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Genomewide Association Study of Tacrolimus Pharmacokinetics Identifies Novel Single Nucleotide Polymorphisms in Convalescence Phase and Stabilizing Phase of Liver function Respectively

ABSTRACT: Following liver transplantation, the liver function of a patient is gradually restored over a period of time, which is divided into a convalescence period (CP) and a stabilizing period (SP). Tacrolimus (TAC), a commonly-used immunosuppressant for the prevention of organ rejection, shows variability in plasma concentration in these patients as a result of variation in its metabolism. The effects of genetic and clinical factors on its plasma levels seem to differ in the CP and SP. To establish a model explaining TAC trough concentration variation between individuals in both the CP and SP, we conducted a retrospective, single-center, discovery study, involving 115 pairs of patients (115 donors and 115 matched recipients) who had undergone liver transplantation. Donors and recipients were genotyped by genomewide association study (GWAS) using an exome chip.

ORGANISM(S): Homo sapiens

PROVIDER: GSE130068 | GEO | 2019/04/29

REPOSITORIES: GEO

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Project description:Delayed graft function (DGF) is associated with a reduced long-term graft survival. Ischemia-reperfusion damage and donors' features have been always considered as key pathogenic factors in this setting. The aim of our study was to evaluate the role of recipients' characteristics in the development of DGF to discover early genomics biomarkers in peripheral blood mononuclear cells (PBMC) in order to identify patients at risk. We prospectively enrolled 932 kidney graft recipients from 466 donors for both kidneys. A total of 226 recipients experienced DGF. Among the 466 donors, 290 couples of recipients both patients presented with early graft function (EGF, group A), 50 couples experienced DGF (group B) and 126 couples of recipients were discordant as one presented DGF and the other promptly recovered graft function (group C). In group C we randomly selected 10 couples of DGF/EGF recipients. Peripheral blood mononuclear cells (PBMC) were harvested before transplantation; their transcriptomic profile was investigated by a microarray approach and microarray results were validated by qPCR in an independent group (DGF n=25; EGF n=25). In the whole study group, DGF was independently associated with both donors’ and recipient’s features. Moreover, group A, B and C presented significant differences in both donors’ and recipients’ characteristics. In group C of patients, DGF was significantly associated with body mass index, dialysis modality and number of mismatches. Two-hundred and seventy-three genes were differentially expressed before transplantation in discordant EGF/DGF patients of group C. Their main biological functions were immune dysfunction and inflammation. Among the differentially expressed genes, we observed a significant increase in the expression of CCR2, the MCP-1 receptor, in DGF patients. CCR-2 and MCP-1 up-regulation was confirmed in an independent cohort of patients. Our results suggest that recipients' clinical and immunological features, potentially modulated by dialysis modality, are associated with the development of DGF independently of donors' features.

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Genomewide Association Study of Tacrolimus Pharmacokinetics Identifies Novel Single Nucleotide Polymorphisms in Convalescence Phase and Stabilizing Phase of Liver function Respectively

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