Correlation between viral load of cytomegalovirus and tacrolimus and sirolimus levels in transplanted pediatric patients.
Correlation between viral load of cytomegalovirus and tacrolimus and sirolimus levels in transplanted pediatric patients.
复制标题
移植儿科患者巨细胞病毒病毒载量与他克莫司和西罗莫司水平之间的相关性。
DOI：
10.1016/j.bmhimx.2015.12.006
复制
发表时间：
2016
影响因子：
0.9
通讯作者：
B. López
中科院分区：
文献类型：
--
作者：
H. Reyes;J. Sánchez;G. Varela;J. C. Romo;A. Morales;E. Fuentes;I. Parra;Graciela Ramírez;B. López
导言：移植患者和移植物的存活在很大程度上取决于免疫抑制药物的使用。然而，免疫抑制、移植排斥和巨细胞病毒(CMV)感染之间的平衡仍然存在，这导致了很高的发病率和死亡率。本研究旨在通过对西罗莫司和他克莫司血药浓度及CMV负荷的分析，确定更好的监测移植患者的策略。方法：55例肾、肝移植后患儿，西罗莫司治疗9例，他克莫司治疗46例。总共获得了541个测量值。用实时荧光定量聚合酶链式反应(Real-Time-PCR)检测免疫抑制剂的全血浓度、血浆和全血中的CMV病毒载量。结果：免疫抑制药剂量与浓度的相关系数r≤为0.0747，全血病毒载量与血浆病毒载量的相关系数r=0.9406，免疫抑制剂浓度与病毒载量的相关系数r≤0.4616。结论：免疫抑制药物的剂量与其在全血中的浓度无关。因此，全身免疫抑制药的水平应与CMV负荷一起持续监测。同时，全血病毒载量与血浆病毒载量之间存在高度相关性。
Introduction:Survival of transplant patients and grafts depends largely on the use of immunosuppressive drugs. However, a balance remains to be established among immunosuppression, transplant rejection and cytomegalovirus (CMV) infection, which results in a high rate of morbidity and mortality. The aim of this study was to define a better strategy for monitoring transplanted patients based on the analysis of the blood concentration of sirolimus and tacrolimus and the burden of CMV.Methods:Fifty five post-transplant (kidney and liver) pediatric patients, nine treated with sirolimus and 46 treated with tacrolimus, were included. A total of 541 measurements were obtained. In each measurement the concentration of immunosuppressant in whole blood and CMV viral load in plasma and whole blood was quantified by real-time PCR. Pearson correlation coefficient (r) was estimated.Results:Values of r≤ 0.0747 were found for the relationship between dose and concentration of immunosuppressant; r= 0.9406 for the relationship between viral load in whole blood and plasma, and r≤ 0.4616 for the relationship between concentration of immunosuppressant and viral load.Conclusions:These data support that the doses of immunosuppressive drugs do not correlate with the levels of the same in whole blood. Therefore, systemic levels of immunosuppressant should be constantly monitored together with CMV load. Meanwhile, a high correlation between viral load measured in whole blood and plasma was found.