The influence of pharmacogenetics and cofactors on clinical outcomes in kidney transplantation. - Inserm - Institut national de la santé et de la recherche médicale Accéder directement au contenu
Article Dans Une Revue Expert Opinion on Drug Metabolism and Toxicology Année : 2011

The influence of pharmacogenetics and cofactors on clinical outcomes in kidney transplantation.

Résumé

INTRODUCTION: Immunosuppressive drugs have a narrow therapeutic range and large inter-individual response variability. This has prompted pharmacogenetic studies, mostly with regard to their dose-concentration relationships, but also about proteins involved in their pharmacodynamics. Some polymorphisms of genes involved in their disposition pathways were shown to affect their dose-concentration relationships. The impact of pharmacogenetics on tissue distribution and the resulting clinical effects have less often been studied. More importantly, a few single nucleotide polymorphisms seem to have a significant impact on the incidence of acute rejection or the adverse effects of immunosuppressants. Environmental factors often interact with such genotype-phenotype relationships. AREAS COVERED: This article reviews the impact of genetic polymorphisms of the metabolic enzymes, membrane transporters and target proteins of mycophenolic acid, calcineurin inhibitors and mammalian target of rapamycin inhibitors on clinical outcomes in kidney transplantation. EXPERT OPINION: The current level of evidence is not yet high enough to recommend pharmacogenetic personalization of immunosuppressive regimens in transplant recipients. The prevention of cellular toxicity associated with local metabolism or transport, which cannot be addressed by routine monitoring, is worth investigating further.
Fichier principal
Vignette du fichier
inserm-00577136_edited.pdf (211.68 Ko) Télécharger le fichier
Marquet_Picard_Expert_Opin_Drug_Metab_Toxicol_DEF_pour_HAL.pdf (200.91 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)
Origine : Fichiers produits par l'(les) auteur(s)
Loading...

Dates et versions

inserm-00577136 , version 1 (23-03-2012)

Identifiants

Citer

Nicolas Picard, Pierre Marquet. The influence of pharmacogenetics and cofactors on clinical outcomes in kidney transplantation.. Expert Opinion on Drug Metabolism and Toxicology, 2011, 7 (6), pp.731-43. ⟨10.1517/17425255.2011.570260⟩. ⟨inserm-00577136⟩
111 Consultations
962 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More