器官移植2018，Vol.9Issue(4)：278-282,5.DOI:10.3969/j.issn.1674-7445.2018.04.007
他克莫司代谢率与肾移植术后早期BK病毒感染的关系
Relationship between metabolic rate of tacrolimus and BK virus infection early after renal transplantation
摘要
Abstract
Objective To investigate the relationship between the metabolic rate of tacrolimus (FK506) and BK virus infection early after renal transplantation. Methods Eighty recipients undergoing allogenic renal transplantation in Institute of Organ Transplantation of the 309thHospital of Chinese People's Liberation Army were recruited in this study. The polymorphism of cytochrome P450 (CYP) 3A5 gene was detected in 80 recipients. All patients were divided into fast metabolism group ( CYP3A5*1/*3 and CYP3A5*1/*1 genotypes, n=38) and slow metabolism group ( CYP3A5*3/*3 genotype, n=42) based on the gene detection results. The distribution of CYP3A5 genotypes in 80 recipients was analyzed. The metabolic rate [concentration/dose ratio (C/D value)] of FK506 was statistically compared between two groups. The incidence of BK virus infection events [BK viruria, BK viremia and BK virus nephropathy(BKVN)] within postoperative 6 months were compared between two groups. Results Among 80 recipients, 5 cases (6%) were detected with CYP3A5*1/*1 genotype, 33 (41%) with CYP3A5*1/*3 genotype, and 42 (53%) with CYP3A5*3/*3 genotype. Among the 160 alleles in 80 recipients, 117 CYP3A5*3 allele were identified, suggesting that the mutation rate of CYP3A5*3 allele was 73.1%. In the fast metabolism group, the C/D values at postoperative 1, 3, and 6 months were significantly lower than those in the slow metabolism group (all P<0.01). The incidence rates of BK viruria in the fast and slow metabolism groups were 37% and 29%, 18% and 2% for BK viremia, and 3% and 0 for BKVN, respectively. In the fast metabolism group, the incidence of BK virenia was significantly higher than that in the slow metabolism group (P=0.02). The incidence of BK viruria and BKVN did not significantly differ between two groups (both P>0.05). Conclusions According to the CYP3A5 genotyping outcomes, the recipients with a high metabolic rate of FK506 have a high risk of BK viremia early after renal transplantation.关键词
BK病毒/肾移植/细胞色素P450(CYP)3A5/基因多态性/他克莫司代谢率/BK病毒血症/BK病毒尿症/BK病毒性肾病(BKVN)Key words
BK virus/Renal transplantation/Cytochrome P450 (CYP) 3A5/Gene polymorphism/Metabolic rate of tacrolimus/BK viremia/BK viruria/BK virus nephropathy (BKVN)分类
医药卫生引用本文复制引用
孙忠蔚,范宇,柏宏伟,钱叶勇..他克莫司代谢率与肾移植术后早期BK病毒感染的关系[J].器官移植,2018,9(4):278-282,5.基金项目
首都临床特色应用研究与成果推广(Z171100001017184) （Z171100001017184）
