Nuclear Factor of Activated T Cell-Regulated Cytokine Gene Expression for Tacrolimus Pharmacodynamics Assay among Live-Donor Kidney Transplant Recipients

Abstract

Background: The correlation between pharmacokinetic monitoring and clinical outcome is insufficient.

Objective: to evaluate the use of quantitative measurement of NFAT (nuclear factor of activated T-cells) regulated cytokine gene expression by real time PCR to profile kidney transplant recipients (KTR) on Tacrolimus (Tac) based immunosuppression in kidney transplant recpients.

Patients and Methods: In 45renal allograft recipients, samples were drawn at event of graft dysfunctionand stable condition. Tac concentrations were measured by immunoassay, while the expression of genes encoding NFATregulated cytokines [interleukin 2 (IL2), interferon gamma (IFNG), colony stimulating factor 2 (CSF2)] were determined by real-time polymerase chain reaction.

Results: In total, 45 kidney allograft recipients were enrolled. Patients in the first group showed a significant increase in NFAT-RE versus the second and thirdgroups (58.3 ± 15, 6.8 ± 1.7&30.9± 10respectively, P = 0.003). There was a significant stabilization of renal function in the normal group compared to theother group (P < 0.023).

Conclusions: Individualizing tacrolimus treatment with NFAT-RE as a translational immune monitoring tool demonstrated beneficial and safe, with the potential to lower rejection and infection risks while improving long-term renal allograft function.