A higher dose requirement of tacrolimus in active Crohn's disease may be related to a high intestinal P-glycoprotein content

被引:20
作者
Buchman, AL
Paine, MF
Wallin, A
Ludington, SS
机构
[1] Northwestern Univ, Feinberg Sch Med, Dept Gastroenterol, Div Gastroenterol, Chicago, IL 60611 USA
[2] Sch Pharm, Div Pharmacotherapy, Chapel Hill, NC USA
关键词
Crohn's disease; inflammatory bowel disease; tacrolimus; P-glycoprotein;
D O I
10.1007/s10620-005-3053-3
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Tacrolimus, a relatively new therapeutic option for patients with corticosteroid-refractory Crohn's disease or ulcerative colitis, is a substrate for the apically directed efflux transporter P-glycoprotein (P-gp). Duodenal biopsy specimens obtained from a patient with corticosteroid-refractory Crohn's disease and with significantly higher-than-average tacrolimus dose requirements were analyzed for P-gp by Western blot. The P-gp content in this patient was more than double that in specimens obtained from 9 of 10 healthy subjects. Elevated intestinal P-gp could have resulted in decreased tacrolimus absorption, thereby leading, to decreased blood concentration and decreased efficacy in this patient. The cause and prevalence of this phenomenon are unknown.
引用
收藏
页码:2312 / 2315
页数:4
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