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.