ReviewActa pharmacologica Sinica2019
Biomarkers for individualized dosage adjustments in immunosuppressive therapy using calcineurin inhibitors after organ transplantation.
Review in Acta pharmacologica Sinica, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 38 citations in OpenAlex.
- Paeoniflorin prevents acute graft-versus-host disease while preserving graft-versus-tumor effects.Frontiers in immunology · 2026Article
- Genetic insights into acute lymphoblastic leukemia: the role of MDR1 and IL18 polymorphisms in Egyptian children.BMC cancer · 2025Article
- Neurotoxicity of Calcineurin Inhibitors.Annals of Indian Academy of Neurology · 2025Article
- Advancing immunomodulation in organ transplantation: the therapeutic potential of self-assembled rapamycin nanoparticles in allograft rejection.Journal of nanobiotechnology · 2025Article
- The impact of different immunosuppressants and acute immune rejection on clinical outcomes in diverse solid organ transplant recipients.Frontiers in immunology · 2025Article
- Impact of cyclosporine A-related single nucleotide polymorphisms on post-transplant outcomes in pediatric hematologic malignancy patients undergoing allogeneic hematopoietic stem cell transplantation.Frontiers in immunology · 2025Article
- Pharmacokinetics of nirmatrelvir/ritonavir and the drug-drug interaction with calcineurin inhibitor in renal transplant recipients.European journal of clinical pharmacology · 2024Article
- The Influence of Tacrolimus Exposure and Metabolism on the Outcomes of Kidney Transplants.Biomedicines · 2024Article
- Individualized dosing parameters for tacrolimus in the presence of voriconazole: a real-world PopPK study.Frontiers in pharmacology · 2024Article
- KIM-1, IL-18, and NGAL, in the Machine Learning Prediction of Kidney Injury among Children Undergoing Hematopoietic Stem Cell Transplantation-A Pilot Study.International journal of molecular sciences · 2023Article
- Calcineurin in development and disease.Genes & diseases · 2022Review
- Role of (pro)renin receptor in cyclosporin A-induced nephropathy.American journal of physiology. Renal physiology · 2022Article
- Cyclosporine A-related neurotoxicity after haploidentical hematopoietic stem cell transplantation in children with hematopathy.Italian journal of pediatrics · 2021Article
- Article
- DonorInternational journal of molecular sciences · 2020Article
- Influence ofInternational journal of molecular sciences · 2020Article
- Tacrolimus Concentration after Letermovir Initiation in Hematopoietic Stem Cell Transplantation Recipients Receiving Voriconazole: A Retrospective, Observational Study.International journal of medical sciences · 2020Observational
- Pathogenesis and Management of Acute Kidney Injury in Patients with Nephrotic Syndrome Due to Primary Glomerulopathies.Medicina (Kaunas, Lithuania) · 2019Review
- Impact ofInternational journal of molecular sciences · 2019Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Calcineurin inhibitors (CNIs), such as cyclosporine A and tacrolimus, are widely used immunosuppressive agents for the prevention of post-transplantation rejection and have improved 1-year graft survival rates by up to 90%. However, CNIs can induce severe reactions, such as acute or chronic allograft nephropathy, hypertension, and neurotoxicity. Because CNIs have varied bioavailabilities, narrow therapeutic ranges, and individual propensities for toxic effects, therapeutic drug monitoring is necessary for all CNIs. Identifying the genetic polymorphisms in drug-metabolizing enzymes will help to determine personalized dosage regimens for CNIs, as CNIs are substrates for CYP3A5 and P-glycoprotein (P-gp, MDR1). CNIs are often concomitantly administered with voriconazole or proton pump inhibitors (PPIs), giving rise to drug interaction problems. Voriconazole and PPIs can increase the blood concentrations of CNIs, and both are primarily metabolized by CYP2C19. Thus, it is expected that interactions between CNIs and voriconazole or PPI would be affected by CYP2C19 and CYP3A5 polymorphisms. CNI-induced acute kidney injury (AKI) is a serious complication of transplantations. Neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule 1 (KIM-1) are noninvasive urinary biomarkers that are believed to be highly sensitive to CNI-induced AKI. In this article, we review the adverse events and pharmacokinetics of CNIs and the biomarkers related to CNIs, including CYP3A5, CYP2C19, MDR1, NGAL, and KIM-1. We hope that these data will help to identify the optimal biomarkers for monitoring CNI-based immunosuppressive therapy after organ transplantation.
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