基因多态性对原发性肾病综合征患者他克莫司个体化治疗的影响  

Effect of genetic polymorphism on individualized treatment of tacrolimus in patients with primary nephrotic syndrome

作　　者：熊炼炼 易斌[1] Xiong Lian-lian;Yi Bin(Department of Nephrology,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院肾内科,长沙410013

出　　处：《临床肾脏病杂志》2021年第5期416-421,共6页Journal Of Clinical Nephrology

摘　　要：他克莫司(tacrolimus, TAC,FK506)是一种高效免疫抑制剂,已越来越多地应用于原发性肾病综合征的治疗,但TAC的使用剂量过大或不足在临床实践中仍较为普遍。近期研究显示,细胞色素P450 3A4酶(cytochrome P450 family 3 subfamily A4,CYP3A4)、细胞色素P450 3A5酶(cytochrome P450 family 3 subfamily A5,CYP3A5)和ABC转运蛋白在TAC代谢和转运中起重要作用,且它们的单核苷酸基因多态性可部分解释个体间药代动力学行为的差异。本文拟就CYP3A4/3A5与ABC转运蛋白基因多态性对原发性肾病综合征患者TAC血药浓度的影响做一综述,为TAC在该人群的个体化治疗提供理论依据。As a highly effective immunosuppressant,tacrolimus(TAC,FK506)has been widely applied for primary nephrotic syndrome.However,excessive dose or underexposure of TAC remains rampant in clinical practices.Recent studies have indicated that cytochrome P450 family 3 subfamily A4(CYP3A4),cytochrome P450 family 3 subfamily A5(CYP3A5)metabolic enzymes and ABC transporter play important roles in its metabolisms and transports and single nucleotide gene polymorphisms may partially explain differences in pharmacokinetic profiles among individuals.This review summarized the effects of CYP3A4/3A5 and ABC transporter gene polymorphisms on TAC plasma concentrations in patients with primary nephrotic syndrome.It was intended as a theoretical basis for individualized treatment of TAC in this population.

关 键 词：他克莫司结合蛋白质类 基因多态性 原发性肾病综合征 

分 类 号：R692[医药卫生—泌尿科学]