RESUMEN
The aim of the study was to determine the impact of CYP3A5 mutation on the serum levels of immunosuppressive drugs (tacrolimus and cyclosporine A), and on the occurrence of acute rejection episodes among patients after kidney transplantation. A limited number of such research in Polish patients was also an important factor encouraging to perform the study. Fifty-two persons were recruited. The tested patients underwent kidney transplantation and were treated either with cyclosporine A (17 persons) or with tacrolimus (35 persons). The group included 21 women and 31 men. DNA was isolated from whole blood and a modified Van Schaik et al. (2002) PCR-RFLP method was used for genotyping. The serum levels were controlled at the 7th, 14th, 30th, 90th, 180th and 360th day after transplantation. The CYP3A5 genotype had no impact on the concentrations of cyclosporine A and tacrolimus at any investigated time point. No correlation between the rate of acute rejection episodes and different genotypes of the CYP3A5 isoenzyme could be proven.
Asunto(s)
Ciclosporina/metabolismo , Ciclosporina/uso terapéutico , Citocromo P-450 CYP3A/metabolismo , Inmunosupresores/metabolismo , Inmunosupresores/uso terapéutico , Trasplante de Riñón/métodos , Tacrolimus/metabolismo , Tacrolimus/uso terapéutico , Ciclosporina/efectos adversos , Citocromo P-450 CYP3A/genética , ADN/genética , Femenino , Genotipo , Rechazo de Injerto/genética , Rechazo de Injerto/prevención & control , Humanos , Inmunosupresores/efectos adversos , Isoenzimas/genética , Isoenzimas/metabolismo , Masculino , Mutación , Polonia , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción/genética , Tacrolimus/efectos adversosAsunto(s)
Glomerulonefritis/diagnóstico , Glomerulonefritis/virología , Hepatitis C/complicaciones , Hepatitis C/diagnóstico , Lupus Eritematoso Sistémico/diagnóstico , Adulto , Antivirales/uso terapéutico , Diagnóstico Diferencial , Femenino , Glomerulonefritis/tratamiento farmacológico , Hepatitis C/tratamiento farmacológico , Humanos , Inmunosupresores/uso terapéutico , Interferones/uso terapéutico , Metilprednisolona/uso terapéutico , Ribavirina/uso terapéutico , Resultado del TratamientoAsunto(s)
Glomerulonefritis Membranosa/tratamiento farmacológico , Inmunosupresores/efectos adversos , Sarcoma de Kaposi/tratamiento farmacológico , Sirolimus/análogos & derivados , Neoplasias Cutáneas/tratamiento farmacológico , Anciano , Biopsia con Aguja , Everolimus , Femenino , Estudios de Seguimiento , Glomerulonefritis Membranosa/complicaciones , Glomerulonefritis Membranosa/diagnóstico , Humanos , Inmunohistoquímica , Inmunosupresores/administración & dosificación , Pruebas de Función Renal , Sarcoma de Kaposi/inmunología , Sarcoma de Kaposi/patología , Índice de Severidad de la Enfermedad , Sirolimus/uso terapéutico , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/patología , Resultado del TratamientoRESUMEN
Antibodies against monomeric C-reactive protein, which is a target antigen expressed both in kidney tubules and uveal cells, have been recently detected in patients with active tubulointerstitial nephritis and uveitis syndrome. We report the case of an 65-year-old woman with acute renal failure caused by biopsy-proven tubulointerstitial nephritis and the onset of uveitis 21 months later. The expression of monomeric C-reactive protein in kidney oligobiopsy was confirmed by immunohistochemical staining using mouse monoclonal antibody against human monomeric C-reactive protein. The levels of antibodies against monomeric C-reactive protein were 117% of the reference during the flare and 22% during the remission of the disease. The difference in the levels of antibodies against monomeric C-reactive protein during flare and remission, and above all positive biopsy staining, supports their pathogenic role in this disease.