RESUMO
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.
Assuntos
Ciclosporina/metabolismo , Ciclosporina/uso terapêutico , Citocromo P-450 CYP3A/metabolismo , Imunossupressores/metabolismo , Imunossupressores/uso terapêutico , Transplante de Rim/métodos , Tacrolimo/metabolismo , Tacrolimo/uso terapêutico , Ciclosporina/efeitos adversos , Citocromo P-450 CYP3A/genética , DNA/genética , Feminino , Genótipo , Rejeição de Enxerto/genética , Rejeição de Enxerto/prevenção & controle , Humanos , Imunossupressores/efeitos adversos , Isoenzimas/genética , Isoenzimas/metabolismo , Masculino , Mutação , Polônia , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição/genética , Tacrolimo/efeitos adversosAssuntos
Glomerulonefrite/diagnóstico , Glomerulonefrite/virologia , Hepatite C/complicações , Hepatite C/diagnóstico , Lúpus Eritematoso Sistêmico/diagnóstico , Adulto , Antivirais/uso terapêutico , Diagnóstico Diferencial , Feminino , Glomerulonefrite/tratamento farmacológico , Hepatite C/tratamento farmacológico , Humanos , Imunossupressores/uso terapêutico , Interferons/uso terapêutico , Metilprednisolona/uso terapêutico , Ribavirina/uso terapêutico , Resultado do TratamentoAssuntos
Glomerulonefrite Membranosa/tratamento farmacológico , Imunossupressores/efeitos adversos , Sarcoma de Kaposi/tratamento farmacológico , Sirolimo/análogos & derivados , Neoplasias Cutâneas/tratamento farmacológico , Idoso , Biópsia por Agulha , Everolimo , Feminino , Seguimentos , Glomerulonefrite Membranosa/complicações , Glomerulonefrite Membranosa/diagnóstico , Humanos , Imuno-Histoquímica , Imunossupressores/administração & dosagem , Testes de Função Renal , Sarcoma de Kaposi/imunologia , Sarcoma de Kaposi/patologia , Índice de Gravidade de Doença , Sirolimo/uso terapêutico , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
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.
