ABCB1 C3435T가 신장이식 수혜자에서 tacrolimus의 최저혈중농도에 미치는 영향: 체계적 문헌고찰 및 메타분석

• 영문명: The Effect of ABCB1 C3435T on Blood trough Concentrations of Tacrolimus in Renal Transplant Recipients: a Systematic Review and Meta-analysis
• 발행기관: 대한약학회
• 저자명: 신혜연(Hye Yeon Sin) 천부순(Pu soon Chun)
• 간행물 정보: 『약학회지』제62권 제5호(2018년), 334~344쪽, 전체 11쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2018.10.30

영문 초록

A large number of studies have investigated the influence of ABCB1 C3435T polymorphism on blood trough concentrations of tacrolimus in kidney transplant recipients. However, the results are inconsistent. The aim of the present study was to clarify the effects of ABCB1 C3435T on trough blood levels of tacrolimus in renal transplant recipients at different post-transplantation times. The databases of PubMed, Embase, Ovid, and Cochrane Library were searched for all published studies from inception to March 2018. In addition, reference lists of articles were also examined. Using the Review Manager 5, weighted mean differences of dose-adjusted trough concentration of tacrolimus were pooled to estimate the effects of ABCB1 C3435T on tacrolimus levels. A total of 11 studies (968 recipients) were included in the present metaanalysis. The adult recipients with CC genotype had lower dose-adjusted trough concentration of tacrolimus than the CT and TT carriers at the first week after kidney transplantation (CC vs CT, WMD: -14.82; 95% CI: -24.73, -4.90; p=0.003; CC vs TT, WMD: -30.73; 95% CI: -47.9, -13.57; p=0.0004). Similar results were observed in adult recipients at the first month after transplantation (CC vs CT, WMD: -19.61; 95% CI: -27.66, -11.56; p<0.00001; CC vs TT, WMD: -25.45; 95% CI: -47.68, -3.22; p=0.02). Furthermore, at 3 months, the pediatric and adult recipients with CC or CT genotype had lower dose-adjusted trough concentration than the TT carriers (CT vs TT, WMD: -11.85; 95% CI: -18.65, -5.04; p=0.0006; CC vs TT, WMD: -30.98; 95% CI: -37.46, -24.50; p<0.00001). In addition, at the time of 6 months, the adult recipients carrying 3435C allele had lower dose-adjusted trough concentration than the TT carriers (CC vs CT, WMD: -19.00; 95% CI: -23.60, -14.39; p<0.00001; CT vs TT, WMD: -6.57; 95% CI: -12.87, -0.28; p=0.04; CC vs TT, WMD: -26.46; 95% CI: -32.04, -20.88; p<0.00001). These results imply that the adult recipients carrying ABCB1 3435C allele need higher dose of tacrolimus to prevent acute rejection after kidney transplantation.

목차

서 론(Introduction)

연구 방법(Methods)

결 과(Results)

고 찰(Discussion)

결 론(Conclusion)

References

키워드

ABCB1 C3435T polymorphism blood trough concentration tacrolimus kidney transplant recipients