Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

22 January 2014 : Original article  

Pharmacodynamic monitoring of nuclear factor of activated T cell-regulated gene expression in liver allograft recipients on immunosuppressive therapy with calcineurin inhibitors in the course of time and correlation with acute rejection episodes – a prospective study

Niels SteinebrunnerABCDEF, Catharina SandigBD, Claudia SommererACDE, Ulf HinzACD, Thomas GieseAD, Wolfgang StremmelACD, Alexandra ZahnABCDEF

DOI: 10.12659/AOT.889809

Ann Transplant 2014; 19:32-40

Abstract

BACKGROUND: Due to considerable pharmacokinetic (PK) variability, immunosuppression with calcineurin inhibitors (CNIs) remains challenging. The objective of this study was to assess a pharmacodynamic (PD) approach of monitoring nuclear factor of activated T cell (NFAT)-regulated gene expression in the course of time and in correlation with rejection episodes.

MATERIAL AND METHODS: 22 de novo liver allograft recipients were observed for a period of up to 12 months and the residual gene expression (RGE) of NFAT-regulated genes was monitored prospectively and correlated to acute rejection episodes.

RESULTS: There was a significant increase in RGEs between the time points 4–7 months and 1 month (25±7 µg/l vs. 9±5 µg/l, p≤0.0001) and 8–12 months and 1 month (50±8 µg/l vs. 10±7 µg/l, p=0.002) in the cyclosporine A (CsA) group, whereas in the tacrolimus (Tac) group a significant increase in RGEs appeared at the time point 8–12 months first. Acute rejection episodes occurred in 4 patients within 1 month after transplantation. These patients demonstrated a higher RGE of all NFAT-regulated genes compared to the other patients (CsA-treated patients: 39±0% vs. 11±5%, p=0.0001, Tac-treated patients: 48±12% vs. 18±10%, p=0.0082).

CONCLUSIONS: RGE of all NFAT-regulated genes show a relation between acute rejection episodes in the early post transplant period. Thus, this PD method has the potential to aid therapeutic drug monitoring.

Keywords: NFAT-regulated gene expression, Liver Transplantation, pharmacodynamic drug monitoring, calcineurin inhibitors, acute rejection episodes

Add Comment 0 Comments

In Press

Original article  

Retrospective Study to Compare Outcomes in 159 Patients Undergoing First Autologous Stem Cell Transplantati...

Ann Transplant In Press; DOI: 10.12659/AOT.947186  

Case report  

Pulmonary Embolism Following Living Donor Hepatectomy: A Report of 4 Cases and Literature Review

Ann Transplant In Press; DOI: 10.12659/AOT.946752  

Most Viewed Current Articles

03 Jan 2023 : Original article   6,513

Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...

DOI :10.12659/AOT.938467

Ann Transplant 2023; 28:e938467

15 Aug 2023 : Review article   6,136

Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ Transplantation

DOI :10.12659/AOT.939750

Ann Transplant 2023; 28:e939750

16 May 2023 : Original article   6,130

Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...

DOI :10.12659/AOT.939258

Ann Transplant 2023; 28:e939258

17 Jan 2023 : Original article   5,257

Non-Cryopreserved Peripheral Blood Stem Cell Graft for Autologous Hematopoietic Stem Cell Transplantation i...

DOI :10.12659/AOT.938595

Ann Transplant 2023; 28:e938595

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358