72(2), 285-299. https://doi.org/10.1016/j.therap.2016.09.016
Yousef, A. M., Qosa, H., Bulatova, N. R., Abuhaliema, A., Almadhoun, H., Khayyat, G., & Olemat, M. (2016). Effects of genetic polymorphism in CYP3A4 and CYP3A5 genes on tacrolimus dose among kidney transplant recipients. Iranian Journal of Kidney Diseases, 10(3), 156-163.
Yu, M., Liu, M., Zhang, W., & Ming, Y. (2018). Pharmacokinetics, pharmacodynamics and pharmacogenetics of tacrolimus in kidney transplantation. Current Drug Metabolism, 19(6), 513-522. https://doi.org/10.2174/1389200219666180129151948
Zhang, H. F., Wang, H. H., Gao, N., Wei, J. Y., Tian, X., Zhao, Y., Fang, Y., Zhou, J., Wen, Q., Gao, J., Zhang, Y. J., Qian, X. H., & Qiao, H. L. (2016). Physiological content and intrinsic activities of 10 cytochrome P450 isoforms in human normal liver microsomes. Journal of Pharmacology and Experimental Therapeutics, 358(1), 83-93. https://doi.org/10.1124/jpet.116.233635
Zolota, A., Miserlis, G., Solonaki, F., Tranda, A., Antoniadis, N., Imvrios, G., & Fouzas, I. (2018). New-onset diabetes after transplantation: Comparison between a cyclosporine-based and a tacrolimus-based immunosuppressive regimen. Transplantation Proceedings, 50(10), 3386-3391. https://doi.org/10.1016/j.transproceed.2018.08.037
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