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Pharmacogenetics of cyclosporine in children suggests an age-dependent influence of ABCB1 polymorphisms

Authors: Mats O. Karlsson; Pertti J. Neuvonen; Siv Jönsson; Janne T. Backman; Mikko Niemi; Samuel Fanta; Christer Holmberg; +1 Authors

Pharmacogenetics of cyclosporine in children suggests an age-dependent influence of ABCB1 polymorphisms

Abstract

To evaluate whether variations in the ABCB1, ABCC2, SLCO1B1, CYP3A4, CYP3A5, or NR1I2 genes are associated with the pharmacokinetics of cyclosporine in pediatric renal transplant candidates, and whether the effects of these variants are related to age.A total of 104 pediatric patients (aged 0.36-16.3 years) were genotyped for 17 putatively functionally significant sequence variations in the ABCB1, SLCO1B1, ABCC2, CYP3A4, CYP3A5, and NR1I2 genes. The patients had undergone a pharmacokinetic study with intravenous and oral ciclosporine (INN, cyclosporin) before renal transplantation.In the whole population, the mean+/-SD cyclosporine oral bioavailability was 0.38+/-0.09, volume of distribution was 2.3+/-0.54 l/kg, and systemic clearance normalized by allometric body weight was 0.88+/-0.16 l/h/kg3/4. The prehepatic extraction ratio was 0.51+/-0.13, and the hepatic extraction ratio was 0.24+/-0.04, the former explaining 95% of the variability in oral bioavailability (PT variant and the related haplotype c.1199G-c.1236C-c.2677G-c.3435C (P<0.05). The estimated oral dose requirement and clearance of cyclosporine remained largely unexplained by the genetic variations.Although these data suggest an age-related effect of ABCB1 polymorphism on oral bioavailability, further studies are required on the predictive value of genotyping for individualization of cyclosporine dosing in children.

Keywords

ATP Binding Cassette Transporter, Subfamily B, Polymorphism, Genetic, Adolescent, Base Sequence, Genotype, Age Factors, Infant, Multidrug Resistance-Associated Protein 2, Haplotypes, Pharmacogenetics, Child, Preschool, Cyclosporine, Humans, ATP Binding Cassette Transporter, Subfamily B, Member 1, Child, DNA Primers

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
72
Top 10%
Top 10%
Top 10%