The pharmacogenetic of cyclosporine in Tunisian renal transplantation

Introduction Our study is the first study, in Tunisia, to investigate the effect of SNPs in CYP3A5, CYP3A4, ABCB1, and POR genes on the response to cyclosporine (CsA).Methods In a retrospective study, a total of 78 renal transplant patients receiving CsA and mycophenolate mofetil (MMF) were recruited. Genotyping was performed using PROFLEX-PCR followed by RFLP.Results We found a significant lower C0/D CsA in patients with at least one CYP3A4*1B allele compared to the wild type (p = 0.001). We found a statistically significant increased risk of acute and chronic rejection associated with carrying CYP3A5*1/*1 or *1/*3 compared to the CYP3A5*3/*3 and of carrying CYP3A*51B/*1B or *1/*1B compared to the CYP3A4*1/*1 (p = 0.001). The occurrence of leukopenia was significantly decreased in patients with at least one CYP3A4*1B allele (p = 0.01). and the occurrence of diarrhea was significantly increased in patients carrying the variant allele of ABCB1-3435C>T (p = 0.005).Conclusion Our results support the usefulness of CsA pharmacokinetics tests in prekidney transplant assessments.