Pharmacodynamic monitoring by residual NFAT-regulated gene expression in stable pediatric liver transplant recipients
Billing H, Breil T, Schmidt J, Tönshoff B, Schmitt C, Giese T, Engelmann G. Pharmacodynamic monitoring by residual NFAT-regulated gene expression in stable pediatric liver transplant recipients. Pediatr Transplantation 2012: 16: 187-194. © 2012 John Wiley & Sons A/S. Abstract: Pharmacokinetic m...
Gespeichert in:
| Hauptverfasser: | , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
24 February 2012
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| In: |
Pediatric transplantation
Year: 2012, Jahrgang: 16, Heft: 2, Pages: 187-194 |
| ISSN: | 1399-3046 |
| DOI: | 10.1111/j.1399-3046.2012.01660.x |
| Online-Zugang: | Verlag, Volltext: http://dx.doi.org/10.1111/j.1399-3046.2012.01660.x Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1399-3046.2012.01660.x 
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| Verfasserangaben: | Heiko Billing, Thomas Breil, Jan Schmidt, Burkhard Tönshoff, Claus Schmitt, Thomas Giese and Guido Engelmann |
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| 245 | 1 | 0 | |a Pharmacodynamic monitoring by residual NFAT-regulated gene expression in stable pediatric liver transplant recipients |c Heiko Billing, Thomas Breil, Jan Schmidt, Burkhard Tönshoff, Claus Schmitt, Thomas Giese and Guido Engelmann |
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| 520 | |a Billing H, Breil T, Schmidt J, Tönshoff B, Schmitt C, Giese T, Engelmann G. Pharmacodynamic monitoring by residual NFAT-regulated gene expression in stable pediatric liver transplant recipients. Pediatr Transplantation 2012: 16: 187-194. © 2012 John Wiley & Sons A/S. Abstract: Pharmacokinetic monitoring of CNI is unsatisfactory, because at comparable CNI blood concentrations frequency and severity of adverse effects vary considerably among individual patients. Determining the RGE of NFAT-regulated genes in leukocytes is a new pharmacodynamic approach to measure directly the functional consequences of calcineurin inhibition in T-lymphocytes. We compared clinical outcome parameters and RGE of activated T-cells after pLtx. We measured prospectively RGE of NFAT regulated genes in 33 pLTX recipients in the maintenance period after pLTX. CsA-treated patients with recurrent infections had significantly lower RGE rates (27%) than children without recurrent infections (50%; p = 0.04), whereas pharmacokinetic parameters of CsA and the concomitant immunosuppressive therapy were comparable between both groups. In patients on tacrolimus-based IS therapy NFAT RGE was only slightly reduced (90%). Pharmacodynamic monitoring of CsA by measurement of RGE in T-lymphocytes has the potential to identify over-immunosuppressed pediatric liver transplant recipients on a CsA-based IS therapy, while in children on low-dose tacrolimus therapy, RGE measurement does not provide additional clinically useful information. | ||
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