Measurement of saliva tacrolimus levels in pediatric renal transplant recipients

被引:11
作者
Belostotsky, Vladimir [1 ]
Adaway, Jo [2 ]
Keevil, Brian G. [2 ]
Cohen, Dena R. [3 ]
Webb, Nicholas J. A. [1 ]
机构
[1] Univ Manchester, Royal Manchester Childrens Hosp, Dept Paediat Nephrol, Manchester Acad Hlth Sci Ctr, Manchester M13 9WL, Lancs, England
[2] S Manchester Univ Hosp Trust, Dept Clin Biochem, Manchester, Lancs, England
[3] Univ Leeds, Clin Trials Res Unit, Leeds, W Yorkshire, England
关键词
Children; Kidney; Saliva; Tacrolimus; Transplantation; TANDEM MASS-SPECTROMETRY; DRUG CONCENTRATION; CHILDREN; FK-506; EXPRESSION; GLANDS;
D O I
10.1007/s00467-010-1670-3
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
The aim of this study was to investigate whether a strong and clinically applicable correlation exists between saliva and whole-blood tacrolimus levels measured by high-performance liquid chromatography-tandem mass spectrometry. A high degree of correlation would potentially allow pain-free saliva sample collection to replace blood sampling for the measurement of tacrolimus levels. Enrolled in the study were 37 children (24 boys) aged 8-18 years [median (IQR) 16.2 (12.9-17.5) years] attending the renal transplant clinic at the Royal Manchester Children's Hospital and 77 paired blood saliva samples were collected. The mean (SD) saliva tacrolimus level was 0.14 (0.16), range 0-0.7 mu g/l. In ten cases, tacrolimus was not detected in the saliva despite being present in blood. The ratio of blood-to-saliva tacrolimus levels varied from 2.6 to 550. The Pearson product-moment correlation suggested a weak linear relationship between tacrolimus levels in blood and saliva with a coefficient 0.36. Individual patients did not demonstrate consistent tacrolimus blood/saliva ratios with a mean correlation of 0.08. Additional experiments excluded saliva contamination with blood and sample collection and storage conditions as causes of poor correlation. The measurement of saliva tacrolimus levels in place of or as an adjunct to blood sampling therefore cannot be recommended.
引用
收藏
页码:133 / 138
页数:6
相关论文
共 18 条
[1]   Pharmacokinetics of tacrolimus (FK 506) in children and adolescents with renal transplants [J].
Filler, G ;
Grygas, R ;
Mai, I ;
Stolpe, HJ ;
Greiner, C ;
Bauer, S ;
Ehrich, JHH .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1997, 12 (08) :1668-1671
[2]  
HORNING MG, 1977, CLIN CHEM, V23, P157
[3]   Evaluation of a rapid micro-scale assay for tacrolimus by liquid chromatography-tandem mass spectrometry [J].
Keevil, BG ;
McCann, SJ ;
Cooper, DP ;
Morris, MR .
ANNALS OF CLINICAL BIOCHEMISTRY, 2002, 39 :487-492
[4]   FK-506, A NOVEL IMMUNOSUPPRESSANT ISOLATED FROM A STREPTOMYCES .2. IMMUNOSUPPRESSIVE EFFECT OF FK-506 INVITRO [J].
KINO, T ;
HATANAKA, H ;
MIYATA, S ;
INAMURA, N ;
NISHIYAMA, M ;
YAJIMA, T ;
GOTO, T ;
OKUHARA, M ;
KOHSAKA, M ;
AOKI, H ;
OCHIAI, T .
JOURNAL OF ANTIBIOTICS, 1987, 40 (09) :1256-1265
[5]   Expression of two drug-metabolizing cytochrome P450-enzymes in human salivary glands [J].
Kragelund, C. ;
Hansen, C. ;
Torpet, L. A. ;
Nauntofte, B. ;
Brosen, K. ;
Pedersen, A. M. L. ;
Buchwald, C. ;
Therkildsen, M. H. ;
Reibel, J. .
ORAL DISEASES, 2008, 14 (06) :533-540
[6]   Determination of cyclosporine in saliva using liquid chromatography-tandem mass spectrometry [J].
Mendonza, A ;
Gohh, R ;
Akhlaghi, F .
THERAPEUTIC DRUG MONITORING, 2004, 26 (05) :569-575
[7]   Analysis of mycophenolic acid in saliva using liquid chromatography tandem mass spectrometry [J].
Mendonza, Anisha E. ;
Gohh, Reginald Y. ;
Akhlaghi, Fatemeh .
THERAPEUTIC DRUG MONITORING, 2006, 28 (03) :402-406
[8]  
MUCKLOW JC, 1978, CLIN PHARMACOL THER, V24, P563
[9]   DRUG LEVEL MONITORING IN PEDIATRIC PRACTICE [J].
RYLANCE, GW ;
MORELAND, TA .
ARCHIVES OF DISEASE IN CHILDHOOD, 1980, 55 (02) :89-98
[10]   SALIVA CARBAMAZEPINE LEVELS IN CHILDREN [J].
RYLANCE, GW ;
BUTCHER, GM ;
MORELAND, T .
BRITISH MEDICAL JOURNAL, 1977, 2 (6100) :1481-1481