According To CYP3A5 Combined CYP3A4 Gene Polymorphism To Guide Individualized Medicication Among Renal Transplant Recipients

Objective:Understand the influence of CYP3A4 and CYP3A5 on FK506 etabolism and elimination, comparing traditional treatment with individualized medication based on genetic typing about advantages and disadvantages, understanding the clinical application value of CYP3A4 and CYPA5 combined with genetic typing. Methodology:From May to December in 2014, 75 cases of kidney recipients in PLA 309 Hospital were collected in this study.Choose renal transplantation recipients and divide them into experimental group and control group randomly.All renal transplant recipients listed in experimental group was evaluated the genotype of CYP3A5 and CYP3A4 preoperatively by fluorescence in situ hybridization method.The experimental group was grouped and given different initial dose of FK506 according to the difference of CYP3A5- CYP3A4 genotype. Results:①The renal transplant recipients of our institution′s CYP3A5*3 and CYP3A4*18B allelic gene mutation frequency were 67.3% and 20% respectively, similar to the domestic and foreign research results,we can conclude that the Chinese kind of CYP3A5*3 and CYP3A4*18B gene distribution is stable.②Kidney transplant recipients whose CYP3A5*3 and CYP3A4*18B gene polymorphism affect the medicine generation of dynamics of FK506. CYP3A5*1 and CYP3A4*18B, promote metabolism, CYP3A5*3 and CYP3A4*1 slow metabolism.③According to genotype to give tacrolimus individualization treatment can make kidney transplant recipients achieve standard blood drug concentration faster after renal transplantation.④Combined high expression of renal transplant recipients need higher doses to reach the target blood drug concentration, individualized treatment make transplant recipients reach the target blood drug concentration quickly and efficiently and traditional medicine dose often cannot, induce a higher risk of rejection.It was statistically significant difference. Conclusion:Compared with traditional methods, individualized medication,according to the difference of genotype, which adjust the initial dose of the FK506 can obviously increase the ratio of achieving target blood concentration of FK506 after renal transplantation,effectively reduce the percentage of patients required to adjust the doses and provide possibility for reducing the occurrence of adverse drug reactions and acute rejectioncaused by too high or too low drug concentration.