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Hussaini SA, Waziri B, Dickens C, Duarte R. Pharmacogenetics of Calcineurin inhibitors in kidney transplant recipients: the African gap. A narrative review. Pharmacogenomics 2024; 25:329-341. [PMID: 39109483 PMCID: PMC11404701 DOI: 10.1080/14622416.2024.2370761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/18/2024] [Indexed: 09/13/2024] Open
Abstract
Calcineurin inhibitors (CNIs) are the mainstay of immunosuppression in kidney transplantation. Interpatient variability in the disposition of calcineurin inhibitors is a well-researched phenomenon and has a well-established genetic contribution. There is great diversity in the makeup of African genomes, but very little is known about the pharmacogenetics of CNIs and transplant outcomes. This review focuses on genetic variants of calcineurin inhibitors' metabolizing enzymes (CYP3A4, CYP3A5), related molecules (POR, PPARA) and membrane transporters involved in the metabolism of calcineurin inhibitors. Given the genetic diversity across the African continent, it is imperative to generate pharmacogenetic data, especially in the era of personalized medicine and emphasizes the need for studies specific to African populations. The study of allelic variants in populations where they have greater frequencies will help answer questions regarding their impact. We aim to fill the knowledge gaps by reviewing existing research and highlighting areas where African research can contribute.
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Affiliation(s)
- Sadiq Aliyu Hussaini
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Internal Medicine, Ibrahim Badamasi Babangida Specialist Hospital, Minna, Nigeria
- Department of Pharmacology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Bala Waziri
- Department of Internal Medicine, Ibrahim Badamasi Babangida Specialist Hospital, Minna, Nigeria
| | - Caroline Dickens
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Raquel Duarte
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Chen MZ, Dai XF, Sun Y, Yu YC, Yang F. Cyclosporine A-induced gingival overgrowth in renal transplant patients accompanied by epithelial-to-mesenchymal transition. J Periodontal Res 2023; 58:511-519. [PMID: 36924118 DOI: 10.1111/jre.13115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 02/20/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To investigate the association between the prevalence of cyclosporin A-induced gingival overgrowth and the expression of the epithelial-to-mesenchymal transition factors in the gingival tissues of renal transplant patients. BACKGROUND Gingival overgrowth (GO) is a frequent complication in organ transplant patients treated with the immunosuppressant cyclosporin A (CsA). The epithelial-to-mesenchymal transition (EMT) is considered a factor contributing to CsA-induced GO. However, current knowledge on this topic is sparse. METHODS Sixty-three renal transplant patients were divided into two groups according to the occurrence of GO: those with gingival overgrowth (GO+ group) and those without gingival overgrowth (GO- group). Data on age, sex, and use of immunosuppressant and calcium channel blocker medications, serum creatinine values, peak concentrations of blood CsA, and gingival hyperplasia scores were recorded to identify clinically pathogenic factors. Gingival tissues from five patients with CsA-induced GO and five healthy subjects were selected for histomorphological observation with hematoxylin-eosin staining, Masson staining, and immunohistochemical staining. The mRNA expression of EMT factors was detected with reverse transcription-quantitative PCR. RESULTS The use of CsA significantly increased the prevalence of GO in renal transplant patients. The expression of α-SMA, SMAD4, and TGM2 was upregulated and that of E-cadherin was downregulated in the gingival tissues of patients with CsA-induced GO compared with those of the corresponding controls. CONCLUSION Treatment with CsA is closely related to the occurrence of GO in renal transplant patients and EMT plays an important role in CsA-induced gingival tissue hyperplasia.
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Affiliation(s)
- Min Zhi Chen
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Jing-An Dental Clinic, Shanghai, China
| | | | - Yang Sun
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - You Cheng Yu
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of Stomatology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China
| | - Fei Yang
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of Stomatology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China
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Peng T, Chang X, Wang J, Zhen J, Yang X, Hu Z. Protective effects of tacrolimus on podocytes in early diabetic nephropathy in rats. Mol Med Rep 2017; 15:3172-3178. [PMID: 28339051 DOI: 10.3892/mmr.2017.6354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 12/05/2016] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to investigate the protective effect of tacrolimus on early podocyte damage in rats with diabetic nephropathy (DN). A total of 38 normal male Sprague‑Dawley rats were randomly divided into four groups: Normal control group (group N; n=8), DN group (n=10), tacrolimus (FK506) treatment group (group F; n=10), benazepril (Lotensin) treatment group (group L; n=10). The rats in groups DN, F and L were administered with streptozotocin (STZ; 60 mg/kg) by intraperitoneal injection to establish the diabetic rat model. After 4 weeks, the diabetic rat model was established, and rats in the different groups were administered intragrastically with the respective drugs. Blood glucose (BS), body weight (BW) and 24‑h urine protein were detected every 4 weeks, serum creatinine (SCr), blood urea nitrogen (BUN) and kidney weight/body weight (KW/BW) were measured at the end of the 8 weeks of drug treatment. Renal pathological changes were observed under a light microscope and electron microscope. Expression of nephrin, which is a podocyte‑specific marker, was detected using western blot analysis. The results showed that the levels of SCr, BUN, KW/BW and 24‑h urine protein in groups D, F and L were significantly higher, compared with those in group N (P<0.05). No significant differences were found between groups F and L for the above indicators, with the exception of BS. However, all indices were significantly lower, compared with those in group DN (P<0.05). Renal pathological expression was normal in group N under light microscopy. There were significant increases in the glomerular volume, proliferative mesangial cells, width of the mesangial area and thickness of the basement membrane in group DN, however, all the above pathological characteristics were reduced in groups F and L, compared with group DN (P<0.05). No significant difference was found between groups F and L. A widened glomerular basement membrane, and disorder, widening and fusion of podocyte processes were observed under the electron microscope in group DN, however, these were reduced in groups F and L, compared with group DN (P<0.05). The results of the western blot analysis showed that the expression of nephrin decreased by 60.1% in group DN, compared with group N, and significant recovery in the expression of nephrin was observed in groups F and L (P<0.05). Tacrolimus reduced urinary protein and slowed the progression of DN, partially by recovering the protein expression of nephrin in the renal tissue of diabetic rats, and maintaining the integrity of the structure and function of podocytes.
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Affiliation(s)
- Tao Peng
- Department of Nephrology, Shandong University Qilu Hospital, Jinan, Shandong 250012, P.R. China
| | - Xiangdi Chang
- Department of Nephrology, Affiliated Hospital of Binzhou Medical School, Yantai, Shandong 264003, P.R. China
| | - Jie Wang
- Department of Nephrology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Junhui Zhen
- Department of Pathology, Shandong University Qilu Hospital, Jinan, Shandong 250012, P.R. China
| | - Xiangdong Yang
- Department of Nephrology, Shandong University Qilu Hospital, Jinan, Shandong 250012, P.R. China
| | - Zhao Hu
- Department of Nephrology, Shandong University Qilu Hospital, Jinan, Shandong 250012, P.R. China
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Bao M, Wang Y, Liu Y, Shi P, Lu H, Sha W, Weng L, Hanabuchi S, Qin J, Plumas J, Chaperot L, Zhang Z, Liu YJ. NFATC3 promotes IRF7 transcriptional activity in plasmacy--toid dendritic cells. J Exp Med 2016; 213:2383-2398. [PMID: 27697837 PMCID: PMC5068237 DOI: 10.1084/jem.20160438] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 09/08/2016] [Indexed: 01/31/2023] Open
Abstract
The transcription factor NFATC3 binds to IRF7 and to type 1 IFN promoters, regulating IRF7-mediated IFN expression in pDCs. Plasmacytoid dendritic cells (pDCs) rapidly produce large amounts of type 1 interferon (IFN) after Toll-like receptor 7 and 9 engagements. This specialized function of type 1 IFN production is directly linked to the constitutive expression of IRF7, the master transcription factor for type 1 IFN production. However, the IRF7 regulatory network in pDCs remains largely unknown. In this study, we identify that the transcription factor NFATC3 specifically binds to IRF7 and enhances IRF7-mediated IFN production. Furthermore, knockout of NFATC3 greatly reduced the CpG DNA–induced nuclear translocation of IRF7, which resulted in impaired type 1 IFN production in vitro and in vivo. In addition, we found that NFATC3 and IRF7 both bound to type 1 IFN promoters and that the NFAT binding site in IFN promoters was required for IRF7-mediated IFN expression. Collectively, our study shows that the transcription factor NFATC3 binds to IRF7 and functions synergistically to enhance IRF7-mediated IFN expression in pDCs.
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Affiliation(s)
- Musheng Bao
- Baylor Institute for Immunology Research, Dallas, TX 75204.,MedImmune, LLC, Gaithersburg, MD 20878
| | - York Wang
- Baylor Institute for Immunology Research, Dallas, TX 75204.,MedImmune, LLC, Gaithersburg, MD 20878
| | - Ying Liu
- Baylor Institute for Immunology Research, Dallas, TX 75204
| | - Peiqing Shi
- Baylor Institute for Immunology Research, Dallas, TX 75204
| | - Hongbo Lu
- Baylor Institute for Immunology Research, Dallas, TX 75204.,MedImmune, LLC, Gaithersburg, MD 20878
| | - Wenwen Sha
- Baylor Institute for Immunology Research, Dallas, TX 75204.,MedImmune, LLC, Gaithersburg, MD 20878
| | - Leiyun Weng
- Baylor Institute for Immunology Research, Dallas, TX 75204.,MedImmune, LLC, Gaithersburg, MD 20878
| | - Shino Hanabuchi
- Baylor Institute for Immunology Research, Dallas, TX 75204.,MedImmune, LLC, Gaithersburg, MD 20878
| | - Jun Qin
- Verna and Marrs McLean Department of Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, TX 77030
| | - Joel Plumas
- Etablissement Français du Sang Rhone-Alpes, 38701 La Tronche, France
| | - Laurence Chaperot
- Etablissement Français du Sang Rhone-Alpes, 38701 La Tronche, France
| | - Zhiqiang Zhang
- Immunobiology and Transplant Research, Houston Methodist Research Institute, Houston, TX 77030
| | - Yong-Jun Liu
- Baylor Institute for Immunology Research, Dallas, TX 75204 .,MedImmune, LLC, Gaithersburg, MD 20878
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