Polymorphisms in the CYP3A5 gene significantly affect the pharmacokinetics of sirolimus after kidney transplantation

Pharmacogenomics. 2021 Sep;22(14):903-912. doi: 10.2217/pgs-2021-0083. Epub 2021 Sep 15.

Abstract

Aim: Sirolimus (SIR) is an immunosuppressant with limitations, including a narrow treatment window, multiple adverse reactions and large differences within and among individuals. Objective: The correlation between numerous SNPs and SIR in terms of trough concentration in the early stage after kidney transplantation was analyzed. Materials & methods: A retrospective cohort study involving 69 kidney transplantation recipients was designed. Blood samples were collected to extract total DNAs, and trough SIR concentrations were measured. Logistic regression was used to analyze the association between SNPs and SIR trough concentrations. Results: At 7 days, 1 month and 3 months, the mean SIR trough concentration of patients in the CYP3A5 rs4646453-CC group was significantly higher than that in the CYP3A5 rs4646453-AA and CYP3A5 rs4646453-CA groups (p < 0.001) and CYP3A5 rs15524-AA group was significantly higher than that in the CYP3A5 rs15524-AG and CYP3A5 rs15524-GG groups (p < 0.001). Conclusion: Our study indicated that both CYP3A5 rs4646453 and CYP3A5 rs15524 had a certain influence on SIR trough concentration at 7 days, 1 month and 3 months.

Keywords: CYP3A5; kidney transplantation; pharmacogenetics; single nucleotide polymorphism; sirolimus; trough concentration.

MeSH terms

  • Adult
  • Cohort Studies
  • Cytochrome P-450 CYP3A / genetics*
  • Cytochrome P-450 CYP3A / metabolism*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / pharmacokinetics*
  • Kidney Transplantation / trends*
  • Male
  • Middle Aged
  • Polymorphism, Single Nucleotide / genetics*
  • Retrospective Studies
  • Sirolimus / pharmacokinetics*

Substances

  • Immunosuppressive Agents
  • CYP3A5 protein, human
  • Cytochrome P-450 CYP3A
  • Sirolimus