Title:Influence of Genetic Polymorphisms on Mycophenolic Acid Pharmacokinetics and Patient Outcomes in Renal Transplantation
Volume: 19
Issue: 14
Author(s): Miao Guo, Zi-Jie Wang, Hai-Wei Yang, Ling Meng, Ruo-Yun Tan, Min Gu*Ji-Fu Wei*
Affiliation:
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029,China
- Research Division of Clinical Pharmacology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029,China
Keywords:
Mycophenolic acid, genetic polymorphisms, pharmacokinetics, pharmacodynamics, renal transplantation, patient outcomes.
Abstract: Background: Mycophenolic Acid (MPA) is an immunosuppressive drug widely used in the treatment of
organ transplantation and autoimmune diseases. Pharmacokinetics and pharmacodynamics of MPA varies between
individuals, the potential reasons being the genetic polymorphisms in key enzymes, drug transporters and target
proteins of MPA.
Objective: We try to provide pharmacogenomics information for drug selection and dose adjustment, aiming to improve
drug efficacy and reduce side effects in clinical application of MPA.
Methods: In this review, we summarize the literatures in Pubmed that reported MPA-related Single Nucleotide Polymorphisms
(SNPs) of renal transplant patients in recent 15 years.
Results: Genetic polymorphisms involving uridine diphosphate glucuronosyltransferase enzymes, organic anion
transport polypeptides, multidrug resistance-associated protein 2, inosine monophosphate dehydrogenase and immune-
response mediators may be associated with the metabolism, efficacy and toxicity of MPA, thus resulting in
different MPA exposure and patient outcomes in renal transplantation.
Conclusion: Several SNPs show significant association with MPA pharmacokinetics and pharmacodynamics, but
conflicting results are reported, and no studies on MPA genetic polymorphisms have been translated into clinical
practice. More prospective studies are needed to clear the role of genetic polymorphisms on MPA in renal transplantation
patients.