CAJ | 학술논문

目的探讨普乐可复(Tacrolimus,FK506)服用剂量和血药浓度的个体差异与供受体多药耐药基因1(multidrug resistance gene 1,MDR1)多态性的关系.方法监测50例口服普乐可复的肝移植受体体重、服药剂量、全血谷浓度,用PCR-限制性片段长度多态性分析的方法检测供受体MDR1第3435位C/T基因型,计算每日每公斤体重的FK506用量和血药浓度与每日每公斤体重的FK506用量的比值,并分析与供受体MDR1基因型的关系.结果在各50例供受体研究中,23%为MDR1 CC基因型,64%为CT基因型,13%为TT基因型.MDR1 CC基因型受体的每日每公斤体重的FK506用量明显高于CT和TT基因型受体,前者血药浓度与每日每公斤体重的FK506用量的比值显著低于后两者,供体MDR1基因型对此无明显影响.结论普乐可复服用剂量和血药浓度与受体的MDR1第3435位点基因多态性相关.MDR1多态性分析可指导肝移植受体普乐可复临床用药的个体化.
목적탐토보악가복(Tacrolimus,FK506)복용제량화혈약농도적개체차이여공수체다약내약기인1(multidrug resistance gene 1,MDR1)다태성적관계.방법감측50례구복보악가복적간이식수체체중、복약제량、전혈곡농도,용PCR-한제성편단장도다태성분석적방법검측공수체MDR1제3435위C/T기인형,계산매일매공근체중적FK506용량화혈약농도여매일매공근체중적FK506용량적비치,병분석여공수체MDR1기인형적관계.결과재각50례공수체연구중,23%위MDR1 CC기인형,64%위CT기인형,13%위TT기인형.MDR1 CC기인형수체적매일매공근체중적FK506용량명현고우CT화TT기인형수체,전자혈약농도여매일매공근체중적FK506용량적비치현저저우후량자,공체MDR1기인형대차무명현영향.결론보악가복복용제량화혈약농도여수체적MDR1제3435위점기인다태성상관.MDR1다태성분석가지도간이식수체보악가복림상용약적개체화.
Objective To investigate whether the polymorphism of multidrug resistance 1 gene( MDR1 ) in the donors and liver transplantation recipients was correlated with interindividual variation in tacrolimus dose requirement and concentration-to-dose ratio. Methods The occurrence of MDR1 3435(C→T) polymorphism was investigated by polymerase chain reaction followed by restriction fragment length polymorphism analysis in 50 liver transplant recipients and their corresponding donors: Doses (mg/kg body weight) and dose-adjusted trough levels (ng/mL per mg/kg body weight ) were compared according to allelic status for MDR1. Results The MDR1 genotype CC was observed in 23 subjects(23% ), whereas 64 (64%) were CT and 13( 13% ) were TT. Tacrolimus doses required to achieve target blood concentrations were higher in the patients withMDR1 CC genotype than in the CT or TT genotype patients, and the doseadjusted trough levels were lower: No significant differences were found in tacrolimus doses or dose-adjusted trough levels according to the donor' s MDR1 genotype. Conclusion Tacrolimus dose requirement and dose-adjusted trough levels were correlated with MDR1 3435( C→ T) polymorphism, and MDR1 3435 ( C→ T) polymorphism analysis is helpful to individualize tacrolimus administration.