Pharmacogenotyping of CYP3A5 in predicting dose-adjusted trough levels of tacrolimus among Malaysian kidney-transplant patients

Tacrolimus (FK506) is a calcineurin inhibitor with a narrow therapeutic index that exhibits large interindividual variation. Seventy-eight kidney transplant patients treated with tacrolimus were recruited to study the correlation of dose adjusted trough level (level/dose; L/D) of tacrolimus with CYP...

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Main Authors: Hamzah, Sharina, Teh, Lay Kek, Shia, John Kwong Siew, Ahmad, Ghazali, Wong, Hin Seng, Zakaria, Zainul Amiruddin, Salleh, Mohd Zaki
Format: Article
Published: NRC Research Press 2014
Online Access:http://psasir.upm.edu.my/id/eprint/34894/
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author Hamzah, Sharina
Teh, Lay Kek
Shia, John Kwong Siew
Ahmad, Ghazali
Wong, Hin Seng
Zakaria, Zainul Amiruddin
Salleh, Mohd Zaki
author_facet Hamzah, Sharina
Teh, Lay Kek
Shia, John Kwong Siew
Ahmad, Ghazali
Wong, Hin Seng
Zakaria, Zainul Amiruddin
Salleh, Mohd Zaki
author_sort Hamzah, Sharina
building UPM Institutional Repository
collection Online Access
description Tacrolimus (FK506) is a calcineurin inhibitor with a narrow therapeutic index that exhibits large interindividual variation. Seventy-eight kidney transplant patients treated with tacrolimus were recruited to study the correlation of dose adjusted trough level (level/dose; L/D) of tacrolimus with CYP3A5 and ABCB1 genotypes, as well as the mRNA copy number of ABCB1 in blood. Patients were genotyped for ABCB1 (C1236T, G2677T/A, and C3435T) and CYP3A5 (G6986A), while ABCB1 mRNA transcript copy number was determined by absolute quantification (real-time PCR) in 46 patients. CYP3A5*3 genotypes were found to be a good predictor of tacrolimus L/D in kidney-transplant patients. Significantly higher L/D was observed among non-expressors (2.85, 95%: 2.05-3.70 (ng·mL(-1))/(mg·kg(-1))) as compared with the expressors (1.15, 95%: 0.95-1.80 (ng·mL(-1))/(mg·kg(-1))) of CYP3A5 (Mann-Whitney U test; P < 0.001). No correlation was observed between L/D and the ABCB1 genotypes. A significant inverse correlation of blood ABCB1 mRNA level with L/D was demonstrated (Spearman's Rank Order correlation; P = 0.016, rs = -0.348). However, in multiple regression analysis, only CYP3A5*3 genotype groups were found to be significantly correlated with tacrolimus L/D (P < 0.001). These findings highlight the importance of CYP3A5*3 pharmacogenotyping among kidney-transplant patients treated with tacrolimus, and confirm the role of blood cell P-glycoprotein in influencing the L/D for tacrolimus.
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spelling upm-348942015-12-23T08:03:25Z http://psasir.upm.edu.my/id/eprint/34894/ Pharmacogenotyping of CYP3A5 in predicting dose-adjusted trough levels of tacrolimus among Malaysian kidney-transplant patients Hamzah, Sharina Teh, Lay Kek Shia, John Kwong Siew Ahmad, Ghazali Wong, Hin Seng Zakaria, Zainul Amiruddin Salleh, Mohd Zaki Tacrolimus (FK506) is a calcineurin inhibitor with a narrow therapeutic index that exhibits large interindividual variation. Seventy-eight kidney transplant patients treated with tacrolimus were recruited to study the correlation of dose adjusted trough level (level/dose; L/D) of tacrolimus with CYP3A5 and ABCB1 genotypes, as well as the mRNA copy number of ABCB1 in blood. Patients were genotyped for ABCB1 (C1236T, G2677T/A, and C3435T) and CYP3A5 (G6986A), while ABCB1 mRNA transcript copy number was determined by absolute quantification (real-time PCR) in 46 patients. CYP3A5*3 genotypes were found to be a good predictor of tacrolimus L/D in kidney-transplant patients. Significantly higher L/D was observed among non-expressors (2.85, 95%: 2.05-3.70 (ng·mL(-1))/(mg·kg(-1))) as compared with the expressors (1.15, 95%: 0.95-1.80 (ng·mL(-1))/(mg·kg(-1))) of CYP3A5 (Mann-Whitney U test; P < 0.001). No correlation was observed between L/D and the ABCB1 genotypes. A significant inverse correlation of blood ABCB1 mRNA level with L/D was demonstrated (Spearman's Rank Order correlation; P = 0.016, rs = -0.348). However, in multiple regression analysis, only CYP3A5*3 genotype groups were found to be significantly correlated with tacrolimus L/D (P < 0.001). These findings highlight the importance of CYP3A5*3 pharmacogenotyping among kidney-transplant patients treated with tacrolimus, and confirm the role of blood cell P-glycoprotein in influencing the L/D for tacrolimus. NRC Research Press 2014 Article PeerReviewed Hamzah, Sharina and Teh, Lay Kek and Shia, John Kwong Siew and Ahmad, Ghazali and Wong, Hin Seng and Zakaria, Zainul Amiruddin and Salleh, Mohd Zaki (2014) Pharmacogenotyping of CYP3A5 in predicting dose-adjusted trough levels of tacrolimus among Malaysian kidney-transplant patients. Canadian Journal of Physiology and Pharmacology , 92 (1). pp. 50-57. ISSN 0008-4212; ESSN: 1205-7541 http://www.nrcresearchpress.com/doi/abs/10.1139/cjpp-2013-0128?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed#.Vnt4vvl96M8 10.1139/cjpp-2013-0128
spellingShingle Hamzah, Sharina
Teh, Lay Kek
Shia, John Kwong Siew
Ahmad, Ghazali
Wong, Hin Seng
Zakaria, Zainul Amiruddin
Salleh, Mohd Zaki
Pharmacogenotyping of CYP3A5 in predicting dose-adjusted trough levels of tacrolimus among Malaysian kidney-transplant patients
title Pharmacogenotyping of CYP3A5 in predicting dose-adjusted trough levels of tacrolimus among Malaysian kidney-transplant patients
title_full Pharmacogenotyping of CYP3A5 in predicting dose-adjusted trough levels of tacrolimus among Malaysian kidney-transplant patients
title_fullStr Pharmacogenotyping of CYP3A5 in predicting dose-adjusted trough levels of tacrolimus among Malaysian kidney-transplant patients
title_full_unstemmed Pharmacogenotyping of CYP3A5 in predicting dose-adjusted trough levels of tacrolimus among Malaysian kidney-transplant patients
title_short Pharmacogenotyping of CYP3A5 in predicting dose-adjusted trough levels of tacrolimus among Malaysian kidney-transplant patients
title_sort pharmacogenotyping of cyp3a5 in predicting dose-adjusted trough levels of tacrolimus among malaysian kidney-transplant patients
url http://psasir.upm.edu.my/id/eprint/34894/
http://psasir.upm.edu.my/id/eprint/34894/
http://psasir.upm.edu.my/id/eprint/34894/