Effects of <italic style="font-style: italic">CYP3A5</italic> gene polymorphism and Wuzhi capsule on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients

XIANG Qiulin; LIU Ling; YANG Yi; LI Guoxing; CHEN Song; YANG Yingying; YU Xian

doi:10.6039/j.issn.1001-0408.2024.14.16

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Effects of CYP3A5 gene polymorphism and Wuzhi capsule on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients

更新时间：2025-09-23

- Effects of CYP3A5 gene polymorphism and Wuzhi capsule on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients
- ZHONGGUO YAOFANG Vol. 35, Issue 14, Pages: 1765-1769(2024)
- 作者机构：
  
  1.重庆医科大学附属第二医院Ⅰ期临床试验中心，重庆　400060
  2.重庆医科大学药学院，重庆　400016
  3.重庆医科大学附属第二医院泌尿肾病中心，重庆　400060
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2024.14.16
  CLC： R969.3;R968
- Received：19 January 2024，
  
  Revised：2024-02-21，
  
  Accepted：09 April 2024，
  
  Published：30 July 2024
- 稿件说明：
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向秋林,刘玲,杨忆,等.CYP3A5基因多态性及五酯胶囊对肾移植术后早期他克莫司暴露及不良反应的影响 [J].中国药房,2024,35(14):1765-1769.

XIANG Qiulin,LIU Ling,YANG Yi,et al.Effects of CYP3A5 gene polymorphism and Wuzhi capsule on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients[J].ZHONGGUO YAOFANG,2024,35(14):1765-1769.
向秋林,刘玲,杨忆,等.CYP3A5基因多态性及五酯胶囊对肾移植术后早期他克莫司暴露及不良反应的影响 [J].中国药房,2024,35(14):1765-1769. DOI： 10.6039/j.issn.1001-0408.2024.14.16.

XIANG Qiulin,LIU Ling,YANG Yi,et al.Effects of CYP3A5 gene polymorphism and Wuzhi capsule on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients[J].ZHONGGUO YAOFANG,2024,35(14):1765-1769. DOI： 10.6039/j.issn.1001-0408.2024.14.16.

摘要

目的

探讨

CYP3A5

基因多态性及五酯胶囊（WZ）对肾移植患者术后早期他克莫司暴露及不良反应的影响。

方法

选择本院2021年9月至2023年9月接受同种异体肾移植术且术后接受他克莫司+霉酚酸类+泼尼松三联免疫治疗的患者132例为研究对象，根据其基因型（

CYP3A5

*1或

CYP3A5

*3/*3）和是否联用WZ（联用为“+WZ”，不联用为“+NO WZ”）将患者分为4组。分析4组患者在肾移植术后14 d、1个月、3个月的他克莫司血药谷浓度/日剂量（

）的差异，比较4组患者术后3个月内急性排斥反应及他克莫司相关不良反应的发生率。

结果

术后14 d、1个月、3个月（

CYP3A5

*1+WZ组患者除外），无论是否联用WZ，

CYP3A5

*1基因型患者的

均显著低于

CYP3A5

*3/*3基因型患者（

＜0.05）。4组患者术后3个月内，虽急性排斥反应及他克莫司相关不良反应发生率差异均无统计学意义（

＞0.05），但

CYP3A5

*3/*3+WZ组高血糖症发生率更高，达41.67%。

结论

CYP3A5

基因多态性与肾移植患者他克莫司

显著相关。在监测他克莫司

的前提下，

CYP3A5

*1基因型患者应在术后尽早联用WZ以加快他克莫司达到治疗浓度范围，而

CYP3A5

*3/*3基因型患者由于高血糖症发生风险较高，不推荐联用WZ。

Abstract

OBJECTIVE

To investigate the effects of

CYP3A5

gene polymorphism and Wuzhi capsule （WZ） on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients.

METHODS

A total of 132 patients who underwent renal

transplantation and received tacrolimus + mycophenolic acids + prednisone after operation in our hospital from September 2021 to September 2023 were selected and divided into four groups according to genotypes （

CYP3A5

*1 or

CYP3A5

*3/*3） and with or without WZ （“+WZ” meant drug combination， “+NO WZ” meant without combination）. The blood trough concentration/daily dose （

） values of the four groups were analyzed on the 14th day， 1 month and 3 months after renal transplantation. The incidence of acute rejection and the incidence of tacrolimus-related adverse reactions within 3 months after transplantation were compared among 4 groups.

RESULTS

On the 14th day， 1 month and 3 months after surgery （except for the

CYP3A5

*1+WZ group），

values of

CYP3A5

*1 genotype patients were significantly lower than those of

CYP3A5

*3/*3 genotype patients regardless of whether they were treated with WZ additionally （

＜0.05）. Within 3 months after surgery， although there was no significant difference in the incidence of acute rejection and tacrolimus-related adverse reactions among the four groups （

＞0.05）， the incidence of hyperglycemia in patients with

CYP3A5

*3/*3 was higher （41.67%）.

CONCLUSIONS

CYP3A5

gene polymorphism is significantly related to tacrolimus

in kidney transplant patients. Under the premise of

monitoring of tacrolimus， patients with

CYP3A5

*1 genotype should be given WZ as soon as possible after surgery to accelerate tacrolimus to reach the therapeutic concentration range， while

CYP3A5

*3/*3 genotype is not recommended to be given WZ because of the higher risk of hyperglycemia.

关键词

Keywords

references

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Effects of CYP3A5 gene polymorphism and Wuzhi capsule on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients

DOI：10.6039/j.issn.1001-0408.2024.14.16

摘要

Abstract

关键词

Keywords

references